Instructions for use DOLAREN
Caution should be exercised if there is a history of blood disease or coagulation disorders, since the drug, by inhibiting prostaglandin synthesis, has an effect on platelets.
Avoid concomitant use of Dolaren with NSAIDs, including selective COX-2 inhibitors, as well as with certain other drugs that may increase the risk of bleeding, such as oral corticosteroids, anticoagulants such as warfarin, selective serotonin reuptake inhibitors or acetylsalicylic acid .
Since fluid retention and edema have been reported with the use of NSAIDs, special attention should be paid to patients with impaired cardiac or renal function (including functional renal failure due to hypovolemia, nephrotic syndrome, lupus nephropathy and decompensated cirrhosis of the liver), or a history of arterial hypertension , elderly patients, patients receiving concomitant therapy with diuretics or drugs that significantly affect renal function, as well as patients with a significant decrease in extracellular fluid volume for any reason (for example, before and after surgery). In such cases, monitoring of renal function is recommended as a precautionary measure.
When using the drug there is a risk of developing hyperkalemia.
Taking the drug can cause nephritis with hematuria, proteinuria and, in rare cases, nephrotic syndrome.
Serious liver reactions, including jaundice and hepatitis, are possible with the use of the drug. If there is a need to prescribe the drug for liver dysfunction, the use of the drug should be carried out under the supervision of a physician. With long-term use, it is necessary to regularly monitor liver function.
Severe (including fatal) skin reactions, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been very rarely reported with NSAIDs, including diclofenac. The highest risk of these reactions occurs at the beginning of therapy, and the development of these reactions is observed in most cases in the first month of treatment. Dolaren should be discontinued at the first manifestation of skin rash, mucosal ulcers or any other manifestations of hypersensitivity.
NSAIDs may increase the risk of serious cardiovascular complications (arterial thrombosis, myocardial infarction and stroke).
Patients with asthma, seasonal allergic rhinitis, nasal edema, chronic obstructive pulmonary disease, or chronic respiratory tract infections are more likely to experience allergic reactions to NSAIDs than other patients. Particular care should be taken when treating such patients.
If the drug Dolaren is prescribed to patients with impaired liver function, medical supervision of their condition is necessary, since exacerbation of complications is possible. During use of the drug, as well as other NSAIDs, the activity of one or more liver enzymes may increase. If abnormalities in liver function parameters persist or worsen, if complaints or symptoms indicating liver disease are noted, as well as if other side effects occur (for example, eosinophilia, rash, etc.), Dolaren should be discontinued. It must be borne in mind that hepatitis when taking the drug can occur without prodromal phenomena. Caution should be exercised when prescribing Dolaren to patients with hepatic porphyria, as it may provoke an exacerbation.
Diclofenac sodium should not be used together with diclofenac potassium. When taking NSAIDs, including diclofenac sodium, stomach ulcers and gastrointestinal bleeding (sometimes life-threatening) may develop, regardless of the presence or absence of previous symptoms. For patients prone to gastrointestinal irritation (especially if there is a history of diseases such as gastric ulcers, melena, diverticulosis, ulcerative colitis, or other inflammatory process), diclofenac sodium is recommended to be taken under medical supervision.
Clinical studies and epidemiological data indicate that the use of diclofenac increases the risk of thrombotic complications (for example, myocardial infarction or stroke), especially with long-term use or in high doses (150 mg / day).
Paracetamol should be taken with caution in patients with impaired liver function. In chronic alcoholism, therapeutic doses of paracetamol can cause hepatotoxicity and severe liver failure.
In case of allergic reactions to paracetamol, it is recommended to stop taking the drug.
In elderly patients, a reduction in the dose of the drug and medical supervision is necessary.
It is not recommended to drink alcohol while using the drug.
Use in pediatrics
The use of the drug in children is contraindicated.
Impact on the ability to drive vehicles and operate machinery
During the period of use of the drug, it is recommended to refrain from driving and work that requires increased concentration.
Dolaren gel 20 g (diclofenac + methyl salicylate)
Pharmacokinetics
Gel for topical use is absorbed through the skin, penetrating deeply into subcutaneous fat, muscle tissue, joint capsule and synovial fluid by direct diffusion and provides an analgesic effect. The effect of the drug begins a few minutes after applying the gel to the skin and reaches a maximum within 20–30 minutes. With prolonged treatment or when applied to large areas of the lesion, diclofenac penetrates into the blood plasma.
Concentrations in synovial fluid are quite stable, and in blood plasma they decrease rapidly. Diclofenac is metabolized in the liver by conjugation with glucuronic acid. Approximately 70% of diclofenac is excreted in urine, the rest in feces.
Pharmacodynamics
When applied topically, Dolaren gel has an analgesic, anti-inflammatory and anti-edematous effect. Eliminates pain and inflammation of joints, reduces morning stiffness and swelling of joints, and helps increase range of motion in joints.
Diclofenac
belongs to the group of NSAIDs (non-steroidal anti-inflammatory drugs), inhibits cyclooxygenase, inhibits the biosynthesis of prostaglandins - endogenous substances that play an important role in the genesis of fever, inflammation and pain. Diclofenac relieves pain and eliminates inflammation.
Menthol
causes irritation of cold receptors. This is accompanied by a narrowing and decrease in the permeability of capillaries at the site of application, and a feeling of coolness. It has a local distracting and moderately expressed analgesic effect, the absorption of menthol is insignificant. Menthol is metabolized in the liver and excreted by the kidneys and bile in the form of gluconides.
Methyl salicylate
is a derivative of salicylic acid and has a local irritant effect. By irritating skin receptors, methyl salicylate leads to a reduction in pain. In addition, methyl salicylate inhibits the synthesis of prostaglandins, which reduces swelling and infiltration of inflamed tissues. When applied topically, it easily penetrates through intact skin deep into the source of inflammation, creating high therapeutic concentrations. In inflamed tissues, methyl salicylate is hydrolyzed and converted into the salicylic acid anion, which is metabolized in the liver to dehydroxybenzoic acid and excreted by the kidneys. The half-life is 2 hours.
Indications for use
Dolaren is prescribed to relieve pain: lumbago , neuralgia , toothache and headache, rheumatoid arthritis , radiculitis , sciatica , ankylosing spondylitis , osteoarthritis , diseases of the spine and joints.
The drug is effective in the treatment of dysmenorrhea , postoperative pain, bursitis , tendinitis , musculoskeletal disorders in the acute period, febrile conditions, and soft tissue diseases.
special instructions
For patients with a history of gastrointestinal diseases, Crohn's disease , ulcerative colitis , functional disorders of the hepatic system, additional supervision is recommended.
Taking the drug Dolaren may cause an increase in liver transaminases .
With a long course of treatment, monitoring of the condition of the liver is required.
Dolaren can provoke attacks of hepatic porphyria .
During treatment, it is necessary to monitor the condition of peripheral blood.
The drug can inhibit platelet aggregation; the phenomenon is temporary. Dolaren reduces the speed of psychomotor reactions.
Pharmacodynamics and pharmacokinetics
The effective effect of the drug is achieved through the combination of its components.
Diclofenac has a pronounced anti-inflammatory and analgesic effect, and moderately reduces elevated body temperature.
Paracetamol has an analgesic effect, anti-inflammatory and antipyretic effects are weakly expressed. The principle of action of the drug is based on inhibition of prostaglandin .
When taken orally, Dolaren begins to act within an hour. Eating slows down the rate of absorption of the active components of the drug. Metabolites are excreted by the renal and hepatic systems.
Dolaren price, where to buy
The price of Dolaren tablets is currently unknown. You cannot buy the drug in Moscow, Kharkov or another city.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
LuxPharma* special offer
- Dolaren tab.
N100 2600 rub. order
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Pharmacy24
- Dolaren Hit gel 50 g Nabros Pharma Pvt. Ltd., India
111 UAH order - Dolaren Hit 30 g gel Nabros Pharma Pvt. Ltd., India
63 UAH order
- Dolaren No. 100 tablets Nabros Pharma Pvt. Ltd., India
300 UAH order
PaniPharmacy
- Dolaren HIT gel 30g India, Nabros Pharma
78 UAH order
- Dolaren tablets Dolaren tablets. No. 100 India, Nabros Pharma
317 UAH. order
- Dolaren HIT gel 50g India, Nabros Pharma
122 UAH order
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Side effects
Gastrointestinal tract: dyspeptic disorders, anorexia , nausea, epigastric pain, stool disorders, flatulence . Long-term use of the drug leads to ulcerative lesions of the gastrointestinal tract, including bleeding.
Central nervous system: depression, drowsiness, headaches.
Urinary system: nephrotic syndrome, hematuria, acute renal failure, proteinuria .
Hematopoietic organs: anemia, thrombocytopenia (rare).
Allergies: erythema, bronchospasm , skin rashes, itching.
