Dexalgin 25 tablets: instructions for use, analogues, price

Indications

Dexalgin 25 is used to relieve pain of various origins (for example, with renal colic, toothache, neuralgia, radiculitis, as well as sciatica, with algodismenorrhea, in the event of post-traumatic and postoperative pain, pain with bone metastases).

Dexalgin 25 is indicated for the symptomatic treatment of both acute and chronic inflammatory, inflammatory-degenerative, and metabolic diseases of the musculoskeletal system (in the case of spondyloarthritis, rheumatoid arthritis, osteochondrosis and osteoarthritis).

In these cases, Dexalgin 25 is prescribed for pain relief and as an anti-inflammatory agent.

Contraindications

Contraindication is hypersensitivity to dexketoprofen or to the components of the drug, as well as to other NSAIDs.

The presence of peptic ulcer of the stomach and duodenum in the acute phase, if there is a history of gastrointestinal bleeding, as well as in cases of other active bleeding (for example, if intracranial bleeding is suspected), with anticoagulant therapy, hemorrhagic diathesis and other coagulation disorders.

Not used in cases of exacerbation of inflammatory bowel diseases (Crohn's disease, ulcerative colitis).

In severe liver dysfunction (10-15 points on the Child-Pugh scale), as well as in severe or moderate renal dysfunction (with creatinine clearance less than 50 ml/min).

Dexalgin 25 is contraindicated in complete or incomplete combination of bronchial asthma, recurrent polyposis and intolerance to acetylsalicylic acid or other NSAIDs (also in history).

In case of severe heart failure, after coronary artery bypass grafting.

Dexalgin 25 is not used for the treatment of children under 18 years of age, as well as during pregnancy and breastfeeding.

Use with caution if you have a history of allergic reactions; for blood clotting disorders; in the presence of systemic lupus erythematosus, as well as mixed connective tissue diseases; with simultaneous use of other drugs; in a state of severe hypovolemia; with existing coronary heart disease; for cerebrovascular diseases.

Caution is required in the presence of diabetes mellitus or hyperlipidemia, in the case of peripheral arterial diseases, and also if there is a history of information about the development of ulcerative lesions of the gastrointestinal tract; with long-term use of NSAIDs. Use with caution when smoking, alcoholism, and in old age (after 65 years).

Enantyum 25 mg 20 Compresse Rivestite

Product Card Therapeutic Indications Enantyum Tablets are used to treat symptoms of disease pain of mild to moderate intensity, such as musculoskeletal pain, dysmenorrhea, toothache.

Dosage and method of administration Depending on the nature and intensity of the pain, the recommended dose of Enantyum Tablets is usually 12.5 mg every 4-6 hours or 25 mg every 8 hours. The total daily dose should not exceed 75 mg.

Side effects can be minimized by using the lowest effective dose for the shortest possible duration of treatment to control symptoms. Long-term treatment is not indicated and administration is limited to symptomatic periods only. Concomitant meals slow down the rate of absorption of the drug, so in case of acute pain it is recommended that the administration occurs at least 30 minutes before meals.

In elderly patients, it is recommended to initiate therapy at the lower end of the therapeutic range (50 mg total daily dose). The dosage may be increased to reach these workers in the general population only after general well-tolerance has been established. Patients with mild to moderate hepatic impairment should begin therapy with low doses (50 mg total daily dose) and should undergo strict monitoring. Do not use in patients with severe hepatic impairment. The initial dosage should be reduced to 50 mg total daily dose in patients with moderate renal impairment. Do not use in patients with moderate to severe renal impairment. Has not been studied in children and adolescents; therefore, safety and effectiveness have not been established, this product cannot be used.

Contraindications

Hypersensitivity to dexketoprofene, or other NSAIDs, or any of the excipients of the drug. Patients in whom active actions similar (eg, aspirin or other NSAIDs) cause asthma attacks, bronchospasm, acute rhinitis, or cause nasal polyps, urticaria or angioedema. In patients with active or suspected peptic ulcer/bleeding or a positive medical history of peptic ulcer/bleeding (two or more separate episodes, verify ulceration or bleeding) or chronic dyspepsia. Patients with a history of gastrointestinal bleeding or perforation due to previous NSAID therapy. Patients who have gastrointestinal bleeding or other active bleeding or clotting disorders. Patients with: diseases such as Crohn's disease or ulcerative colitis; history of bronchial asthma; severe heart failure; moderate to severe renal failure; severe liver failure; hemorrhagic diathesis and other blood clotting disorders. Pregnancy and lactation period.

Special instructions The safety of use in children and adolescents has not been established. Use with caution in patients with a history of allergic conditions. Concomitant use with other NSAIDs, including selective cyclooxygenase 2 inhibitors, should be avoided. Side effects can be minimized by using the lowest effective dose for the shortest possible duration of treatment to control symptoms.

Gastrointestinal bleeding, ulceration or perforation, which can be fatal, has been reported with all NSAIDs at various stages of treatment, with or without symptoms or a history of serious GI events. If gastrointestinal bleeding or ulceration occurs, you should stop treatment. The risk increases with increasing dose of NSAIDs, in patients with a history of peptic ulcer disease, especially if complicated by bleeding or perforation, and in elderly patients. These have an increased incidence of adverse reactions to NSAIDs, particularly bleeding and gastrointestinal perforation, which can be fatal; start treatment with the lowest dose possible.

Before starting treatment with dexketoprofene trometamol, one should look for a past history of esophagitis, gastritis and/or gastric ulcer and ensure their complete healing. Patients with gastrointestinal symptoms or a history of gastrointestinal disorders should be carefully monitored for the occurrence of digestive upset, in particular gastrointestinal bleeding. Administer with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), as their conditions may be exacerbated.

Combination therapy with protective agents (eg, misoprostolo or proton pump inhibitors) should be taken into account for these patients, as well as for patients who are concomitantly taking low-dose aspirin or other drugs that may increase the risk of gastrointestinal symptoms. Patients with a history of gastrointestinal poisoning, particularly if elderly, should report any unusual abdominal symptoms (especially gastrointestinal bleeding), particularly during the initial stages of treatment.

Caution is advised in patients receiving concomitant medications that may increase the risk of ulceration or bleeding, such as oral corticosteroids, anticoagulants such as warfarin, selective serotonin reuptake inhibitors, or antiplatelet agents such as aspirin. All selective NSAIDs fail to inhibit platelet aggregation and prolong bleeding time by inhibiting prostaglandin synthesis. Therefore, the use of dexketoprofene trometamol in patients who are receiving other medications that interfere with blood clotting, such as warfarin or other coumarin or heparin derivatives, is not recommended. The drug may cause an increase in blood urea nitrogen and creatinine. This may be due to side effects on the load on the kidneys, which can lead to glomerular nephritis, interstitial nephritis, renal papillary necrosis, nephrotic syndrome and acute renal failure. May cause slight transient increases in some liver parameters and even significant increases in AST and ALT. If a significant increase in these parameters occurs, treatment should be discontinued. Administer with caution in patients with hematopoietic disorders, systemic lupus erythematosus, or connective tissue diseases. And dexketoprofene may mask the symptoms of an infectious disease.

Use with caution in patients with impaired liver and/or kidney function and in patients with arterial hypertension and/or heart failure. In these patients, the use of NSAIDs may lead to deterioration of renal function, fluid retention and edema. Caution is also required in patients under diuretic therapy or in those patients who may develop hypovolemia, due to the increased risk of nephrotoxicity'. Use with extreme caution in patients with a history of cardiovascular disease, in particular those with past episodes of heart failure, for a greater risk of precipitating heart failure. Elderly patients tend to be more likely to have kidney failure, cardiovascular failure, or liver failure. Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported very rarely in combination with NSAIDs. Patients appear to be at increased risk of developing such reactions early in therapy, as the onset of reactions occurs in most cases within the first month of treatment. Treatment should be discontinued at the first appearance of skin rashes, mucosal lesions or any other signs of hypersensitivity. May cause infertility in women and is not recommended in women wishing to become pregnant.

You should consider stopping treatment with dexketoprofene trometamol in women who are having difficulty conceiving or are undergoing investigations for infertility. Adequate monitoring and appropriate instructions are required in patients with a positive medical history of hypertension and/or mild to moderate congestive heart failure, since fluid retention and edema have been observed in association with NSAID treatment. Clinical studies and epidemiological data suggest that the use of some NSAIDs (especially at high doses and for long-term treatment) may be associated with a modest increase in the risk of arterial thrombotic events (eg, myocardial infarction or stroke). There is insufficient data to exclude a similar risk for dexketoprofene trometamol. Similar considerations should be made before initiating long-term treatment in patients with risk factors for cardiovascular disease (eg, hypertension, hyperlipidemia, diabetes mellitus, smoking).

Pregnancy and lactation It is contraindicated during pregnancy and lactation.

Pregnancy

Inhibition of prostaglandin synthesis may adversely affect pregnancy and/or the development of the embryo/fetus. The results of epidemiological studies suggest an increased risk of miscarriage and cardiac malformations and gastroschisis after the use of prostaglandin synthesis inhibitors in the early stages of pregnancy. The absolute risk of heart defects appears to have increased from less than 1% to about 1.5%. And it was believed that the risk increases with increasing dose and duration of therapy. In animals, administration of prostaglandin synthesis inhibitors has been shown to lead to increased loss of pre- and post-implantation and embryo-fetal mortality. In addition, an increase in the incidence of various malformations, including cardiovascular disease, has been reported in animals that were administered prostaglandin synthesis inhibitors during the period of organogenesis.

However, studies conducted in animals with dexketoprofene trometamol have not shown reproductive toxicity. During the first and second trimester of pregnancy, it should not be prescribed unless absolutely necessary. If dexketoprofene trometamol is used in women awaiting conception, or during the first and second trimester, the dose and duration of treatment should be kept as low as possible. During the third quarter, all prostaglandin synthesis inhibitors may expose the fetus to cardiopulmonary toxicity (with premature closure of the ductus arteriosus and pulmonary hypertension) and/or renal dysfunction, which may progress to renal failure with oligoidroamnios; mother and newborn, at the end of pregnancy, there may be an increase in bleeding time, an antiaggregation effect that can occur even in low doses and/or inhibition of uterine contractions that lead to delay or prolongation of labor.

During lactation

It has not been established if dexketoprofene is secreted into breast milk.

Expiry date and shelf life Check the expiration date indicated on the packaging. The expiration date indicated on the package refers to the product in the package being in good working order and stored correctly. Do not store at temperatures above 30°C. Store in blisters in outdoor packaging to keep it away from light.

Attention: do not use the drug after the expiration date indicated on the package.

Composition of Efferalgan Suppositories contains: Active ingredient: dexketoprofene 25 mg Excipients: corn starch, microcrystalline cellulose, sodium starch glycolate, glycerol distearato, hypromellose, titanium dioxide, propylene glycol, macrogol 6000.

Enantyum 25 mg Pack of 20 Tablets, Coated

Mode of application

Dexalgin 25 is taken orally with meals.

The dosage depends on the intensity of the pain syndrome, with the recommended dose for adults being 12.5 mg (1/2 tablet) every 4-6 hours or 25 mg (1 tablet) every 8 hours. The maximum daily dose is 75 mg.

In patients of the older age group, as well as in patients with impaired liver and/or kidney function, use

Dexalgin 25 is started with lower doses, and the maximum daily dose is 50 mg.

It should be remembered that Dexalgin 25 is not intended for long-term therapy; the course of treatment should not exceed 3-5 days.

Dexalgin 25 (Dexalgin 25)

Release form, composition and packaging

White, film-coated tablets, round, biconvex, scored on both sides. 1 tab. dexketoprofen trometamol 36.9 mg, which corresponds to the content of dexketoprofen 25 mg. Excipients: microcrystalline cellulose, corn starch, sodium carboxymethyl starch type A, glycerol monostearate 40-50%. Shell composition: hypromellose, macrogol 6000, titanium dioxide (E171), propylene glycol.

Clinical and pharmacological group: NSAIDs.

pharmachologic effect

Non-steroidal anti-inflammatory drug. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action of the drug is based on inhibition of prostaglandin synthesis due to inhibition of cyclooxygenase. The analgesic effect occurs 30 minutes after taking the drug, its duration is from 4 to 6 hours.

Pharmacokinetics

Suction

After taking the drug orally, Cmax of dexketoprofen in humans is achieved on average after 30 minutes (15-60 minutes).

Distribution and elimination

Plasma protein binding - 99%. The distribution time and T1/2 of dexketoprofen are 0.35 and 1.65 hours, respectively. The average Vd is less than 0.25 l/kg. The main part of the drug is excreted in the urine in the form of metabolites (after glucuronidation).

Indications

Pain syndrome of mild to moderate intensity in the following diseases and conditions:

acute and chronic inflammatory diseases of the musculoskeletal system (rheumatoid arthritis, spondyloarthritis, arthrosis, osteochondrosis);
dysmenorrhea;
toothache.

Dosage regimen

Installed individually. The average recommended single dose is 12.5 mg (1/2 tablet) from 1 to 6 times/day every 4-6 hours as needed or 25 mg (1 tablet) from 1 to 3 times/day every 8 hours. Maximum daily dose the dose is 75 mg (6 tablets). In patients with impaired liver or kidney function, or in the elderly, the drug should be started in lower doses - no more than 50 mg / day. The drug is not intended for long-term use: the duration of use should not exceed 3-5 days.

Side effect

From the digestive system: heartburn, abdominal pain; rarely - erosive and ulcerative lesions of the gastrointestinal tract.
From the central nervous system and peripheral nervous system: headaches, dizziness, nervousness, sleep disturbance, paresthesia.
From the cardiovascular system: palpitations, increased blood pressure. Allergic reactions: skin rash, bronchospasm.

Other: chills, swelling of the extremities, photosensitivity; rarely - changes in the peripheral blood picture, renal dysfunction. When used according to indications and in recommended doses, the drug is well tolerated.

Contraindications

peptic ulcer of the stomach and duodenum;
gastrointestinal bleeding;
active bleeding of various origins;
increased bleeding;
anticoagulant therapy;
Crohn's disease;
nonspecific ulcerative colitis;
bronchial asthma (including history);
severe heart failure;
severe renal failure;
severe liver failure;
pregnancy;
lactation period;
hypersensitivity to dexketoprofen or other NSAIDs.

Pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation due to the lack of reliable clinical data confirming the safety of its use.

Use for liver dysfunction

Side effects

When using Dexalgin 25, various side effects may occur:

Blurred vision and occasional tinnitus may occur.
Very rarely, neutropenia and thrombocytopenia are possible.
Infrequently, headache, dizziness, insomnia, or drowsiness may occur; Paresthesia is rarely possible.
From the cardiovascular system: infrequently, a feeling of heat and redness of the skin may occur; Extrasystole rarely appears, blood pressure may increase, and cases of tachycardia or decreased blood pressure are very rare.
From the respiratory system: bradypnea may rarely occur; cases of bronchospasm or shortness of breath are very rare.
From the gastrointestinal tract: a feeling of nausea or vomiting, dyspepsia and diarrhea, abdominal pain may occur, constipation, flatulence, and dry mouth may occur infrequently. Rarely, erosions and ulcers may occur in the gastrointestinal tract, as well as bleeding from an ulcer or its perforation. Damage to the pancreas is very rare.
From the liver and biliary tract: rarely, increased activity of liver enzymes may occur and jaundice may appear; very rarely the liver may be affected.
From the genitourinary system: polyuria may rarely occur; cases of nephritis or nephrotic syndrome are very rare, disturbances in the menstrual cycle in women are rare, and in men, with long-term use, temporary dysfunction of the prostate gland may occur.
From the musculoskeletal system: rarely, muscle spasms, back pain, and difficulty in the motor function of joints may occur.
From the skin: infrequently - cases of dermatitis, rash; rarely the appearance of urticaria or acne, as well as sweating; very rarely, cases of severe skin reactions (such as Stevens-Johnson syndrome, Lyell's syndrome), as well as the occurrence of angioedema, allergic dermatitis and photosensitivity are possible.
Cases of hypo- or hyperglycemia, as well as hypertriglyceridemia, are rare.
Laboratory findings may (rarely) include ketonuria or proteinuria.
General disturbances may include (infrequently) fever, fatigue; very rarely there is a possibility of anaphylactic shock and facial swelling.
Rarely, aseptic meningitis can occur, mainly in patients with systemic lupus erythematosus, as well as mixed connective tissue diseases. Hematological disorders may also appear (purpura, anemia - both aplastic and hemolytic); the likelihood of agranulocytosis and bone marrow hypoplasia is very rare.

Overdose

Symptoms of overdose may include nausea, abdominal pain, headache or dizziness. Insomnia, disorientation, and anorexia may occur.

Treatment of overdose depends on the symptoms that appear. If necessary, gastric lavage and hemodialysis are allowed.

special instructions

Interactions are typical for all NSAIDs.

Undesirable combinations:

With other NSAIDs, including salicylates in high doses (more than 3 g per day), since when taking several NSAIDs simultaneously, a synergistic effect occurs, which increases the likelihood of gastrointestinal bleeding and ulcerative phenomena.
With oral anticoagulants, heparin, in doses higher than prophylactic, as well as with ticlopidine: the risk of bleeding increases due to inhibition of platelet aggregation and damage to the gastrointestinal mucosa.
With lithium preparations: NSAIDs can increase the concentration of lithium in the blood, up to toxic levels; therefore, monitoring this indicator is necessary both when using or changing the dose, and after discontinuation of NSAIDs.
With methotrexate in high doses (15 mg per week or more): during NSAID therapy, its renal clearance decreases and, as a consequence, the hematological toxicity of methotrexate increases.
With hydantoins and sulfonamides: the risk of toxic effects of these drugs increases.

Combinations requiring caution

With diuretics, ACE inhibitors: in this case, the use of NSAIDs can cause the development of acute renal failure in patients with reduced water balance, since with a decrease in PG synthesis, glomerular filtration may decrease. NSAIDs can also reduce the therapeutic effect of some antihypertensive drugs.
With low-dose methotrexate (less than 15 mg per week): the use of NSAIDs reduces the renal clearance of methotrexate, which in turn increases its hematological toxicity. In this regard, during the period of joint therapy, weekly blood cell counts are recommended, especially in the first week. In case of existing renal dysfunction, even to a mild degree, as well as in patients of the older age group, careful monitoring is necessary.
The likelihood of developing bleeding from the gastrointestinal tract increases with the simultaneous use of NSAIDs and serotonin reuptake inhibitors (for example, fluoxetine, citalopram, sertraline), and oral glucocorticoids.
With pentoxifylline: when used together, the likelihood of bleeding also increases.
Constant monitoring of blood clotting time is necessary.
With zidovudine: There is a potential for increased risk of toxic effects on red blood cells, which in turn are due to effects on reticulocytes, which may lead to anemia one week after starting NSAID use. In this case, after one or two weeks of therapy, a blood test and reticulocyte count are required.
With sulfonylurea derivatives: NSAIDs have the ability to enhance the hypoglycemic effect of sulfonylureas, displacing it from sites of binding to plasma proteins.
With low molecular weight heparin preparations: due to an increased likelihood of bleeding.

Combinations to consider

With β-blockers: NSAIDs, by inhibiting the synthesis of PG, are thereby able to reduce the hypotensive effect of β-blockers.
With cyclosporine and tacrolimus: NSAIDs may increase nephrotoxicity, which is mediated by the action of renal PGs. During concomitant therapy, monitoring of renal function is required.
With thrombolytics: the likelihood of bleeding increases.
With probenecid: plasma concentrations of NSAIDs may increase, this may be due to the inhibitory effect of probenecid on renal tubular secretion and/or conjugation with glucuronic acid, in which case it is necessary to adjust the NSAID dosage if necessary.
With cardiac glycosides: there is a possibility that NSAIDs may increase plasma concentrations of glycosides.
With mifepristone: the use of NSAIDs is not recommended earlier than 8-12 days after stopping mifepristone, since theoretically there is a possibility of a change in the effectiveness of mifepristone due to the influence of PG synthesis inhibitors.
With quinolones: Based on experimental animal studies, there is a risk of seizures when using NSAIDs in conjunction with high-dose quinolone therapy.

Like other NSAIDs, Dexalgin 25 can increase the concentration of creatinine and nitrogen in plasma; Dexalgin 25 can also have a side effect on the urinary system, and there is a possibility of interstitial nephritis or glomerulonephritis, as well as papillary necrosis, nephrotic syndrome and acute renal failure.

During therapy with Dexalgin 25, a slight transient increase in liver parameters and a significant increase in the activity of AST and ALT in the serum sometimes occur. In this regard, in patients of the older age group it is necessary to monitor the functions of the liver and kidneys. In case of a significant increase in indicators, it is recommended to discontinue the use of Dexalgin 25.

Dexketoprofen therapy can hide the symptoms of infectious diseases. If you suspect an infection or if your condition worsens while using Dexalgin 25, you should immediately consult a doctor.

When using Dexalgin 25, there is a possibility of a feeling of drowsiness, and dizziness may also occur, while the patient’s ability to concentrate and the speed of psychomotor reactions may decrease in the first hours after taking the drug.

In this regard, during therapy with Dexalgin 25, caution is required when driving vehicles or during activities that require concentration and speed of psychomotor reactions.

Dexalgin film-coated tablets 25 mg 10 pcs

Undesirable side effects can be minimized by using the drug in the lowest effective dose with the minimum duration of use necessary to relieve pain.

The risk of complications from the gastrointestinal tract increases in patients with a history of ulcerative lesions of the gastrointestinal tract, in elderly patients, with an increase in the dose of NSAIDs; therefore, the use of Dexalgin® 25 in this category of patients should begin with the lowest recommended dose.

For patients in the above categories, as well as patients who require simultaneous use of low doses of acetylsalicylic acid or other drugs that increase the risk of gastrointestinal complications, additional simultaneous use of gastroprotectors (misoprostol or proton pump blockers) is recommended.

In patients simultaneously taking antiplatelet agents or anticoagulants, glucocorticosteroids, the risk of gastrointestinal bleeding also increases.

Patients with gastrointestinal disorders or a history of gastrointestinal diseases should be under close medical supervision. If gastrointestinal bleeding or ulcerative lesions occur, use of Dexalgin® 25 should be discontinued.

The drug Dexalgin ®25 should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), since exacerbation of these diseases is possible.

All NSAIDs can inhibit platelet aggregation and prolong bleeding time by inhibiting prostaglandin synthesis. In this regard, the use of Dexalgin® 25 in patients simultaneously taking drugs that affect the hemostatic system, such as warfarin, coumarin derivatives and heparins, is not recommended.

Like other NSAIDs, Dexalgin® 25 can lead to increased concentrations of creatinine and nitrogen in the blood plasma. Like other prostaglandin synthesis inhibitors, Dexalgin® 25 may have side effects on the urinary system, which can lead to the development of glomerulonephritis, interstitial nephritis, papillary necrosis, nephrotic syndrome and acute renal failure. Caution should be exercised when using the drug in patients concomitantly using diuretics and patients who may develop hypovolemia, due to the increased risk of nephrotoxicity.

As with the use of other NSAIDs, during therapy with Dexalgin® 25, a slight transient increase in the activity of liver enzymes may be observed. In elderly patients, monitoring of liver and kidney function is necessary. In case of a significant increase in the corresponding indicators, the use of the drug Dexalgin® 25 should be discontinued.

Like other NSAIDs, dexketoprofen may mask the symptoms of infectious diseases. If signs of infection or deterioration in health are detected while using the drug Dexalgin® 25, the patient should immediately consult a doctor.

The drug can cause fluid retention in the body, therefore, in patients with arterial hypertension, renal and/or heart failure, Dexalgin® 25 should be used with extreme caution. If the condition worsens, the use of Dexalgin® 25 should be discontinued.

In patients with uncontrolled arterial hypertension, coronary artery disease, congestive heart failure, peripheral arterial disease and/or cerebrovascular disease, the drug should be used with caution. A similar approach is applicable to patients with risk factors for developing cardiovascular diseases (arterial hypertension, hyperlipidemia, diabetes mellitus, smoking).

Caution must be exercised when prescribing Dexalgin® to patients with a history of cardiovascular disease, especially patients with heart failure, due to the possible risk of progression.

Clinical studies and epidemiological data suggest that NSAIDs, especially in high doses and with long-term use, may lead to a small risk of acute myocardial infarction or stroke. There is insufficient data to exclude the risk of these events when using dexketoprofen.

Elderly patients are especially susceptible to adverse reactions when using NSAIDs, including the risk of life-threatening gastrointestinal bleeding and perforation, and decreased renal, liver, and cardiac function. When using the drug Dexalgin® 25 in this category of patients, proper clinical monitoring is necessary.

There is evidence of rare cases of skin reactions (such as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) with the use of NSAIDs. At the first manifestations of a skin rash, damage to the mucous membranes or other signs of an allergic reaction, you should immediately stop taking Dexalgin® 25 and consult a doctor.

Impact on the ability to drive vehicles and other mechanisms

Due to the possible occurrence of dizziness and drowsiness during the period of use of the drug Dexalgin® 25, the ability to concentrate and the speed of psychomotor reactions in patients may decrease, especially in the first hour after administration. Therefore, while using the drug Dexalgin® 25, care should be taken when driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.