Diclofenac rectal suppositories - how to use correctly and where to insert? Diclofenac suppositories: instructions for use Diclofenac suppositories 100.
Excipients: colloidal silicon dioxide, miglyol 812, solid fat (Witepsol H15).
Rectal suppositories are white to almost white with a yellowish tint, in the shape of a cylinder with a pointed end.
pharmachologic effect
NSAID, phenylacetic acid derivative. It has a pronounced anti-inflammatory, analgesic and moderate antipyretic effect. The mechanism of action is associated with inhibition of the activity of COX - the main metabolic enzyme arachidonic acid, which is a precursor of prostaglandins, which play an important role in the pathogenesis of inflammation, pain and fever. The analgesic effect is due to two mechanisms: peripheral (indirectly, through suppression of prostaglandin synthesis) and central (due to inhibition of prostaglandin synthesis in the central and peripheral nervous system).In vitro, at concentrations equivalent to those achieved when treating patients, it does not inhibit the biosynthesis of cartilage tissue proteoglycans.
For rheumatic diseases, it reduces pain in the joints at rest and during movement, as well as morning stiffness and swelling of the joints, and helps to increase range of motion. Reduces post-traumatic and postoperative pain, as well as inflammatory swelling.
In case of post-traumatic and postoperative inflammatory phenomena, it quickly relieves pain (arising both at rest and during movement), reduces inflammatory swelling and swelling of the postoperative wound.
Suppresses platelet aggregation. With long-term use it has a desensitizing effect.
Indications for use
- inflammatory and degenerative diseases of the musculoskeletal system, incl. rheumatoid, juvenile, chronic arthritis; ankylosing spondylitis and other spondyloarthropathy;- osteoarthritis;
- gouty arthritis;
- bursitis, tendovaginitis;
- pain syndrome from the spine (lumbago, sciatica, ossalgia, neuralgia, myalgia, arthralgia, radiculitis);
- post-traumatic postoperative pain syndrome accompanied by inflammation (for example, in dentistry and orthopedics);
- algodismenorrhea;
- inflammatory processes in the pelvis (including adnexitis);
- infectious and inflammatory diseases of the ENT organs with severe pain syndrome (as part of complex therapy): pharyngitis, tonsillitis, otitis media.
Isolated fever is not an indication for the use of the drug.
The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use, and does not affect the progression of the disease.
Mode of application
The dose is selected individually; it is recommended to use the drug in the minimum effective dose, with the shortest possible treatment period.For oral and rectal use
Adults
When taken orally in the form of tablets of regular duration or rectally in the form of suppositories, the recommended initial dose is 100-150 mg/day. In relatively mild cases of the disease, as well as for long-term therapy, 75-100 mg/day is sufficient. The daily dose should be divided into several doses.
When taken in the form of extended-release tablets, the recommended initial dose is 100 mg 1 time / day. The same daily dose is used for moderately severe symptoms, as well as for long-term therapy. In cases where the symptoms of the disease are most pronounced at night or in the morning, extended-release tablets
It is advisable to take actions at night.
To relieve night pain or morning stiffness, in addition to taking the drug during the day, diclofenac is prescribed in the form of rectal suppositories before bedtime; in this case, the total daily dose should not exceed 150 mg.
For primary dysmenorrhea, the daily dose is selected individually; usually it is 50-150 mg. The initial dose should be 50-100 mg; if necessary within a few menstrual cycles it can be increased to 150 mg/day. The drug should be started when the first symptoms appear. Depending on the dynamics clinical symptoms Treatment can be continued for several days.
In elderly patients (65 years and older), no adjustment of the initial dose is required.
In weakened patients and patients with low body weight, it is recommended to adhere to the minimum dose.
Children aged 1 year and older
The drug is prescribed in a dose of 0.5-2 mg/kg body weight/day (in 2-3 doses, depending on the severity of the disease). For the treatment of rheumatoid arthritis, the daily dose can be increased to a maximum of 3 mg/kg (in several doses). The maximum daily dose is 150 mg.
The drug in the form of extended-release tablets should not be used in children and adolescents under the age of 18 years.
For parenteral use
Adults
Injected deep into the / m. Single dose - 75 mg. If necessary, repeated administration is possible, but not earlier than after 12 hours.
Duration of use is no more than 2 days, if necessary, then switch to oral or rectal use of diclofenac.
In severe cases (for example, with colic), as an exception, 2 injections of 75 mg each can be given, with an interval of several hours (the second injection should be carried out in the opposite gluteal region). Alternatively, IM administration once a day (75 mg) can be combined with diclofenac in other dosage forms (tablets, rectal suppositories), and the total daily dose should not exceed 150 mg.
During migraine attacks, diclofenac is recommended to be administered as early as possible after the onset of the attack, IM at a dose of 75 mg, followed by the use of suppositories at a dose of up to 100 mg on the same day, if required. The total daily dose should not exceed 175 mg on the first day.
In elderly patients (65 years and older), no adjustment of the initial dose is required. In weakened patients and patients with low body weight, it is recommended to adhere to the minimum dose.
The drug should be used with extreme caution in patients with diseases of the cardiovascular system (including uncontrolled hypertension) or a high risk of developing cardiovascular diseases. If long-term therapy (more than 4 weeks) is necessary in such patients, the drug should be used in a daily dose not exceeding 100 mg.
Children and teenagers under 18 years of age
Diclofenac should not be used intramuscularly in children and adolescents under 18 years of age due to the difficulty of dosing the drug.
Interaction
Potent CYP2C9 inhibitors - when diclofenac is co-administered with strong CYP2C9 inhibitors (such as voriconazole), it is possible to increase the concentration of diclofenac in the blood serum and enhance the systemic effect caused by inhibition of the metabolism of diclofenac.Lithium, digoxin - it is possible to increase the concentration of lithium and digoxin in plasma. It is recommended to monitor the concentration of lithium and digoxin in the blood serum.
Diuretics and antihypertensive drugs - when used simultaneously with diuretics and antihypertensive drugs (for example, beta-blockers, ACE inhibitors), diclofenac may reduce their hypotensive effect.
Cyclosporine - the effect of diclofenac on the activity of prostate glandins in the kidneys may increase the nephrotoxicity of cyclosporine.
Drugs that can cause hyperkalemia - the combined use of diclofenac with potassium-sparing diuretics, cyclosporine, tacrolimus and trimethoprim can lead to an increase in the level of potassium in the blood plasma (in the case of such a combination, this indicator should be monitored frequently).
Antibacterial agents quinolone derivatives - there are isolated reports of the development of seizures in patients receiving quinolone derivatives and diclofecac simultaneously.
NSAIDs and GCS - with simultaneous systemic use of diclofenac and other systemic NSAIDs or GCS may increase the incidence of adverse events (in particular, from the gastrointestinal tract).
Anticoagulants and antiplatelet agents - an increased risk of bleeding cannot be ruled out when diclofenac is used simultaneously with drugs from these groups.
Selective inhibitors recapture serotonin - may increase the risk of gastrointestinal bleeding.
Hypoglycemic drugs - cases of both hypoglycemia and hyperglycemia cannot be excluded, which necessitated the need to change the dose of hypoglycemic drugs during the use of diclofenac.
Methotrexate - when using diclofenac within 24 hours before or within 24 hours after taking methotrexate, the concentration of methotrexate in the blood may increase and its toxic effect may increase.
Phenytoin - the effect of phenytoin may be enhanced.
Side effect
Frequency determination adverse reactions: very often (?1/10), often (?1/100, from the digestive system:- often - abdominal pain, nausea, vomiting, diarrhea, dyspepsia, flatulence, decreased appetite, anorexia, increased aminotransferase activity in the blood serum;
- rarely - gastritis, gastrointestinal bleeding, vomiting blood, melena, diarrhea mixed with blood, stomach and intestinal ulcers (with or without bleeding or perforation), hepatitis, jaundice, liver dysfunction;
- very rarely - stomatitis, glossitis, damage to the esophagus, the occurrence of diaphragm-like strictures in the intestine, colitis (nonspecific hemorrhagic colitis, exacerbation of ulcerative colitis or Crohn's disease), constipation, pancreatitis, fulminant hepatitis, liver necrosis, liver failure.
From the outside nervous system:
- often - headache, dizziness;
- rarely - drowsiness;
- very rarely - sensory disturbances, including paresthesia, memory disorders, tremors, convulsions, anxiety, acute cerebrovascular accidents, aseptic meningitis;
- very rarely - disorientation, depression, insomnia, nightmares, irritability, mental disorders.
From the senses:
- often - vertigo;
- very rarely - visual impairment (blurred vision), diplopia, hearing impairment, tinnitus, dysgeusia.
Dermatological reactions:
- often - skin rash;
- rarely - urticaria;
- very rarely - bullous rashes, eczema, erythema, erythema multiforme, Stevens-Johnson syndrome, Lyell's syndrome (toxic epidermal necrolysis), exfoliative dermatitis, itching, hair loss, photosensitivity reactions; purpura, Henoch-Schönlein purpura.
From the genitourinary system: very rarely - acute renal failure, hematuria, proteinuria, tubulointerstitial nephritis, nephrotic syndrome, papillary necrosis.
From the hematopoietic system: very rarely - thrombocytopenia, leukopenia, hemolytic anemia, aplastic anemia, agranulocytosis.
Allergic reactions:
- rarely - hypersensitivity, anaphylactic/anaphylactoid reactions, including decreased blood pressure and shock;
- very rarely - angioedema (including facial swelling).
From the cardiovascular system: very rarely - palpitations, chest pain, increased blood pressure, vasculitis, heart failure, myocardial infarction. There is evidence of a slight increase in the risk of developing cardiovascular thrombotic complications (for example, myocardial infarction), especially with long-term use of diclofenac in high doses (daily dose more than 150 mg).
From the respiratory system:
- rarely - asthma (including shortness of breath);
- very rarely - pneumonitis.
General reactions: rarely - swelling.
Contraindications
- hypersensitivity to diclofenac and excipients of the drug used;- “aspirin triad” (attacks of bronchial asthma, urticaria and acute rhinitis when taking acetylsalicylic acid or other NSAIDs);
- erosive and ulcerative lesions of the gastrointestinal tract in the acute phase;
- proctitis (only for suppositories);
- pregnancy (for intramuscular administration);
- III trimester of pregnancy (for oral and rectal administration);
- children and adolescents up to 18 years of age (for intramuscular administration and for long-acting dosage forms).
Carefully:
- suspicion of gastrointestinal disease;
- history of gastrointestinal bleeding and ulcer perforation (especially in elderly patients), Helicobacter pylori infections, ulcerative colitis, Crohn's disease, dysfunction;
- light and moderate impairment liver function, hepatic porphyria (diclofenac can provoke attacks of porphyria);
- in patients with bronchial asthma, seasonal allergic rhinitis, swelling of the nasal mucosa (including with polyps in the nasal cavity), COPD, chronic infectious diseases respiratory tract (especially associated with allergic rhinitis-like symptoms);
- cardiovascular diseases(including coronary artery disease, cerebrovascular diseases, compensated heart failure, peripheral vascular diseases);
- impaired renal function, including chronic renal failure (creatinine clearance 30-60 ml/min);
- dyslipidemia/hyperlipilemia;
- diabetes;
- arterial hypertension;
- a significant decrease in BCC of any etiology (for example, in the periods before and after massive surgical interventions);
- violation of the hemostasis system;
- risk of developing thrombosis (including myocardial infarction and stroke);
- elderly patients, especially those who are weakened or have low body weight (diclofenac should be used in the minimum effective dose);
- in patients receiving drugs that increase the risk of gastrointestinal bleeding, including systemic corticosteroids (including prednisolone), anticoagulants (including warfarin), antiplatelet agents (including clopidogrel, acetylsalicylic acid), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline);
- simultaneous treatment with diuretics or other drugs that can impair renal function;
- when treating patients who smoke or abuse alcohol;
- when administered intramuscularly to patients with bronchial asthma due to the risk of exacerbation of the disease (since sodium bisulfite, which is contained in some dosage forms for injection, can cause severe reactions hypersensitivity).
special instructions
Use with extreme caution in patients with a history of liver, kidney, gastrointestinal diseases, dyspeptic symptoms, bronchial asthma, arterial hypertension, heart failure, immediately after major surgical interventions, as well as in elderly patients.If there is a history of allergic reactions to NSAIDs and sulfites, diclofenac is used only in emergency cases. During treatment, systematic monitoring of liver and kidney function and peripheral blood patterns is necessary.
Rectal use is not recommended in patients with diseases of the anorectal area or a history of anorectal bleeding. It should be used externally only on undamaged areas of the skin.
Avoid contact of diclofenac with the eyes (except for eye drops) or mucous membranes. Patients using contact lenses should use eye drops no earlier than 5 minutes after removing the lenses.
Not recommended for use in children under 6 years of age.
During the treatment period dosage forms For systemic use, alcohol consumption is not recommended.
Impact on ability to manage vehicles and mechanisms
During the treatment period, the speed of psychomotor reactions may decrease. If your vision becomes blurred after using eye drops, you should not drive a car or engage in other potentially hazardous activities.
The sudden onset of inflammation and pain are the main symptoms of most diseases.
In the vast majority of cases, to eliminate them, multifunctional drugs with a wide range of effects are used, which have and.
It is considered one of the most effective. The medicine itself is a non-steroidal anti-inflammatory drug medications. It is used to effectively combat diseases of the musculoskeletal system and other pathologies that cause severe pain in the patient.
But before using Diclofenac suppositories, you need to read the instructions in order to avoid the occurrence of adverse reactions in the future.
IN official instructions it is written that the drug Diclofenac in the form of suppositories can be used by those patients who exhibit the following pathologies:
- pain syndrome from the lumbar spine;
- acute form of inflammation of the musculoskeletal system of the body (rheumatism, arthritis, gout, spondylitis, arthrosis);
- postoperative inflammation and tenderness of soft tissues;
- postoperative and post-traumatic pain syndromes (dental, gynecological or extensive surgery);
- non-infectious conjunctivitis, post-traumatic penetrating or non-penetrating damage to the eyeball, severe pain when passing an excimer laser, removal and implantation of the lens;
- infectious lesions of the respiratory tract - tonsillitis, pharyngitis, otitis media;
- prevention and treatment of acute headaches;
- non-rheumatic pathologies that are accompanied by inflammatory processes (bursitis, synovitis, tendinitis, neuritis, capsulitis, tenosynovitis);
- feverish state with influenza and severe colds;
- severe pain syndrome with a wide spectrum of action (migraine, myalgia, toothache, cancer, colic in the kidneys or gall bladder, inflammatory processes, post-traumatic syndrome, postoperative period, neuralgic pain);
- advanced form of disease supporting apparatus(lumbago, bursitis, sciatica, arthralgia, ossalgia, tendovaginitis, radiculitis);
- gynecological pathologies - the occurrence of inflammatory foci in the pelvis, algodismenorrhea, adnexitis.
In addition, Diclofenac suppositories are often used together with antispasmodics for effective fight with pain syndrome due to hepatic or renal colitis.
Mode of application
Diclofenac suppositories must be inserted into the anus with the pointed end forward, and the deeper the suppository is inserted, the better. In order to speed up the process of absorption of the components of the drug, before the procedure it is necessary to empty the intestines naturally or with the help of a cleansing enema.
Diclofenac suppositories
To make this process less painful, you need to lie on your side and bend your knees, pressing them slightly towards your stomach. When inserting a suppository into the anus, you do not need to apply much force to quickly insert the suppository.
One sudden movement of the hand can damage the mucous membrane. When the procedure is completed, you cannot immediately get out of bed. If the patient additionally takes laxative medications, then preliminary bowel cleansing can be abandoned.
In order for the drug to be absorbed, you need to lie down in a supine position for at least 30 minutes, which is why it is better to carry out the procedure before bed.
Usage rectal suppositories in rare cases, it can provoke unpleasant and even painful sensations in the anal area. Minor symptoms that are uncomfortable for a person are not a reason to refuse to use the drug. If the intensity of unpleasant symptoms increases, then it is best to contact your doctor for advice.
Dosage
According to the instructions, suppositories should be administered rectally in a dosage of 50 mg twice a day or 100 mg of the drug no more than once a day.
In standard situations, the daily dose medicinal product should not exceed 100 mg.
If the patient is diagnosed with another illness with a characteristic pain syndrome, then the dosage can be increased to 150 mg. During a period of severe exacerbation of migraine, cope with severe pain 100 mg of the drug will help.
In most cases, the patient is prescribed only one suppository per day, which is best used before bedtime.
In practice, for the effective treatment of arthritis and arthrosis, the use of Diclofenac suppositories is permissible only after the patient has completed a full course of the same medication to prevent relapses. In more severe cases, the patient uses two suppositories per day.
Overdose
In some cases, if the medication is used incorrectly or the permissible dosage is exceeded, overdose symptoms characteristic of Diclofenac may occur:
- darkening of the eyes;
- Strong headache;
- clouding of mind;
- tachycardia;
- limb spasms;
- vomit (consistency of coffee grounds);
- paleness of the skin;
- diarrhea (black bowel movements);
If symptoms of Diclofenac poisoning occur, the drug is immediately discontinued and the victim is given first aid.
Side effects
In an effort to achieve a speedy recovery, many patients independently increase the dosage of the drug, which is strictly prohibited.
Diclofenac suppositories, like any other medicine, can cause side effects, the main of which are:
- painful bowel movements;
- severe abdominal pain, nausea, vomiting, diarrhea, flatulence;
- bleeding in the gastrointestinal tract, sudden weight loss, gastritis, ulcers, jaundice;
- irritation of the rectal mucosa, bleeding;
- exacerbation of existing hemorrhoids, proctitis;
- sleep disturbance, headaches, loss of sensitivity;
- chest pain, rapid heartbeat, myocardial infarction, hypertension;
- visual and hearing impairment, depression, tinnitus;
- leukopenia, renal failure, nephritis;
- shortness of breath, swelling of the lungs, asthma;
- Crohn's disease, aphthous stomatitis, pancreatitis, hepatitis, colitis;
- photosensitivity, erythema, urticaria, itching, erythroderma;
- tremor, memory disorder, anxiety, convulsions.
Contraindications
Despite the effectiveness of the drug, thanks to which the patient can quickly get rid of his illness, experts do not recommend using Diclofenac suppositories for the following pathologies:
- chronic damage to the intestines and stomach;
- acute kidney damage;
- the patient's tendency to frequent intestinal bleeding;
- chronic high blood pressure (hypertension);
- an allergic reaction to at least one component of the drug or other non-steroidal anti-inflammatory drugs.
If the patient experiences at least one of the symptoms listed above, he needs to urgently contact his doctor. In any case, a qualified specialist will select effective drug a similar spectrum of action that will help get rid of health problems without adverse reactions.
It is also worth noting that the most important contraindications are minor age, as well as pregnancy and lactation.
The practice of using Diclofenac suppositories indicates that the components of the drug can reduce alertness and reaction. For this reason, during the therapeutic course, it is advisable to refrain from driving vehicles and not operating any other moving mechanisms.
Video on the topic
How to use Diclofenac suppositories for prostatitis:
As a result, Diclofenac suppositories are a universal medicine that has been around for over 35 years. During this time, many other drugs have appeared on the market, but this particular suppository still occupies a leading position in demand due to its effectiveness and accessibility.
In addition, Diclofenac is well tolerated by most patients and is not addictive. But despite this, it is important to remember the contraindications of the drug. In order to achieve positive result, you must adhere to all doctor’s instructions and follow the correct dosage.
Read the instructions " rel="diklofenak-svechi" class="fancybox pill-photo"> Diclofenac has anti-inflammatory, analgesic and antipyretic effects. By indiscriminately inhibiting cyclooxygenase 1 and 2, it disrupts the metabolism of arachidonic acid, reduces the amount of prostaglandins at the site of inflammation. For rheumatic diseases The anti-inflammatory and analgesic effect of diclofenac helps to significantly reduce the severity of pain, morning stiffness, and swelling of the joints, which improves the functional state of the joint in case of injuries. postoperative period diclofenac reduces painful sensations and inflammatory edema. Read instructions " rel="diklofenak-svechi" class="none fancybox pill-photo"> Diclofenac has anti-inflammatory, analgesic and antipyretic effects. Indiscriminately inhibiting cyclooxygenase 1 and 2, disrupts the metabolism of arachidonic acid, reduces the number of prostaglandins in the lesion inflammation. In rheumatic diseases, the anti-inflammatory and analgesic effect of diclofenac helps to significantly reduce the severity of pain, morning stiffness, and swelling of the joints, which improves the functional state of the joint. In case of injuries, in the postoperative period, diclofenac reduces pain and inflammatory swelling. Read the instructions " rel="diklofenak- svechi" class="none fancybox pill-photo"> Diclofenac has anti-inflammatory, analgesic and antipyretic effects. By indiscriminately inhibiting cyclooxygenase 1 and 2, it disrupts the metabolism of arachidonic acid and reduces the amount of prostaglandins at the site of inflammation. In rheumatic diseases, the anti-inflammatory and analgesic effect of diclofenac helps to significantly reduce the severity of pain, morning stiffness, and swelling of the joints, which improves the functional state of the joint. For injuries, in the postoperative period, diclofenac reduces pain and inflammatory swelling. Read the instructions " rel="diklofenak-svechi" class="none fancybox pill-photo"> Diclofenac has anti-inflammatory, analgesic and antipyretic effects. Indiscriminately inhibiting cyclooxygenase 1 and 2, disrupts the metabolism of arachidonic acid, reduces the amount of prostaglandins in the site of inflammation. In rheumatic diseases, the anti-inflammatory and analgesic effect of diclofenac helps to significantly reduce the severity of pain, morning stiffness, swelling of the joints, which improves the functional state of the joint. In case of injuries, in the postoperative period, diclofenac reduces pain and inflammation. swelling. Read instructions " rel="diklofenak-svechi" class="none fancybox pill-photo"> Diclofenac has anti-inflammatory, analgesic and antipyretic effects. By indiscriminately inhibiting cyclooxygenase 1 and 2, it disrupts the metabolism of arachidonic acid and reduces the amount of prostaglandins at the site of inflammation. In rheumatic diseases, the anti-inflammatory and analgesic effect of diclofenac helps to significantly reduce the severity of pain, morning stiffness, and swelling of the joints, which improves the functional state of the joint. For injuries, in the postoperative period, diclofenac reduces pain and inflammatory swelling. Read instructions " rel="diklofenak-svechi" class="none fancybox pill-photo"> Prices for Diclofenac suppositories in Moscow pharmacies:
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Diclofenac 100 suppositories is a non-steroidal anti-inflammatory drug of systemic action. Used to relieve pain, swelling and other signs of inflammation. It has contraindications and side effects, so it should be used as prescribed by a doctor.
pharmachologic effect
The active substance has the following properties:
- Suppresses the activity of cyclooxygenase, prevents the occurrence of reactions of the arachidonic cascade.
- Reduces the rate of platelet aggregation and, with long-term use, reduces the likelihood of inflammatory reactions.
- Suppresses the production of prostaglandins, which are mediators of inflammation. This explains the long-lasting anti-inflammatory effect of diclofenac.
- Eliminates pain, slows down the destruction of cartilage tissue in diseases of the musculoskeletal system. Helps get rid of the feeling of stiffness, restores joint mobility.
Indications for the use of Diclofenac 100 suppositories
Diclofenac rectal suppositories are prescribed for the following pathologies and conditions:
- degenerative and inflammatory processes in joints;
- chronic juvenile arthritis;
- inflammation of the joint capsule;
- rheumatism;
- rheumatoid arthritis and psoriatic joint damage;
- radiculitis;
- ankylosing spondylitis;
- autoimmune lesions of soft tissues;
- gouty arthritis;
- pain syndrome of various origins (headaches, dental and muscle pain, biliary and renal colic, malignant tumors, neuralgia);
- postoperative inflammatory complications;
- gynecological pathologies (painful menstruation, inflammation of the uterus and appendages, trichomoniasis, chlamydia);
- prostatitis and prostate adenoma;
- inflammatory processes in the upper respiratory tract (pharyngitis, sore throat, tonsillitis).
- autoimmune diseases of the thyroid gland.
Dosage regimen for Diclofenac 100 suppositories
Suppositories are inserted into the rectum once a day. The recommended daily dose of diclofenac for adults is 100 mg, for children over 12 years of age – 50 mg.
Before or after meals
The administration of Diclofenac 100 suppositories does not depend on meals.
Side effect
During treatment with Diclofenac 100, the following may occur: Negative consequences:
- digestive disorders (nausea and vomiting, abdominal pain, loss of appetite, increased gas formation, false urge to defecate, intestinal bleeding, inflammation of the pancreas);
- MPS diseases (inflammation of the mucous membranes Bladder, decreased amount of urine excreted);
- neurological disorders (headaches, poor coordination, sleep problems, chronic fatigue, non-infectious meningitis);
- shortness of breath, bronchospasm, signs of bronchial asthma;
- dysfunction of the hematopoietic system (anemia, decreased number of leukocytes, granulocytes and platelets);
- allergic reactions (skin rash like urticaria, eczema, increased skin sensitivity to sunlight, anaphylactic shock, Quincke's edema);
- other side effects (facial swelling and lower limbs, arterial hypertension).
Contraindications to the use of Diclofenac 100 suppositories
Candles are contraindicated:
- with ulceration of the walls of the stomach and duodenum;
- in acute inflammatory processes in the large intestine;
- with individual intolerance to acetylsalicylic acid and other non-steroidal anti-inflammatory drugs;
- with paraproctitis (inflammation of the rectum and surrounding tissue);
- for acute hemorrhoids.
special instructions
Use during pregnancy and breastfeeding
The drug may have Negative influence on the development of the fetus, so it should not be used during pregnancy.
If treatment is necessary during lactation, the child is weaned from the breast for a while.
Use for renal impairment
For diseases of the excretory system, Diclofenac suppositories are used with extreme caution.
Use in children
The drug is not used to treat inflammatory diseases in children under 12 years of age.
Alcohol compatibility
The use of the drug in combination with alcohol increases side effects. Doctors recommend avoiding drinking alcohol during treatment.
Impact on transport management
The drug may cause dizziness, fatigue, and decreased concentration. During treatment with Diclofenac, you should refrain from driving a car or other vehicles.
Overdose
Overdose with the administration of rectal suppositories rarely occurs. In such cases, increased side effects are observed. Therapy is supportive. It is aimed at reducing blood pressure, elimination of seizures, respiratory disorders and signs of damage to the gastrointestinal tract.
Drug interactions
At joint use Diclofenac and cardiac glycosides may enhance the effect of the latter. Suppositories reduce the effectiveness of antihypertensive and diuretic drugs. The use of Diclofenac in combination with potassium-sparing diuretics contributes to the development of hyperkalemia. Acetylsalicylic acid increases the likelihood of side effects. Diclofenac enhances the negative effect of cyclosporine on the excretory system.
Joint reception medication with anticoagulants requires constant monitoring of blood clotting.
Storage conditions and periods
Conditions for dispensing from pharmacies
Price
Analogues
The following drugs have a similar effect:
- Naklofen;
- Ortofen;
- Voltaren;
- Diclovit;
- Diklak.
COMPOSITION AND FORM OF RELEASE:
Diclofenac suppositories 50 mg. No. 10 1 suppository contains diclofenac sodium 50 mg;
Diclofenac suppositories 100 mg. No. 10 1 suppository contains diclofenac sodium 100 mg;
Excipients:
hard fat.
International and chemical names
diclofenac (diclofenac); 2-[(2,6-dichlorophenyl)-amino]phenylacetic acid sodium salt;
Basic physical and chemical properties: suppositories from white to white with a yellowish or creamy tint, cigar-shaped. The presence of plaque on the surface of the suppository is allowed
INSTRUCTIONS
PHARMACOLOGICAL PROPERTIES:
Pharmacodynamics.
Anti-inflammatory, analgesic, antipyretic agent. The mechanism of action is due to the suppression of prostaglandin biosynthesis by inhibiting cyclooxygenase, reducing the formation of kinins and other mediators of inflammation and pain, and having a stabilizing effect on lysosomal membranes. For rheumatic diseases, it reduces swelling, hyperemia and pain at rest and during movement, morning stiffness and swelling of the joints, improving their functional ability. Relieves migraine attacks.
Pharmacokinetics.
When administered rectally, diclofenac is well absorbed into the systemic circulation. Plasma protein binding is more than 99%. The maximum concentration in the blood is achieved within 1 hour after administration, i.e. faster than when using diclofenac orally (2-4 hours). It undergoes biotransformation in the liver by hydroxylation, methoxylation and glucuronidation with the formation of several phenolic metabolites. The half-life is 1-2 hours. Excreted by the kidneys (about 65%) and bile (about 35%) in the form of inactive compounds with glucuronic and sulfuric acids; less than 1% is excreted in unchanged form.
There are no peculiarities in the pharmacokinetics of diclofenac in patients with chronic hepatitis compensated for liver cirrhosis. In patients with impaired renal function, subject to the recommended dosage regimen, accumulation of diclofenac in the body is not observed. When creatinine clearance is less than 10 ml/min, the concentrations of diclofenac hydroxymetabolites are approximately 4 times higher than in healthy volunteers, and the metabolites are excreted exclusively in bile.
INDICATIONS FOR USE
Rheumatoid arthritis, ankylosing spondylitis, acute gouty, infectious, psoriatic and traumatic arthritis, osteoarthritis, bursitis, tendovaginitis, radiculitis, thrombophlebitis, neuralgia, myalgia, post-traumatic inflammation of muscles, joints, tendons and ligaments (sprains, bruises), post-operative swelling and pain syndrome , as well as as a symptomatic treatment of other diseases accompanied by inflammation and pain.
METHOD OF APPLICATION AND DOSES
Adults are prescribed 1 suppository (100 mg of diclofenac) rectally 1 time per day. Having freed the suppository from the contour packaging, it is introduced into the rectum after an enema or spontaneous bowel movement. After administration, you should lie down for 20–30 minutes.
For inflammatory diseases, the use of suppositories can be combined with diclofenac in tablet form, and the total daily dose of the drug should not exceed 150 mg of diclofenac.
The duration of treatment is determined individually, taking into account the effectiveness and tolerability of therapy.
APPLICATION FEATURES
Prescribe with caution to patients with acute inflammatory diseases of the rectum and anus, diseases of the liver, kidneys, gastrointestinal tract in history, congenital disorders of hematopoiesis, arterial hypertension, heart failure, elderly patients.
During treatment with diclofenac, it is necessary to monitor the level of transaminases and other liver enzymes during the first 4 weeks from the start of therapy.
If side effects from the central nervous system (drowsiness, etc.) or the organ of vision occur, patients should refrain from driving vehicles or operating machinery.
SIDE EFFECTS
From the gastrointestinal tract: pain in the epigastric region, nausea, vomiting, diarrhea, abdominal cramps, dyspepsia, flatulence, anorexia; rarely - hidden or macroscopically visible gastrointestinal bleeding, erosive and ulcerative lesions of the gastrointestinal tract, increased levels of liver transaminases, hepatitis; in some cases - aphthous stomatitis, glossitis, damage to the esophagus, the occurrence of diaphragm-like strictures in the intestine, intestinal perforation, fulminant hepatitis, disorders of the distal colon: nonspecific hemorrhagic colitis, exacerbation of ulcerative colitis or Crohn's disease, constipation, pancreatitis.
From the central and peripheral nervous system: headache, dizziness, rarely - drowsiness; very rarely - sensitivity disorders, including paresthesia, memory disorders, disorientation, insomnia, irritability, convulsions, depression, anxiety, tremor, psychotic reactions, aseptic meningitis.
From the senses: very rarely - visual impairment (blurred vision, diplopia), hearing impairment, tinnitus, impaired taste.
From the cardiovascular system: rarely - swelling, in some cases - palpitations, pain in the heart, increased blood pressure, worsening congestive heart failure.
From the urinary system: very rarely - acute renal failure, hematuria, proteinuria, interstitial nephritis, nephrotic syndrome, papillary necrosis.
From the hematopoietic system: rarely - thrombocytopenia, leukopenia, hemolytic anemia, aplastic anemia, agranulocytosis.
Dermatological reactions: itching, rash; rarely - urticaria; in some cases - bullous reactions, eczema, erythema multimorpha, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome), erythroderma, hair loss, photosensitivity, purpura, incl. allergic.
Allergic reactions: local irritation reactions are possible (burning, itching in the anorectal area), rarely - bronchospasm, immediate hypersensitivity reactions (including anaphylactic and anaphylactoid, including hypotension), in some cases - vasculitis, pneumonitis.
INTERACTION WITH OTHER MEDICINES
With the simultaneous use of lithium, digoxin and phenytoin, the concentration of the latter in plasma may increase. Acetylsalicylic acid may reduce the concentration of diclofenac in blood plasma.
Diclofenac may weaken the effect of antihypertensive drugs and diuretics. Concomitant use of potassium-sparing diuretics may result in increased serum potassium levels. When prescribing such combination therapy, it is necessary to monitor the level of potassium in the blood.
When diclofenac is used simultaneously with other non-steroidal anti-inflammatory drugs or corticosteroids, the risk of developing erosive and ulcerative lesions and bleeding in the gastrointestinal tract increases.
The combined use of the drug with anticoagulants, fibrinolytics, and antiplatelet agents should be avoided due to an increased risk of bleeding.
With the simultaneous use of diclofenac and oral hypoglycemic agents, isolated cases of the development of hypoglycemia and hyperglycemia were described, which required dose adjustment of hypoglycemic drugs.
When used concomitantly, diclofenac may increase the toxicity of cyclosporine and methotrexate.
There are isolated reports of the occurrence of seizures in patients taking simultaneously non-steroidal anti-inflammatory drugs and quinolone antibacterial drugs.
CONTRAINDICATIONS
Inflammatory diseases of the rectum, hemorrhagic colitis, exacerbation of hemorrhoids, rectal or anal bleeding (including a history), peptic ulcer stomach or intestines, hematopoietic disorders unknown etiology, bronchial asthma, incl. history, pregnancy, period breastfeeding, age under 18 years, increased individual sensitivity to diclofenac and other non-steroidal anti-inflammatory drugs and/or components of the drug.
OVERDOSE
If the recommended doses are exceeded, disorders of the central nervous system are possible (headache, dizziness, loss of consciousness, abdominal pain, nausea, vomiting, bleeding of the digestive tract, impaired renal and liver function are also possible). Treatment: drug withdrawal, rectal lavage, symptomatic therapy . There is no specific antidote.
STORAGE CONDITIONS
In a place protected from light, at a temperature from +8 oC to + 15 oC. Keep out of the reach of children. Shelf life – 2 years.
Before using Diclofenac suppositories 100 mg, you should consult your doctor. This instruction is intended for informational purposes only. To get more complete information Please refer to the manufacturer's instructions.