Aertal
Use during pregnancy and breastfeeding
Pregnancy
Airtal® is contraindicated during pregnancy. There is no information on the use of aceclofenac during pregnancy.
Inhibition of prostaglandin synthesis may adversely affect the course of pregnancy and/or the development of the embryo/fetus.
During the third trimester of pregnancy, all prostaglandin synthesis inhibitors:
- having cardiopulmonary toxicity, they can cause premature closure of the ductus bollus with the development of pulmonary hypertension;
- may cause impaired fetal renal function, which can progress to renal failure in combination with oligohydramnios.
Late pregnant mothers and newborns:
- the drug may affect the duration of bleeding due to the antiplatelet effect, which can develop even after using very low doses;
- the drug may suppress uterine contractions, leading to delayed labor or prolonged labor.
Lactation
Airtal® should not be taken during breastfeeding. There is no data on the excretion of aceclofenac in human milk; When radioactive 14C-aceclofenac was administered to lactating rats, no noticeable transfer of radioactivity into milk was observed.
Fertility
NSAIDs may affect fertility and are not recommended for use by women planning pregnancy.
Use for liver dysfunction
The drug is contraindicated in patients with severe liver failure or active liver disease.
When treating patients with mild to moderate liver dysfunction, lower doses of aceclofenac should be used. The recommended starting dose is 100 mg/day.
Use for renal impairment
The drug is contraindicated in patients with severe renal failure (creatinine clearance <30 ml/min), progressive kidney disease, confirmed hyperkalemia.
There is no evidence for the need to change the dose of aceclofenac when treating patients with mild to moderate renal impairment, but caution is recommended.
Use in children
The drug is contraindicated in children under 18 years of age. The safety and effectiveness of the drug for the treatment of children and adolescents has not been established.
Use in elderly patients
Caution should be exercised when taking the drug to elderly patients.
special instructions
Avoid using Airtal® simultaneously with other NSAIDs, including selective COX-2 inhibitors.
Adverse events can be reduced by shortening the duration of treatment as much as possible and reducing the dose of the drug to the minimum necessary to achieve control of the symptoms of the disease.
Effect on the gastrointestinal tract
Aceclofenac should be prescribed with caution and under close medical supervision to patients with the diseases listed below, because their course may worsen:
- symptoms indicating gastrointestinal diseases, including the upper and lower gastrointestinal tract;
- a history of ulcer, bleeding or perforation of a stomach or intestinal ulcer in the presence of Helicobacter pylori infection;
- history of ulcerative colitis;
- history of Crohn's disease;
- hematological diseases, systemic lupus erythematosus (SLE), porphyria and hematopoietic disorders.
There have been reports of gastrointestinal bleeding, gastric or intestinal ulceration or perforation of the ulcer, which can lead to death with any NSAID at any time during treatment, with or without alarm symptoms, regardless of a history of serious gastrointestinal complications .
The risk of gastrointestinal bleeding, ulceration, or ulcer perforation is greater when treated with high doses of NSAIDs in patients with a history of gastric or intestinal ulcers, especially if complicated by bleeding or perforation, and in elderly patients. Treatment of these patients should begin with the lowest effective dose. Also, when treating these groups of patients and patients who require concomitant use of low-dose acetylsalicylic acid or other drugs that may increase the risk of gastrointestinal complications, the need for combination therapy with protective drugs (for example, misoprostol or proton pump inhibitors) should be considered. .
Patients with a history of gastrointestinal disease, especially the elderly, should report any unusual abdominal symptoms (especially gastrointestinal bleeding), paying maximum attention to symptoms early in treatment. Caution should be exercised when treating patients receiving concomitant medications that may increase the risk of ulceration or bleeding, such as systemic corticosteroids, anticoagulants such as warfarin, selective serotonin reuptake inhibitors or antiplatelet drugs such as acetylsalicylic acid.
If gastrointestinal bleeding or ulceration occurs in patients taking Airtal®, treatment should be discontinued.
Effect on the cardiovascular system and cerebral circulation
When treating patients with arterial hypertension and/or chronic heart failure, it is necessary to carry out appropriate monitoring and give recommendations, because There are reports of the development of fluid retention and edema during treatment with NSAIDs.
There is evidence to suggest that some NSAIDs (especially in high doses and in long-term treatment) may increase the risk of arterial thrombotic complications (eg, myocardial infarction or stroke). There is insufficient data to exclude this risk when using aceclofenac.
Patients with uncontrolled arterial hypertension, congestive heart failure, established coronary artery disease, peripheral arterial disease and/or cerebrovascular disease should begin treatment with aceclofenac only after an informed decision by the attending physician. Likewise, the indications for long-term treatment in patients with risk factors for cardiovascular disease (eg, hypertension, hyperlipidemia, diabetes mellitus, and smoking) should be carefully assessed before initiation.
Caution and close medical supervision should also be exercised when using aceclofenac in patients with a history of cerebral hemorrhage.
Effect on the liver and kidneys
Treatment with NSAIDs may cause a dose-dependent decrease in prostaglandin synthesis and precipitate renal failure. The importance of prostaglandins in maintaining renal blood flow in patients with impaired cardiac or renal function, liver dysfunction, patients receiving diuretic treatment or recovering from abdominal surgery, and elderly patients should be taken into account.
Caution should be exercised when treating patients with impaired liver or kidney function, as well as patients with other diseases predisposing to fluid retention. In these patients, treatment with NSAIDs may lead to impaired renal function and fluid retention. Caution must also be exercised when using the drug in patients receiving diuretic treatment or, conversely, in patients at risk of hypovolemia. The minimum effective dose should be prescribed and renal function should be regularly monitored. The effect of the drug on renal function is usually reversible after discontinuation of aceclofenac.
Treatment with aceclofenac should be discontinued if deviations from normal liver function tests persist or increase, clinical symptoms consistent with the development of liver failure appear, or other manifestations (eg, eosinophilia, rash) appear.
Hepatitis can develop without previous symptoms.
In patients with hepatic porphyria, the use of NSAIDs may provoke an exacerbation of the disease.
Hypersensitivity and skin reactions
As with the use of other NSAIDs, allergic reactions, including anaphylactic/anaphylactoid reactions, may occur early in the use of the drug. In very rare cases, serious skin reactions have been observed with the use of NSAIDs, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, some of which can be fatal. Patients are at highest risk of developing these reactions early in treatment, with most reactions occurring within the first month of treatment. At the first sign of skin rash, damage to the mucous membranes or any other symptoms of hypersensitivity, treatment with Airtal® should be discontinued.
In extremely rare cases, chickenpox can cause serious infectious complications of the skin and soft tissues. At the moment, the role of NSAIDs in worsening the course of these infectious complications cannot be excluded. Therefore, it is recommended to avoid the use of Airtal® for chickenpox.
Effect on hematological parameters
Aceclofenac can reversibly inhibit platelet aggregation.
Respiratory system disorders
Caution must be exercised when using the drug in patients with bronchial asthma or with a history of bronchial asthma, because There are reports that NSAIDs may cause bronchospasm in such patients.
Elderly patients
Caution should be exercised when treating elderly patients, because... In this age group, the incidence of adverse events associated with NSAID treatment is increased, especially gastrointestinal bleeding and ulcer perforation, which can lead to death. In addition, older patients are more susceptible to renal, hepatic or cardiovascular failure.
Long-term treatment
It is necessary to carefully monitor all patients receiving long-term treatment with NSAIDs, regularly performing complete blood count, liver and kidney function tests.
Each sachet of Airtal®, powder for oral suspension, 100 mg, contains 2.64 g of sorbitol, which can cause gastrointestinal disorders and diarrhea. Patients with rare hereditary fructose intolerance should not be prescribed this drug.
Airtal®, powder for oral suspension, 100 mg, contains aspartame, a source of phenylalanine. Patients with phenylketonuria should note that each sachet contains 5.61 mg of phenylalanine.
Impact on the ability to drive vehicles and operate machinery
You should refrain from driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions, because the drug may cause dizziness and other side effects that may affect these abilities.
Aertal® ()
The simultaneous use of Airtal® and other NSAIDs, including selective cyclooxygenase-2 (COX-2) inhibitors, should be avoided.
Adverse events can be minimized by using the lowest effective dose and reducing the duration of treatment needed to control symptoms.
Effect on the gastrointestinal tract (GIT)
Bleeding, ulcers or perforation of the gastrointestinal tract with a fatal outcome were observed when taking any NSAIDs during any period of treatment, both in the presence of corresponding symptoms and a history of serious gastrointestinal diseases (peptic ulcer of the stomach and duodenum, Crohn's disease, ulcerative colitis, etc.), and and without them.
The risk of bleeding, ulceration, and gastrointestinal perforation increases with increasing doses of NSAIDs in patients with a history of peptic ulcers, especially those accompanied by bleeding or perforation, and in elderly patients. These patients should take the minimum effective dose of the drug. They require combination therapy with protective drugs (for example, misoprostol or proton pump inhibitors). Such treatment is necessary for patients who take small doses of aspirin or other drugs that negatively affect the gastrointestinal tract.
Patients with gastrointestinal diseases, including the elderly, should report any unusual gastrointestinal symptoms (especially bleeding), including when initially taking the drug. Particular caution should be exercised in patients concomitantly taking drugs that may increase the risk of bleeding or ulceration, such as systemic corticosteroids, anticoagulants (such as warfarin), selective serotonin reuptake inhibitors, or antiplatelet agents (such as acetylsalicylic acid).
If gastrointestinal bleeding or ulcers occur in patients taking Airtal®, treatment should be discontinued.
Effects on the cardiovascular and central nervous system
Patients with arterial hypertension and/or mild or moderate congestive heart failure require appropriate monitoring, since fluid retention and edema are associated with the use of NSAIDs.
Aceclofenac is structurally close to diclofenac and has similar metabolism. With regard to diclofenac, there is evidence indicating an increased risk of thromboembolic complications (for example, myocardial infarction or stroke, particularly with long-term treatment with high doses). There is also an increased risk of developing acute coronary syndrome associated with aceclofenac. Patients with chronic heart failure (New York Heart Association class I) and patients with risk factors for developing complications from the cardiovascular system (for example, hypertension, diabetes mellitus, smoking) should begin treatment with aceclofenac only after an informed decision by the attending physician. . Cardiovascular risks may depend on the dose and duration of treatment, so the drug should be prescribed at the lowest effective dose and for the shortest possible period of time.
Effect on the liver and kidneys
Taking NSAIDs can cause a dose-dependent decrease in prostaglandin formation and acute renal failure. The importance of prostaglandins in maintaining renal blood flow should be considered when taking the drug in patients with impaired cardiac, renal or hepatic function, in patients receiving diuretics or in patients after surgery, as well as in the elderly.
Caution should be exercised when prescribing the drug to patients with mild or moderate impairment of liver and kidney function, as well as patients with other conditions predisposing to fluid retention in the body. In these patients, NSAIDs may cause renal dysfunction and fluid retention. Patients taking diuretics and those with an increased risk of hypovolemia should also be careful when taking the drug Airtal®, film-coated tablets, 100 mg. It is necessary to prescribe the minimum effective dose and regular medical monitoring of renal function. Adverse renal events usually resolve after discontinuation of aceclofenac.
Aceclofenac should be discontinued if changes in liver function tests persist or worsen, clinical signs or symptoms of liver disease develop, or other manifestations (eosinophilia, rash) occur. Hepatitis can develop without prodromal symptoms.
The use of NSAIDs in patients with hepatic porphyria may precipitate an attack. Hypersensitivity and skin reactions
Like other NSAIDs. the drug may cause allergic reactions, including anaphylactic/anaphylactic reactions, even if the drug is taken for the first time. Severe skin reactions (some of which can be fatal), including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been very rare after taking NSAIDs. The highest risk of these reactions occurring in patients is observed at the beginning of taking the drug, and the development of these adverse reactions is observed during the first month of taking the drug. If skin rash, damage to the oral mucosa, or other signs of hypersensitivity occur, stop taking aceclofenac.
In some cases, chickenpox can cause skin and soft tissue infections.
At present, the role of NSAIDs in worsening the course of these infections cannot be ruled out. Therefore, you should avoid taking Airtal® for chickenpox.
Hematological disorders
Aceclofenac may cause reversible inhibition of platelet aggregation.
Respiratory system disorders
Caution should be exercised when taking the drug in patients with a history or current bronchial asthma, since taking NSAIDs may trigger the development of sudden bronchospasm in such patients.
Elderly patients
Caution should be exercised when taking the drug in elderly patients, as they are more likely to experience side effects (especially bleeding and perforation of the gastrointestinal tract) when taking NSAIDs. Complications can be fatal. Older patients are also more likely to suffer from kidney, liver or cardiovascular diseases.
Long-term use
All patients receiving long-term treatment with nonsteroidal anti-inflammatory drugs should be closely monitored (eg, complete blood count, liver function tests, and renal function tests).
AERTAL (cream)
questions about the process of his studies.
Can the cream be used not only for arthritis and arthrosis? Is it possible for osteochondrosis, including cervical osteochondrosis, which I myself recently suffered from (in complex treatment I could use Airtal cream). We have plenty of patients with manifestations of arthrosis and arthritis, and usually nothing helps them. Moreover, they have tried many ointments many times and no longer help. The worst thing is when people themselves begin to uncontrollably inject themselves with diclofenac (this is even in the best case), of which more than 5 injections cannot be given at once.
I will give several examples that prove the effectiveness of airtal.
Although the drug is prescription (it’s an over-the-counter cream), few people go to doctors, especially when the treatment they prescribed no longer helps and the patient goes to the pharmacy for help. I understand that I do not have the right to prescribe treatment, but I want to help people and I tell them about the new drug Airtal, which can be purchased in the form of three dosage forms - cream, tablets and sachets, which are equivalent in strength to injections. This is the first time I’ve told a woman suffering from arthrosis about Airtal cream. A day later she returned and ordered two more tubes, saying that this was the only cream that helped her. Then she bought pills.
The second case, a good friend of mine, a former employee from my previous place of work, came to my pharmacy with a severe attack of sciatica. The pain started from the tailbone and went along the entire surface of the leg. The woman had to leave in a week, but she couldn’t walk. What did I offer her? Airtal cream and tablets. Then she came to me about 5 days later and said that the doctor she finally turned to fully approved of her treatment, and that she herself would first prescribe Airtal cream, and on a piece of paper the doctor wrote the treatment I recommended. By that time the woman had already felt much better. But, out of ignorance, instead of applying the cream directly to the tailbone, she applied it to the entire leg. Pain in the leg is just a symptom and pain along the nerve, and applying the cream not to the source of the pain is unlikely to achieve results. The woman was upset, she used the entire tube on her whole leg and it didn’t really help. So she had to buy a second one. I have already explained to her in detail how and where to apply the cream. After a couple of days, the pain subsided and it was possible to walk and sleep without the pain that exhausts the patient. Indeed, Aertal cream turned out to have a pronounced not only analgesic, but also an anti-inflammatory effect. Another plus is that it has chondroprotective properties, that is, it slowly restores damaged joint tissue.
For our market, Airtal is an original drug, its effectiveness has been clinically proven. It also has many side effects, like the entire non-steroidal anti-inflammatory group, but they are less common and less pronounced. In the cream they are kept to a minimum. Airtal has no analogues, I have already encountered the fact that some patients read the fine print of aceclofenac and think that they can find a cheaper option. But in vain. Even if Russian analogues appear for the drug, clinical trials for generics are not conducted in our country and all their effectiveness and safety are based on honesty.
My weak point is my neck (cervical osteochondrosis). Since I was sick in the spring, I don’t want to be sick anymore. And if my neck starts to hurt, and this happens and usually ends very badly for me, I apply Aertal cream to the spine on the inflamed cervical vertebrae, the pain usually goes away the next day. I won’t advise everyone to do this, but since I am often asked, what ointment is effective? I must assert not only unfoundedly, but also having tried it on myself. And I can say with confidence, yes, Airtal is an effective cream.
What I want to add. Let me remind you once again that Aertal in any dosage form is a prescription drug. It must be prescribed by the attending physician.
Second. Contacting doctors. Do not prescribe treatment to a patient on a piece of paper. Write on prescription forms. In our city this is not accepted at all.
And its main focus is joint pain, joint bruises, arthrosis and arthritis. It was for the treatment of these diseases that the drug was created. Although there are also positive dynamics with the use of airtal in the complex treatment of osteochondrosis.
Airtal is the drug of choice for pain correction
“Pain issues require a lot of attention, since these symptoms significantly affect the lives of patients,” Academician of the Russian Academy of Medical Sciences Valentina Aleksandrovna Nasonova began her speech. What is characteristic, she says, is that in the vast majority of cases, pain is accompanied by a negative emotional experience. Speaking about modern methods of drug treatment for painful inflammatory diseases, V.A. Nasonova focused on a drug whose active ingredient is aceclofenac, as “the drug of choice in the opinion of both doctors and patients.”
Professor M. Airani from Ashford London Hospital spoke about the history of the creation of the active substance. The aceclofenac molecule was synthesized in 1982, and the first clinical trial took place in 1986. In 1992, the drug appeared on the Spanish market, and 10 years later in Russia under the name “Aertal”. According to Mr. M. Airani, during all this time a large number of comparative, placebo-controlled studies have been conducted, in which more than 20,000 patients took part. As a result, it was shown that aceclofenac is “a safe, high-quality, high-quality, reliable, strong active substance, the focused action of which helps to quickly achieve the desired result - an analgesic and anti-inflammatory effect.”
As follows from the speech of Academician V.A. Nasonova, the world experience of using aceclofenac has been confirmed in Russia, where it is popular and widely used by doctors. According to her, the first studies of Aertal (), containing aceclofenac, demonstrated the drug’s ability to quickly relieve pain without damaging the gastrointestinal tract, which is characteristic of almost all NSAIDs.
Data on Aertal research both in Russia and abroad were also presented by Lyudmila Ivanovna Alekseeva, professor at the Institute of Rheumatology. For example, in Latvia, 74 patients who took aceclofenac for a month showed an improvement in joint functionality and a decrease in pain. Aceclofenac has been proven to be highly effective in treating osteoarthritis, pain in which is experienced by 30-40% of patients, and rheumatoid arthritis.
The original drug aceclofenac, which has a multicomponent effect on inflammation, does not have a damaging effect on cartilage, but rather, on the contrary, has a hotdroprotective effect. Good gastrointestinal tolerability, which was mentioned by all the speakers, as well as its greater effectiveness compared to classic non-steroidal anti-inflammatory drugs, make Airtal (aceclofenac) the optimal choice in the treatment of patients with chronic pain in various rheumatic diseases.
