Voltarol (Diclofenac)

Active Ingredient: Diclofenac
Dosage: 100 mg
Route of Administration: Oral
Dosage Form: Tablets
Quantity per package: 30

Voltarol (Diclofenac) is a non-steroidal anti-inflammatory drug (NSAID) derived from phenylacetic acid. It has anti-inflammatory, analgesic, antiplatelet and antipyretic effects.

Indications

• Symptomatic treatment of diseases of the musculoskeletal system (rheumatoid arthritis, psoriatic arthritis, juvenile chronic arthritis, ankylosing spondylitis;
• Gouty arthritis;
• Rheumatic soft tissue lesions, osteoarthritis of the peripheral joints and spine, including with radicular syndrome, tendonitis, tendonitis;
• The drug relieves or reduces pain and inflammation during the treatment period without affecting the disease progression.
• Pain syndrome of mild or moderate severity: neuralgia, myalgia, lumboischialgia, post-traumatic pain syndrome accompanied by inflammation, postoperative pain, headache, migraine, algomenorrhea, adnexitis, proctitis, toothache.

Dosage and administration

In all patients taking Voltarol (Ddiclofenac), it should be used at the lowest effective dose for the shortest possible time required to reduce the severity of symptoms. Oral administration, without chewing, during or after meals, washed down with plenty of water. Dose regimen: 1 tablet once a day. If an additional dose of the drug is required, 50 mg tablets are used. The maximum daily dose is 150 mg.

Contraindications

• Erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
• Bleeding from the gastrointestinal tract;
• Aspirin-induced asthma;
• Violations of hematopoiesis;
• Violations of hemostasis (including hemophilia);
• Pregnancy;
• Children’s up to 6 years old;
• Lactation period;
• Hypersensitivity (including to other NSAIDs).

Take Voltarol (Ddiclofenac) with care in the following cases:

• anemia;
• bronchial asthma;
• congestive heart failure;
• arterial hypertension;
• edematous syndrome;
• hepatic or renal failure;
• alcoholism;
• inflammatory bowel diseases;
• erosive and ulcerative diseases of the gastrointestinal tract without exacerbation;
• diabetes mellitus;
• condition after major surgical interventions;
• induced porphyria;
• elderly age;
• diverticulitis;
• systemic connective tissue diseases.

Side effects

• The gastrointestinal tract: often – epigastric pain, nausea, vomiting, diarrhea, dyspepsia, flatulence, anorexia, rarely – gastritis, proctitis, bleeding from the gastrointestinal tract (GIT) (vomiting, melena, diarrhea mixed blood), gastrointestinal ulcers (with or without bleeding or perforation), very rarely – stomatitis, glossitis, esophagitis, nonspecific hemorrhagic colitis, exacerbation of ulcerative colitis or Crohn’s disease, the occurrence of diaphragmatic strictures in the intestine, constipation, pancreatitis, the frequency is unknown – ischemic colitis.
• Liver and biliary tract disorders: often – increased aminotransferase activity, rarely – hepatitis, jaundice, liver dysfunction, very rarely – fulminant hepatitis, liver necrosis, hepatic failure.
• Nervous system: often – headache, dizziness, rarely – drowsiness, very rarely – impaired sensitivity, incl. paresthesia, memory disorders, tremors, convulsions, anxiety, cerebrovascular disorders, aseptic meningitis.
• Mental disorders: very rarely – disorientation, depression, insomnia, nightmares, irritability, mental disorders.
• The organs of senses: often – vertigo, very rarely – visual impairment (blurred vision, diplopia), hearing impairment, tinnitus, impaired taste.
• Kidneys and urinary tract: very rarely – acute renal failure, hematuria, proteinuria, interstitial nephritis, nephrotic syndrome, papillary necrosis.
• Blood and lymphatic system: very rarely – thrombocytopenia, leukopenia, hemolytic and aplastic anemia, agranulocytosis, eosinophilia.
• Immune system disorders: anaphylactic/anaphylactoid reactions, including a marked decrease in blood pressure (BP) and shock, very rarely – angioedema (including the face).
• Cardiovascular system: very rarely – a feeling of palpitations, chest pain, high blood pressure, vasculitis, heart failure, myocardial infarction.
• Respiratory system, chest and mediastinal organs: rarely – exacerbation of bronchial asthma, cough, laryngeal edema, very rarely – pneumonitis.
• Skin and subcutaneous tissues: often – skin rash, rarely – urticaria, very rarely – bullous rashes, eczema, incl. multiforme and Stevens-Johnson syndrome, Lyell’s syndrome, exfoliative dermatitis, pruritus, hair loss, photosensitivity, purpura, incl. allergic.
• General disorders and disorders at the injection site: rarely – edema.

Overdose

Symptoms: nausea, vomiting, epigastric pain, bleeding from the gastrointestinal tract, diarrhea, dizziness, headache, tinnitus, convulsions, lowering blood pressure, respiratory depression, with a significant overdose – acute renal failure, hepatotoxic effect.

Treatment: gastric lavage, activated charcoal, symptomatic therapy aimed at eliminating arterial hypotension, impaired renal function, seizures, gastrointestinal tract damage, respiratory depression. Forced diuresis, hemodialysis are ineffective (due to the significant connection with proteins and intensive metabolism).

Interaction

Diclofenac increases plasma concentration of digoxin, lithium preparations, cyclosporine. It reduces the effects of diuretic, antihypertensive and hypnotics, increases the likelihood of side effects of other NSAIDs, the toxicity of methotrexate, the nephrotoxicity of cyclosporine and gold preparations. With simultaneous use with oral antidiabetic drugs, both hypo- and hyperglycemia are possible, with potassium-sparing diuretics – the risk of hyperkalemia increases, with anticoagulants – the risk of bleeding.

Acetylsalicylic acid reduces the concentration of diclofenac in the blood, cefamandol, cefaperazone, cefotetan, valproic acid, plikamycin increase the incidence of hypoprothrombinemia. Concomitant use with ethanol, colchicine, corticotropin, St. John’s wort preparations, glucocorticoids increases the risk of gastric and intestinal bleeding.