Inflammatory processes are caused by the influence of pathogenic microorganisms that can cause other diseases. A drug from the group of non-steroidal anti-inflammatory drugs - Dicloberl helps to fight the consequences of their activity.
For the treatment of diseases accompanied by an inflammatory process, Dicloberl or Dicloberl retard are best suited (a longer effect is provided after application).
Dikloberl instruction: composition and release forms
The drug in Russia is available in several forms, which can be used depending on which one is convenient or as indicated by the doctor's prescription.
- Dicloberl 50 - tablets with enteric capsules, and the number next to the name indicates the presence of 50 mg diclofenac sodium as the main substance in the composition. The auxiliary ingredients are:
- talc;
- simethicone emulsion;
- macrogol 400, 6000;
- povidone K-30;
- magnesium stearate;
- methacrylic acid;
- hypromellose;
- lactose monohydrate;
- copolymer of ethacrylate;
- corn starch.
E172 (iron oxide pigment) and E171 (titanium dioxide) are used as additives to tablets for patients. The drug is sold in the form of blisters of 50 and 100 pieces.
- Dicloberl suppositories 50 and 100, respectively, contain diclofenac sodium in two dosages of 50 mg and 100 mg. As auxiliary substances for the manufacture of this form is used:
- propyl gallate;
- solid fats;
- ethyl alcohol (96%);
- corn starch.
Suppositories can also be purchased in blisters (5 and 10 pieces).
- Dicloberla 75 solution, contains 75 mg of diclofenac. It is produced for intramuscular injection in ampoules of 3 ml, and there are 5 of them in each box.
- Dicloberl retard is a long-acting (prolonged) drug available in 100 mg diclofenac sodium capsules. Diklober retard is available in blisters - 10, 20 and 50 capsules.
Action and from what it is assigned
The medicine has pronounced anti-inflammatory, antipyretic, analgesic and antirheumatic properties. When the body is affected by rheumatism, the effect is manifested in the form of a decrease in stiffness in the joints in the morning, swelling over them and a decrease in the level of pain. Dicloberl is excreted in the urine, where 1% is unchanged diclofenac, and the rest is metabolites released in the bile and feces.
The drug can be divided, depending on the indications, into forms that are convenient to take in a particular case:
- Dicloberl in the form of tablets is used for rheumatic diseases (ankylosing spondylitis, spondyloarthritis, osteoarthritis); inflammatory pathology in gynecology, combined with pain syndrome (adnexitis); diseases of the ENT organs with symptoms of inflammation and pain (otitis media). It is often prescribed in conditions after surgery (orthopedic or dental intervention) or after trauma with signs of inflammation, pain; gout in the acute stage; the presence of pain syndrome with lesions of the spine; diseases of soft tissues after injury from rheumatism.
- Dicloberl in capsules allows you to relieve pain and reduce inflammation in musculoskeletal diseases (ankylosing spondylitis, gout attack, shoulder scapular periarthritis, tendovaginitis and others). Often the remedy is used for injuries of various origins, such as: dislocations, fractures, sprains, providing a noticeable analgesic effect. After a non-extensive dental or orthopedic intervention has been performed, the capsules can be used as an anti-inflammatory drug and in order to relieve pain.
- Dicloberl in the form of injections is allowed to inject with ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, pain syndrome of vertebrogenic origin (osteochondrosis), non-articular form of rheumatism, renal and hepatic colic, mild forms of migraine attacks, no pain syndrome, no pain syndrome.
In studies, it was found that the pharmacological effect is achieved by significantly reducing the synthesis of prostaglandins (responsible for inflammation, fever and pain syndrome). An analgesic effect is possible when applied in case of pain of a non-traumatic nature.
Application
Depending on the form of release, the drug must be used in different dosages, observing an individual approach and only after a prescription by a doctor.
Dicloberl tablets are taken at the beginning of therapy in the lowest dose in order to reduce the occurrence of side symptoms. They are taken 30 minutes or an hour before meals, washed down with water, and it is also forbidden to chew them when taken. The starting dose is not more than 150 mg / day. If the symptoms are not pronounced, then 75 mg / day may be prescribed. The prescribed dose must be divided in several doses, but in case of pain at night, the administration of rectal form of Dikloberl in the form of suppositories (50 mg) is allowed before bedtime.
If the drug is prescribed when the diagnosis of primary dysmenorrhea is established, then the dosage should not be exceeded 100 mg / day. With the onset of severe pain, it is allowed to increase it the same way, but for several periods. The appointment of treatment with Dikloberl is made on the first day after the onset of pain syndrome.
There is a certain specificity of prescribing medication for the elderly population. Prescribing the same dose does not affect the symptoms and effect, but they are more prone to side reactions from the stomach or intestines.
Important! When prescribing therapy, it is necessary to monitor the condition for gastric bleeding due to a decrease in the protective factors of the mucous membrane.
When prescribing Dikloberl in capsules, the recommended maximum dose is initially no more than 150 mg / day, Dikloberl retard - no more than 100 mg / day. As a rule, the maximum dosage (100 mg / day) of the prolonged form is sufficient to relieve the symptoms of pain and inflammation and is not recommended for use in children.
Dicloberl in the form of a solution for injection is not used for more than 2 days. If the need for further treatment persists, it is necessary to switch to tablets or suppositories. The drug is administered intramuscularly (1 ampoule), adhering to the minimum dose, if necessary, you can give an additional injection in the same dose, but observing an interval of at least 2-3 hours.
There are some nuances in the use of Dikloberl by patients with liver or kidney pathology of mild or moderate severity. The maximum allowable dose is considered to be 150 mg / day, so that undesirable effects do not occur.
Contraindications
If the patient has one of the restrictions indicated in the list, it is necessary to choose an individual dose acceptable for him with constant monitoring, or prescribe another drug.
- Intolerance to the drug or individual components in the composition.
- Bleeding from the stomach or intestines, history of perforation.
- Inflammatory bowel disease in the form of ulcerative colitis or Crohn's disease.
- Ulcers of the stomach, duodenum.
- Cerebrovascular disorders or diseases of the hematopoietic organs.
- Pathology of the kidneys or liver in severe severity.
- Pregnancy.
- Previous myocardial infarction, history of angina pectoris.
- Congestive heart failure.
- In all cases when the patient shows symptoms of bronchial asthma, angioedema, acute rhinitis or urticaria while using ibuprofen, aspirin.
Interaction
If the need arises for the simultaneous administration of lithium preparations, potassium-sparing diuretics, trimethoprim, cyclosporine, constant monitoring of the level of lithium or potassium is required. This is important due to the increase in their concentration in blood plasma in combination with NSAIDs.
If you need to take diuretics, antihypertensive drugs and Dikloberl, then constant monitoring of blood pressure is necessary in connection with the possibility of increasing the hypotensive effect. It is also important to monitor renal function due to the risk of nephrotoxicity.
Side effects
Adverse events after the use of Dikloberl are possible both after a short-term intake and as a result of long-term treatment from all organs and systems individually:
- Perhaps the appearance of mental disorders in the form of irritability, insomnia, depression.
- Side effects from the hematopoietic system are manifested in the form of anemia.
- On the part of the immune system, characteristic signs of hypersensitivity, severe urticaria and itching on the skin appear.
- The defeat of the respiratory system is manifested by bronchial asthma.
- Violations of the visual system and auditory system in the form of a decrease in their acuity, ringing in the ears and fog before the eyes.
- The digestive system is characterized by rich symptoms, which are characterized by: flatulence, pain in the abdomen, symptoms of gastritis, ulcers in the stomach or duodenum, constipation, stomatitis, glossitis and pancreatitis.
- Tachycardia, palpitations, vasculitis and a drop in blood pressure levels appear with disorders of the cardiac system.
- On the part of the skin, alopecia, toxic epidermal necrolysis, erythema, Stevens-Johnson syndrome, pruritus and eczema are possible.
- The renal system is disturbed in the form of the appearance of edema, nephrotic syndrome.
- Infiltrates or abscesses appear at the injection site with the introduction of Dicloberl solutions.
The appearance of side effects is possible with prolonged treatment with NSAIDs and on how much the drug is administered orally (more than 150 mg / day).
Dikloberl's analogs, price
There is a large list of funds called the analogue of Dicloberl. The most commonly purchased drugs are similar in pharmacological action and effects as follows:
- Pentalgin (tablets), the cost of which is 100-150 rubles.
- Voltaren emulgel (tablets, injections, ointment, patch). Price from 150 rubles.
- Analgin (tablets, suppositories, injections, capsules) can be purchased cheaper than other drugs, costing from 50 rubles.
- Nimesil (granules in sachets for suspension preparation) can be bought at a price of 630 rubles.
If we compare generics and original drugs, then the second ones have the highest positive result due to their greatest purity of structure and research. Generics are most often not experimented with, and therefore the final result is not clear.
In order to get acquainted with the instructions and effects in more detail, there is a forum where specialists of different specialties can answer questions of interest to patients.
1 ampoule with 3 ml of solution for injection contains diclofenac sodium 75 mg; in a box 5 pcs.
pharmachologic effect
pharmachologic effect- antipyretic, analgesic, anti-inflammatory.Inhibits cyclooxygenase, which is involved in the exchange of arachidonic acid, blocks the synthesis of PG.
Pharmacodynamics
The anti-inflammatory effect is due to interference in different links of the pathogenesis of inflammation: in addition to the main antiprostaglandin effect, increased permeability, microcirculation processes are normalized, the effect of histamine, bradykinin and other inflammatory mediators is reduced; the formation of ATP is inhibited, the energetics of the inflammatory process is reduced, etc. Analgesic properties are due to the ability to weaken the algogenicity of bradykinin, antipyretics - by a calming effect on the excitability of the heat-regulating centers of the diencephalon, changed under the influence of the pathological process.
Pharmacokinetics
After oral administration, it is completely absorbed. C max in plasma is achieved after 1-16 hours (with intramuscular injection - after 10-20 minutes, with rectal administration - after about 30 minutes). When administered orally, 35-70% enters the bloodstream unchanged (after passing through the liver). Plasma protein binding is about 99%. T 1/2 - 2 hours. Approximately 30% is excreted from the body in the form of metabolites by the intestines. About 70% is metabolized in the liver and excreted through the kidneys as inactive derivatives.
Indications of the drug Dikloberl ® N 75
Arthritis (rheumatoid, polyarthritis, gout attacks); ankylosing spondylitis (ankylosing spondylitis) and other rheumatic diseases of the spine, degenerative diseases of the joints and spine (arthrosis, spondyloarthrosis), rheumatic lesions of soft tissues, painful swelling and inflammation after trauma or surgery. Acute pain syndrome in the cases listed above (injections).
Contraindications
Hypersensitivity, hematopoiesis disorders of unexplained etiology, gastric and duodenal ulcers, induced porphyrias, bronchial asthma, children and adolescents (up to 18 years).
Application during pregnancy and lactation
Not recommended in the first six months of pregnancy, contraindicated in the last trimester (possibly inhibition of labor, premature closure of the arterial duct botanical, increased tendency to bleeding in the mother and child, intensive formation of edema in the mother). Avoid use during breastfeeding (passes into mother's milk).
Side effects
NSAID gastropathy, stomach and intestinal ulcers, bloody vomiting, bloody stools or diarrhea, headaches, dizziness, agitation, irritability, weakness, deafness, impaired sensitivity and taste, visual disturbances, tinnitus, hearing impairment, memory impairment, disorientation, fear , nightmares, tremors, depression, symptoms of aseptic meningitis, alopecia, eczema, erythema, blister eruptions, photosensitization, small-spotted skin hemorrhages, Stevens-Johnson syndrome, Lyell's syndrome, impaired renal function, renal failure, proteinuria, hematuria, transient transient increase in liver activity , hepatitis, isolated cases of changes in the level of glycemia, anemia, leukopenia, agranulocytosis, thrombocytopenia, pancreatitis, edema, palpitations, cardialgia, hypertension, allergic reactions (skin rash, itching, urticaria); local reactions (for suppositories): irritation, bloody mucus, painful bowel movements.
Interaction
Increases the level of digoxin and lithium in the blood plasma, the toxicity of cyclosporine for the kidneys, weakens the effect of diuretics and antihypertensive drugs. Acetylsalicylic acid reduces the serum concentration of diclofenac. When taken simultaneously with potassium-sparing diuretics, the likelihood of developing hyperkalemia increases. Glucocorticoids and other anti-inflammatory drugs increase the risk of gastrointestinal bleeding.
Method of administration and dosage
V / m, once. The maximum daily dose is 150 mg.
Overdose
Symptoms: disorders of the central nervous system (dizziness, headaches, hyperventilation, blurred consciousness, in children - myoclonic seizures), gastrointestinal disorders (nausea, vomiting, abdominal pain, bleeding), disorders of liver and kidney function.
Treatment: symptomatic.
Precautionary measures
Solution for injection is contraindicated in patients with bronchial asthma with hypersensitivity to sulfites. It is prescribed with caution to patients with pain in the stomach or intestines, persons with stomach and intestinal ulcers, incl. a history of patients with liver or kidney disease, high blood pressure and / or heart failure, who have undergone major surgical interventions, in old age. When administered together with anticoagulants, careful monitoring of the state of hemocoagulation is necessary. Combine with caution with potassium-sparing diuretics, glucocorticoids and other NSAIDs.
Storage conditions of the drug Dikloberl ® N 75
In a dry, dark place at a temperature not exceeding 25 ° C.Keep out of the reach of children.
Shelf life of the drug Dikloberl ® N 75
3 years.Do not use after the expiration date printed on the package.
Synonyms for nosological groups
| ICD-10 heading | Synonyms for diseases according to ICD-10 |
|---|---|
| M05 Seropositive rheumatoid arthritis | Arthritis rheumatoid seropositive |
| M10 Gout | Exacerbation of gout |
| Acute joint attack with gout | |
| Acute gouty attack | |
| Gout attack | |
| Recurrent gout attacks | |
| Chronic gout | |
| M45 Ankylosing spondylitis | Ankylosing spondylitis |
| Ankylosing spondylarthrosis | |
| Ankylosing spondylitis | |
| Pain syndrome in acute inflammatory diseases of the musculoskeletal system | |
| Pain syndrome in chronic inflammatory diseases of the musculoskeletal system | |
| Diseases of the spinal column | |
| Ankylosing spondylitis | |
| Ankylosing spondylitis-Marie-Strumpell disease | |
| Marie-Strumpel disease | |
| Rheumatic spondylitis | |
| Ankylosing spondylitis | |
| M47 Spondylosis | Diseases of the spinal column |
| Spondylosis | |
| Spondyloarthrosis | |
| Spondyloarthrosis | |
| M79.0 Rheumatism, unspecified | Degenerative rheumatic disease |
| Degenerative and rheumatic tendon diseases | |
| Degenerative rheumatic diseases | |
| Localized forms of soft tissue rheumatism | |
| Rheumatism | |
| Rheumatism with a pronounced allergic component | |
| Articular and extra-articular rheumatism | |
| Rheumatic attack | |
| Rheumatic complaints | |
| Rheumatic diseases | |
| Rheumatic diseases of the intervertebral disc | |
| Rheumatic disease | |
| Rheumatic spine disease | |
| Rheumatoid diseases | |
| Relapses of rheumatism | |
| Articular and extra-articular rheumatism | |
| Articular and muscular rheumatism | |
| Articular rheumatism | |
| Articular syndrome in rheumatism | |
| Chronic rheumatic pain | |
| Chronic articular rheumatism | |
| R52.1 Persistent intractable pain | Pain syndrome in oncological practice |
| Pain syndrome pronounced | |
| Pain syndrome in malignant neoplasms | |
| Pain syndrome in cancer | |
| Pain syndrome with tumors | |
| Pain syndrome in cancer patients | |
| Pain in malignant neoplasms | |
| Pain in malignant tumors | |
| Pain with tumors | |
| Pain in cancer patients | |
| Pain with bone metastases | |
| Pain in cancer | |
| Malignant pain syndrome | |
| Intense chronic pain | |
| Intense pain syndrome | |
| Intense intractable pain syndrome | |
| Intense chronic pain syndrome | |
| Unrestrained pain | |
| Unrestrained pain | |
| Tumor pain | |
| Post-traumatic pain syndrome | |
| Severe pain | |
| Chronic pain | |
| Chronic pain syndrome | |
| R52.2 Other persistent pain | Pain syndrome of non-rheumatic origin |
| Pain syndrome with vertebral lesions | |
| Pain syndrome with neuralgia | |
| Pain syndrome with burns | |
| Pain syndrome is mild or moderate | |
| Neuropathic pain | |
| Neuropathic pain | |
| Perioperative pain | |
| Moderate to severe pain | |
| Moderate or mild pain syndrome | |
| Moderate to severe pain syndrome | |
| Ear pain with otitis media | |
| Z100 * CLASS XXII Surgical Practice | Abdominal surgery |
| Adenomectomy | |
| Amputation | |
| Coronary angioplasty | |
| Angioplasty of the carotid arteries | |
| Antiseptic skin treatment for wounds | |
| Antiseptic hand treatment | |
| Appendectomy | |
| Atheroectomy | |
| Balloon coronary angioplasty | |
| Vaginal hysterectomy | |
| Coronal bypass | |
| Interventions on the vagina and cervix | |
| Bladder interventions | |
| Intervention in the oral cavity | |
| Reconstructive surgery | |
| Hand hygiene of medical personnel | |
| Gynecological surgery | |
| Gynecological interventions | |
| Gynecological operations | |
| Hypovolemic shock during operations | |
| Disinfection of purulent wounds | |
| Disinfection of wound edges | |
| Diagnostic interventions | |
| Diagnostic procedures | |
| Diathermocoagulation of the cervix | |
| Long-term surgical operations | |
| Replacing fistula catheters | |
| Orthopedic surgery infection | |
| Artificial heart valve | |
| Cystectomy | |
| Short-term outpatient surgery | |
| Short-term operations | |
| Short-term surgical procedures | |
| Cricothyrotomy | |
| Surgical blood loss | |
| Bleeding during surgery and in the postoperative period | |
| Culdocentesis | |
| Laser coagulation | |
| Laser coagulation | |
| Retinal laser coagulation | |
| Laparoscopy | |
| Laparoscopy in gynecology | |
| CSF fistula | |
| Small gynecological operations | |
| Minor surgical interventions | |
| Mastectomy and subsequent plasty | |
| Mediastinotomy | |
| Microsurgery on the ear | |
| Mucogingival operations | |
| Suture | |
| Minor surgical interventions | |
| Neurosurgery | |
| Immobilization of the eyeball in ophthalmosurgery | |
| Orchiectomy | |
| Complications after tooth extraction | |
| Pancreatectomy | |
| Pericardiectomy | |
| Rehabilitation period after surgery | |
| Convalescence period after surgery | |
| Percutaneous transluminal coronary angioplasty | |
| Pleural thoracocentesis | |
| Postoperative and post-traumatic pneumonia | |
| Preparing for Surgical Procedures | |
| Preparing for surgery | |
| Preparing the surgeon's hands before surgery | |
| Colon preparation for surgery | |
| Postoperative aspiration pneumonia in neurosurgical and thoracic operations | |
| Postoperative nausea | |
| Postoperative bleeding | |
| Postoperative granuloma | |
| Postoperative shock | |
| Early postoperative period | |
| Myocardial revascularization | |
| Root apex resection | |
| Stomach resection | |
| Bowel resection | |
| Resection of the uterus | |
| Liver resection | |
| Small bowel resection | |
| Resection of a part of the stomach | |
| Reocclusion of the operated vessel | |
| Bonding of tissues during surgery | |
| Removal of stitches | |
| Condition after eye surgery | |
| Condition after surgery | |
| Condition after surgery in the nasal cavity | |
| Condition after gastric resection | |
| Condition after resection of the small intestine | |
| Condition after tonsillectomy | |
| Condition after removal of the duodenum | |
| Condition after phlebectomy | |
| Vascular surgery | |
| Splenectomy | |
| Sterilization of surgical instruments | |
| Sterilization of surgical instruments | |
| Sternotomy | |
| Dental operations | |
| Dental intervention on periodontal tissues | |
| Strumectomy | |
| Tonsillectomy | |
| Thoracic surgery | |
| Thoracic surgery | |
| Total gastrectomy | |
| Transdermal intravascular coronary angioplasty | |
| Transurethral resection | |
| Turbinectomy | |
| Removal of a tooth | |
| Removal of cataracts | |
| Removal of cysts | |
| Removal of tonsils | |
| Removal of fibroids | |
| Removal of movable milk teeth | |
| Removal of polyps | |
| Removing a broken tooth | |
| Removal of the body of the uterus | |
| Removal of stitches | |
| Urethrotomy | |
| Fistula of the cerebrospinal fluid | |
| Frontoetmoidogaymorotomy | |
| Surgical infection | |
| Surgical treatment of chronic limb ulcers | |
| Surgery | |
| Anal surgery | |
| Colon surgery | |
| Surgical practice | |
| Surgical procedure | |
| Surgical interventions | |
| Surgical interventions on the gastrointestinal tract | |
| Surgical interventions on the urinary tract | |
| Surgical interventions on the urinary system | |
| Surgical interventions on the genitourinary system | |
| Heart surgery | |
| Surgical manipulations | |
| Surgical operations | |
| Vein surgery | |
| Surgical intervention | |
| Vascular surgery | |
| Surgical treatment of thrombosis | |
| Surgery | |
| Cholecystectomy | |
| Partial gastric resection | |
| Transperitoneal hysterectomy | |
| Percutaneous transluminal coronary angioplasty | |
| Percutaneous transluminal angioplasty | |
| Coronary artery bypass surgery | |
| Tooth extirpation | |
| Extirpation of milk teeth | |
| Pulp extirpation | |
| Extracorporeal circulation | |
| Tooth extraction | |
| Extraction of teeth | |
| Extraction of cataract | |
| Electrocoagulation | |
| Endourological interventions | |
| Episiotomy | |
| Ethmoidotomy |
For diseases of the joints and nerves, Dicloberl is widely used. The article will tell you in what cases and for what it is used, and helps you understand how to take the drug correctly in case of concomitant diseases in order to avoid problems with unwanted effects.
Attention is paid to important changes in the instructions for the use of Dikloberl in injections, tablets and retard capsules, prices for analogues and reviews of the drug.
Instructions for use
Dicloberl is a German medicine containing the anti-inflammatory component diclofenac. The substance belongs to the non-steroidal group of chemical compounds and, in addition to reducing inflammation, it exhibits antipyretic and analgesic effects.
Indications for use
The drug is used as part of therapeutic regimens for rheumatic lesions of the musculoskeletal system, in neurological, traumatological, surgical and general practice to reduce pain and inflammation. Injections are used for a short time, up to 2 days, in cases:
- articular and extra-articular manifestations of rheumatism;
- spondylloarthritis;
- osteochondrosis;
- inflammation of the vertebrae with ankylosis;
- osteoarthritis;
- rheumatoid joint lesions;
- arthritis with pain syndrome with gout;
- pain relief after injuries and operations;
- hepatic and urinary colic.
Tablets and capsules are intended for long-term treatment of the listed conditions and for the treatment of infectious and inflammatory lesions of different localization: in the pathology of ENT organs, in gynecology, urology.
In the same cases, suppositories are used for insertion into the rectum. For diseases of the pelvic organs, they work better than tablets and capsules.
Forms of release and composition
The drug is available in several dosage forms:
- Solution for injection "Dikloberl N75". Available in ampoules of 3 ml, the dose of diclofenac is 75 mg.
- 50 milligram tablets containing standard auxiliary ingredients.
- Dikloberl-retard capsules with a sustained release of the active substance with a dosage of 0.1 gram.
- Suppositories for rectal use, 50 and 100 milligrams... They contain solid fat as a form-building component.
Price in pharmacies
The average cost of a medicine in Ukrainian pharmacies: the price of a package of 5 ampoules is 105 hryvnia, the same amount is 50 tablets, 10 candles or 20 retard capsules will cost 120 hryvnia.
Dikloberl is not registered in Russia and is not available for purchase in pharmacies; it can be purchased only in neighboring countries - Kazakhstan, Belarus, Ukraine.
Features of use
For a long time, diclofenac was considered the reference substance for the treatment of inflammation, but it began to lose out to new drugs due to the relatively frequent undesirable effects.
Its gastrotoxicity is well known - a negative effect on the stomach. This problem is partially solved by taking medicine after meals and using medicines that reduce acidity - omeprazole, ranitidine.
The likelihood of developing thrombosis is important and much more dangerous - the list of side effects includes formidable complications in the form of myocardial infarction and stroke... To reduce the risk, you should avoid taking Dikloberl for any problems with heart rhythm, congestive circulatory failure and thrombosis, and not only in the presence of obvious contraindications such as coronary artery disease or a previous heart attack.
It is necessary to remember about the decrease in the effect of antihypertensive drugs against the background of long-term use of diclofenac and not to exceed the duration of treatment with Dicloberl injections, which, according to the instructions, should not be more than 2 days.
The use of the minimum required doses allows you to reduce the unwanted effects of the drug. This also applies to substitute drugs.
Dikloberl's analogs
Pharmacies offer a huge selection of diclofenac preparations in all forms of release and a sufficient number of similar anti-inflammatory drugs containing other active ingredients.
Medicines identical to suppositories, retard capsules and ampoules of Dikloberl are represented by several dozen cheap generic drugs of Russian and foreign production with names according to the active substance, and the original drug Voltaren (a reference drug that is more expensive than others).
The cost of other synonyms is much more affordable:
- injections made in Russia cost from 30 rubles for 5 ampoules, foreign - from 55 rubles;
- imported tablets 50 milligrams No. 20 cost from 45 rubles, domestic - from 30;
- candle price differs 5 times, amounting to 40-60 and 250 rubles for Russian and British suppositories;
- differences in the cost of capsules also in favor of the domestic manufacturer: packs of 20 are sold at 70 and 40 rubles.
At the same time, some patients note the best effect from the use of expensive diclofenac drugs.
Most other NSAIDs replace Dicloberl depending on the clinical situation. OTC anti-inflammatory drugs - ibuprofen, naproxen and aspirin are inferior in strength to diclofenac.
Meloxicam, aceclofenac, celecoxib and ketoprofen will have a similar effect on chronic joint damage. With severe acute pain syndrome, Dicloberl can be replaced with lornoxicam and ketorolac. Often They are trying to replace diclofenac with nimesulide, but this option is much worse.
Meloxicam
The best replacement option when treating joints because improves cartilage condition... It is produced in ampoules of 15 mg, injected intramuscularly 1 time per day.
Tablets of 7.5 and 15 milligrams are intended for a single daily dose. Medication not so bad for the stomach and can be used for a long time.
Imported drug Meloxicam-Teva stot 210 rubles for 10 tablets of 15 mg. This analogue of the drug Dikloberl in injections is available in Russia at a price of about 450 rubles for 5 ampoules, and the Russian-made drug will be 2-3 times cheaper.
Aertal
An improved version of diclofenac, available in oral form. Aceclofenac is chosen when looking for what to replace Dicloberl in retard capsules and tablets. The analog is the closest in action and application features.
The cost of the Hungarian drug "", 20 doses of 100 mg in tablets or packets are sold for 320-390 rubles. Russian-made aceclofenac costs three times less.
This analogue of Dikloberl can be purchased in Belarus, the cost is from 10 Belarusian rubles.
Ketoprofen
Available in ampoules, capsules, suppositories and tablets. It has a similar pharmacological profile and is easier to tolerate.
Prices for inexpensive Russian drugs of ketoprofen: 10 ampoules - 70 rubles, 10 suppositories - 250 rubles, tablets and capsules of 50 and 100 milligrams cost 70 and 130 rubles for 20 pieces.
Celecoxib capsules
Selective anti-inflammatory drug that replaces oral versions of Dicloberl, produced in doses of 100 and 200 mg. Does not affect the stomach.
Its options in Russia: foreign Dilaxa and Russian Roucoxib-Routek with a cost of 275 rubles for 10 doses. An import analogue of Dikloberl is available in Ukraine - Ranselex, 10 capsules cost 50 hryvnia.
Ketorolac
Medication in ampoules and tablets used for pain relief in postoperative conditions, trauma, toothache and even in oncology. It is not used for inflammatory diseases of the joints, since it shows the maximum effect in violation of the integrity of tissues.
Lornoxicam
Shows the strongest analgesic effect in inflammatory and traumatic pain. Its analgesic effect is comparable to ketorolac, but it loses in price.
In Russia, only the original Austrian drug lornoxicam Ksefokam is sold, 10 vials of this analogue of Dicloberl for injections of 8 mg cost from 600 rubles, 10 tablets of the same dosage - 180 rubles. In Ukraine, its cheap substitute Larfix is available at 30 hryvnia for 10 tab.
Nimesulide (Nimesil)
This drug should be mentioned separately, because it is often positioned as a remedy for the treatment of joints and is advised as a substitute for diclofenac. In fact, osteoarthritis was excluded from the list of indications for its use, the drug is recommended to be prescribed only for acute pain and dysmenorrhea. The cost of 30 doses of 100 mg each - from 650 rubles.
Replacing a non-steroidal anti-inflammatory drug, the doctor determines how much the strength of action can change when using an analogue, therefore it is worth using the help of doctors. You do not need to find another medicine yourself.
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Alexander Igorevich
As I got older, I developed knee problems. It turns out that inflammation of the right knee joint began to develop. He was treated as best he could and using different methods. But a few months ago, the pain became so severe that I could no longer tolerate it. My doctor prescribed Dicloberl injections. It is anti-inflammatory and antirheumatic. It is quite strong and effective. But... As I got older, I developed knee problems. It turns out that inflammation of the right knee joint began to develop. He was treated as best he could and using different methods. But a few months ago, the pain became so severe that I could no longer tolerate it. My doctor prescribed Dicloberl injections. It is anti-inflammatory and antirheumatic. It is quite strong and effective. But you need to consider a huge list of contraindications and side effects. The injections were not easy for me, they were very painful. But there is a result from them. After them, I felt better and the terrible pains disappeared.
Catherine
The whole family tried Dikloberl - through joint pains. My husband had lower back pain, my grandmother suffers from rheumatoid arthritis, and my dad has gout. Dikloberl relieves the inflammatory process. The active agent is diclofenac, which also relieves pain. It can cause various side effects, so you need to use it carefully. The whole family tried Dikloberl - through joint pains. My husband had lower back pain, my grandmother suffers from rheumatoid arthritis, and my dad has gout. Dicloberl relieves the inflammatory process.
The active agent is diclofenac, which also relieves pain.
It can cause various side effects, so you need to use it carefully.
razumova
Well helped with inflammation of the hip joint. I put only 3 candles, one for the night, then switched to midocalm and ultra elbon, the pain was no longer so strong. As a result, there are no side effects and a good result.
I suffered a mengito encephalitis in 2002 .. over the years my knees feel sad and my veins otikat whine I get tired I drank calcium and it’s good -0.
I don’t know how to write it correctly! but I started injecting Dicloberl No. 75 and after it my leg was taut! that almost after the injection I can't stand on it! do you think this is normal or should you stop using it?
Did mammoplasty, in the postoperative period terrible pain in the back and not only, slept for 2 hours and walked for 30 minutes so that it became easier for the back, the swelling is very strong. With the help of the drug, Dikloberg slept all night for the first time and felt normal during the day. while... did mammoplasty, in the postoperative period terrible pain in the back and not only, slept for 2 hours and walked for 30 minutes so that it became easier for the back, the swelling is very strong. With the help of the drug, Dikloberg slept all night for the first time and felt normal during the day. while the 3rd injection, maybe I will still inject
In this article, you can read the instructions for using the medicinal product. Dicloberl... The reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Dicloberl in their practice are presented. A big request to more actively add your reviews about the drug: did the medicine help or did not help get rid of the disease, what complications and side effects were observed that may not have been declared by the manufacturer in the annotation. Dikloberl's analogs in the presence of available structural analogs. Use for the treatment of arthritis, arthrosis and pain relief in adults, children, as well as during pregnancy and lactation. Composition of the preparation.
Dicloberl- non-steroidal anti-inflammatory drug (NSAID), a derivative of phenylacetic acid. The active ingredient of the drug is sodium diclofenac. Has a pronounced anti-inflammatory effect by inhibiting the synthesis of prostaglandins. It has antipyretic, analgesic and decongestant (tissue edema during inflammation) effect. Reduces the adhesive properties of platelets under the action of collagen and ADP.
The anti-inflammatory effect is due to interference in different links of the pathogenesis of inflammation: in addition to the main antiprostaglandin effect, increased permeability, microcirculation processes are normalized, the effect of histamine, bradykinin and other inflammatory mediators is reduced; the formation of ATP is inhibited, the energetics of the inflammatory process is reduced, etc. Analgesic properties are due to the ability to weaken the algogenicity of bradykinin, antipyretics - by a calming effect on the excitability of the heat-regulating centers of the diencephalon, changed under the influence of the pathological process.
Composition
Diclofenac sodium + excipients.
Pharmacokinetics
After oral administration, diclofenac is completely absorbed from the intestine. After absorption from the intestine, presystemic metabolism occurs due to the primary passage through the liver. 35-70% of the active substance enters the post-hepatic circulation. After the introduction of the suppository into the rectum, Cmax in the blood plasma is observed after 30 minutes.
Approximately 30% of diclofenac is metabolized. Metabolic products are eliminated by the intestines. Inactive metabolites obtained by conjugation and hydroxylation by hepatocytes are eliminated by the kidneys. The half-life is 2 hours and does not depend on the functions of the kidneys and liver. Binds to blood proteins 99% of the drug.
Indications
Symptomatic treatment of pain and inflammation in:
- acute arthritis (including gout attacks);
- chronic arthritis, in particular with rheumatoid arthritis (chronic polyarthritis);
- ankylosing spondylitis (ankylosing spondylitis) and other inflammatory rheumatic diseases of the spine;
- painful tissue irritation with arthrosis and spondyloarthrosis;
- inflammatory diseases of a rheumatic nature with damage to soft tissues;
- edema with pain syndrome or post-traumatic inflammation;
- fever and fever.
Forms of issue
Tablets 50 mg.
Rectal suppositories 50 mg.
Solution for injection N 75 (injections in ampoules).
Sustained-release capsules 100 mg (Dicloberl Retard).
Instructions for use and dosage
Ampoules
Adults. Dicloberl N 75 injection is performed once (75 mg of sodium diclofenac). To continue treatment, dosage forms for oral or rectal administration are used. Moreover, even on the day of injection, the total dose of diclofenac sodium should not exceed 150 mg.
Method and duration of use
Dicloberl N 75 is injected intramuscularly deep into the buttocks. Dicloberl N 75 injection is performed once. Due to the potential risk of anaphylactic reactions (up to shock), the patient after the administration of Dikloberl 75 should be monitored for at least an hour; at the same time, the necessary for the provision of emergency care and serviceable (functioning) medical instruments must be at the ready. The patient needs to explain the meaning of these measures.
The duration of the drug is determined by the attending physician.
Pills
Dicloberl 50 tablets are taken orally during meals (to eliminate the irritating effect on the gastric mucosa), with a small amount of liquid. Do not chew. The daily dose - 50-150 mg - is divided into 2-3 doses. The duration of therapy is determined by the doctor individually.
Retard capsules
The dose in adults is 1 capsule of Dicloberl retard with prolonged action per day (equivalent to 100 mg of sodium diclofenac).
Dikloberl retard should be taken orally whole, without chewing, and washed down with plenty of liquid. Patients with a sensitive stomach are advised to take Dicloberl retard with meals.
The question of the duration of the use of the drug is decided by the attending physician.
Therapy of rheumatic diseases may require long-term use of the drug Dikloberl retard.
Undesirable effects can be reduced by prescribing the minimum effective dose of the drug for the shortest possible period of time necessary to relieve the symptoms of the disease.
Rectal suppositories
Dicloberl 50 suppositories are injected deep into the rectum after a bowel movement. The dose is determined individually by the doctor, depending on the severity of the disease. Usually, the daily dose should be in the range of 50-150 mg (for adults and children over 15 years of age). The daily dose is administered in 2-3 doses.
Side effect
- dyspepsia;
- glossitis;
- esophagitis;
- liver damage;
- exacerbation of gastrointestinal diseases;
- pancreatitis;
- constipation, diarrhea;
- stomach ache;
- nausea, vomiting;
- decreased appetite;
- possible small gastrointestinal bleeding;
- in patients with gastrointestinal diseases, bleeding and ulcer perforation may occur;
- melena;
- bloody vomiting;
- bloody diarrhea;
- dizziness;
- headache;
- insomnia;
- increased fatigue;
- excitation;
- changes in taste;
- sensitivity disorders;
- changes in the perception of sounds;
- visual impairment;
- disorientation;
- a feeling of fear;
- convulsions;
- depression;
- tremor;
- stiff neck muscles (aseptic meningitis);
- confusion of consciousness;
- skin rash;
- bullous rashes;
- burning sensation at the injection site;
- sterile abscess at the injection site;
- Lyell's syndrome;
- necrosis of subcutaneous adipose tissue at the injection site;
- swelling of the tongue, face and larynx;
- Stevens-Johnson syndrome;
- anaphylactic shock;
- bronchospasm;
- thrombocytopenia, anemia, agranulocytosis, leukopenia;
- chest pain;
- palpitations;
- lowering blood pressure;
- arterial hypertension;
- pulmonitis.
Contraindications
- hypersensitivity to the active substance or to any of the other components of the drug;
- reactions in the form of bronchospasm, asthma, rhinitis or urticaria rash after taking acetylsalicylic acid or other nonsteroidal antirheumatic / anti-inflammatory drugs (NSAIDs) in history;
- unexplained disorders of hematopoiesis;
- current or previous recurrent peptic ulcer / bleeding (at least two different episodes of confirmed peptic ulcer or bleeding);
- a history of gastrointestinal bleeding or perforation associated with previous NSAID therapy;
- cerebrovascular or other currently available bleeding;
- severe impairment of liver or kidney function;
- severe heart failure;
- the last trimester of pregnancy;
- children under 15 years of age (suppositories), under 18 years of age (Retard capsules and injections).
Application during pregnancy and lactation
Pregnancy
Suppression of prostaglandin synthesis can adversely affect pregnancy and / or embryo / fetal development. According to the results of epidemiological studies, in the early stages of pregnancy, the use of drugs that suppress prostaglandin synthesis can increase the risk of spontaneous abortion, the occurrence of heart defects in the fetus and anterior abdominal wall non-closure. Thus, the absolute risk of the formation of cardiovascular malformations increased from less than 1% to approximately 1.5%. It is believed that the risk of these phenomena increases with an increase in the dose of the drug and the duration of its use.
In animals, the use of an inhibitor of prostaglandin synthesis contributed to an increase in pre- and post-implantation rejection and an increase in embryofetal mortality. In addition, in animals that received an inhibitor of prostaglandin synthesis during organogenesis, the incidence of various fetal malformations, including malformations of the cardiovascular system, increased.
The appointment of Dikloberl during the first and second trimester of pregnancy is possible only when there is an urgent need for it. In the case of prescribing diclofenac to women planning pregnancy, or in the first and second trimester of pregnancy, the lowest possible dose and the shortest possible duration of treatment should be chosen.
In the third trimester of pregnancy, all inhibitors of prostaglandin synthesis can lead to the development in the fetus:
- phenomena of cardiopulmonary toxicity (eg, premature closure of the ductus arteriosus and hypertension in the pulmonary artery system);
- renal dysfunction, which can progress to renal failure with the development of oligohydramnios;
at the end of pregnancy can lead to the mother and fetus:
- prolongation of bleeding time, antiaggregatory effect, which can occur even with very low doses of the drug;
- suppression of the contractile activity of the uterus, which can lead to a delay or delay in labor.
In this regard, Dicloberl is contraindicated in the third trimester of pregnancy.
Lactation
The active ingredient diclofenac and its decay products in small quantities enter the mother's milk. Since at present the harmful effects of the drug on newborns have not been established, then, as a rule, with short-term use of the drug, interruption of breastfeeding is not required. However, with prolonged treatment with diclofenac or when using high doses for diseases of a rheumatic nature, the possibility of stopping breastfeeding should be considered.
Fertility
Dicloberl can reduce female fertility, and therefore it is not recommended for women planning pregnancy. In women who have difficulty conceiving or undergoing examination for infertility, the possibility of canceling Dicloberl should be considered.
Application in children
Contraindicated in children and adolescents under the age of 18 (injections, Dicloberl Retard capsules).
Contraindicated in children under 15 years of age (rectal suppositories).
Use in elderly patients
Elderly patients have an increased incidence of adverse reactions to NSAIDs, especially gastrointestinal bleeding and perforation, including fatal ones.
special instructions
Gastrointestinal precautions
Avoid the co-administration of the drug Dicloberl and other NSAIDs, including selective inhibitors of cyclooxygenase-2.
Adverse effects can be reduced by using the lowest effective dose for the shortest period necessary to relieve symptoms.
Gastrointestinal bleeding, ulcer and ulcer perforation
Gastrointestinal bleeding, ulceration or perforation, in some cases fatal, has been reported for all NSAIDs at all stages of treatment, with or without precursor symptoms and regardless of the presence or absence of a history of serious gastrointestinal pathology.
The risk of gastrointestinal bleeding, ulceration, or perforation increases with an increase in the dose of the nonsteroidal anti-inflammatory drug in patients with a history of ulcers, especially those complicated by bleeding or perforation, and in older patients. In such cases, treatment should be started with the lowest possible dose. For these patients, and for patients on low-dose aspirin or other drugs that increase the risk of gastrointestinal adverse events, combination therapy with drugs that have a protective effect on the gastrointestinal tract (for example, misoprostol or proton inhibitors) should be considered. pump).
Patients with a history of gastrointestinal toxicity, in particular elderly patients, should report any unusual abdominal symptoms (especially gastrointestinal bleeding); this is most important for the initial stages of treatment. Diclofenac should be used with caution in patients who are simultaneously taking drugs that may increase the risk of ulcers or bleeding; These include oral corticosteroids, anticoagulants such as warfarin, selective serotonin reuptake inhibitors, or antiplatelet agents (antiplatelet agents) such as. aspirin.
With the development of gastrointestinal bleeding during treatment with diclofenac, the drug should be discontinued.
Nonsteroidal anti-inflammatory drugs should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease) due to the risk of their exacerbation.
Effects on the cardiovascular system and cerebrovascular circulation
Diclofenac should be used with caution in patients with arterial hypertension and / or decompensated heart failure from mild to moderate severity in history, since fluid retention and the development of edema are possible during the treatment of NSAIDs.
According to the results of clinical studies and epidemiological data, the use of diclofenac, especially in high doses (150 mg per day) and for a long time, may be accompanied by a slight increase in the risk of arterial thrombosis (for example, myocardial infarction or stroke).
Patients with uncontrolled arterial hypertension, heart failure, ischemic heart disease, obliterating endarteritis and / or cerebrovascular pathology should be prescribed diclofenac only after weighing everything carefully. The same issues should be resolved before starting long-term treatment of patients with risk factors for cardiovascular diseases (for example, arterial hypertension, hyperlipidemia, diabetes mellitus, smoking).
Skin reactions
Reported rare cases of serious skin reactions, sometimes fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's syndrome), during treatment with NSAIDs. The risk of such reactions is highest at the beginning of treatment; most of the described phenomena were observed in the first months of therapy. Dicloberl should be canceled at the first appearance of a skin rash, mucosal lesions or other signs of hypersensitivity.
Liver effects
Diclofenac should be used with caution in patients with impaired liver function, as their condition may worsen during treatment. With long-term treatment or repeated administration of diclofenac, it is recommended - as a precaution - to regularly check liver function. When clinical signs of liver pathology appear, the drug must be canceled.
Further instructions
In the following cases, Dicloberl should be prescribed only after a careful assessment of the benefit-risk ratio:
- with congenital disorders of porphyrin metabolism (for example, with acute intermittent porphyria);
- with systemic lupus erythematosus (SLE) and mixed collagen diseases.
In the following cases, especially careful monitoring by the attending physician is necessary:
- with a decrease in kidney function;
- with impaired liver function;
- immediately after major surgery;
- with allergies to pollen, nasal polyps and chronic obstructive respiratory diseases, since these patients have an increased risk of allergic reactions. These reactions can be manifested by asthma attacks (called analgesic asthma), Quincke's edema, or urticarial rash;
- with allergies to other substances, since such patients have an increased risk of hypersensitivity reactions, including during treatment with Dicloberl.
Dicloberl should not be injected into the site of inflammation or infection.
Very rarely, severe acute hypersensitivity reactions (eg, anaphylactic shock) have been observed. When the first signs of a hypersensitivity reaction appear, Dikloberl should be canceled, and professional treatment should be started in accordance with the developed symptoms.
Diclofenac may temporarily suppress platelet aggregation. In this regard, it is necessary to monitor the condition of patients with bleeding disorders.
Like other NSAIDs, diclofenac can mask the manifestations of infection due to its pharmacodynamic properties. If, against the background of treatment with Dicloberl, the symptoms of infection reappear or worsened, the patient is advised to immediately consult a doctor who will determine whether there are indications for the appointment of anti-infective therapy or antibiotic therapy.
With long-term treatment with diclofenac, kidney function and complete blood count should be checked regularly.
Long-term use of pain relievers may cause headaches. You should not try to eliminate the headache by increasing the dose of the drug.
Prolonged use of pain relievers, especially when several anesthetic active ingredients are combined, may damage the kidneys of a persistent nature with the risk of renal failure (analgesic nephropathy).
With a combination of NSAIDs and alcohol, it is possible to increase the undesirable effects of the active substance of the drug, especially on the gastrointestinal tract or the central nervous system.
Impact on the ability to drive and maintain machinery
When treating with Dikloberl in high doses, side effects from the central nervous system may occur, such as increased fatigue and dizziness; therefore, in some cases, patients may have impaired reaction and a deterioration in the ability to actively participate in traffic and to maintain mechanisms. These phenomena are enhanced when the drug is combined with alcohol intake.
Drug interactions
Other NSAIDs, including salicylates: Concomitant use of some NSAIDs may increase the risk of ulcers and gastrointestinal bleeding due to the synergistic action of the drugs. In this regard, the combined use of diclofenac and other NSAIDs is not recommended.
Digoxin, phenytoin, lithium: When administered together, Dicloberl can increase the concentration of digoxin, phenytoin and lithium in the blood. In this regard, during treatment with diclofenac, control of serum lithium concentration is mandatory, and digoxin and phenytoin is recommended.
Diuretics, ACE inhibitors and angiotensin 2 antagonists: NSAIDs can reduce the effectiveness of diuretics and other antihypertensive drugs. In some patients with impaired renal function (e.g., dehydration or elderly patients with impaired renal function), when taking ACE inhibitors or angiotensin 2 antagonists in conjunction with a drug that inhibits cyclooxygenase, further deterioration of renal function is possible, including the possible development of acute renal failure. which, however, in most cases is reversible. In this regard, these drugs should be prescribed with caution in combination with diclofenac, especially in elderly patients. With the joint administration of diclofenac and these drugs, it is necessary to ensure that the patient takes an adequate amount of fluid, and also should - after the start of treatment, regularly monitor renal function.
The concomitant use of Dicloberl and potassium-sparing diuretics can lead to the development of hyperkalemia. In this regard, it is recommended to control the concentration of potassium in the blood with the joint administration of these drugs.
Glucocorticoids: When administered together with diclofenac, the risk of ulcers and gastrointestinal bleeding increases.
Drugs that inhibit platelet aggregation (for example, acetylsalicylic acid) and selective serotonin reuptake inhibitors (SSRIs): When administered together with diclofenac, the risk of gastrointestinal bleeding increases.
Methotrexate: With the introduction of Dicloberl within 24 hours before or after the administration of methotrexate, an increase in the concentration of methotrexate in the blood and an increase in its toxic effects are possible.
Cyclosporine: NSAIDs (eg, diclofenac sodium) may increase the nephrotoxic effects of cyclosporine.
Anticoagulants: NSAIDs can enhance the effect of anticoagulants such as warfarin.
Sulfonylurea: There are isolated reports of changes in blood glucose concentration after the use of diclofenac, requiring a dose adjustment of the antidiabetic drug. In this regard, with joint therapy, it is recommended to control the concentration of glucose in the blood.
Probenecid and sulfinpyrazone: Medicines containing probenecid and sulfinpyrazone may delay the elimination of diclofenac from the body.
There have been no studies on the compatibility of diclofenac, so it should not be mixed with other drugs.
Analogues of the drug Dikloberl
Structural analogues for the active substance:
- Veral;
- Voltaren;
- Diklak;
- Diklo F;
- Diclobene;
- Dicloberl N 75;
- Dicloberl Retard;
- Diklovit;
- Diclogen;
- Diklomax;
- Diclomelan;
- Diklonak;
- Diclonat P;
- Dicloran;
- Diclorium;
- Diclofen;
- Diclofenac;
- Diclofenac sodium;
- Diclofenac retard;
- Diclofenacol;
- Diphen;
- Naklofen;
- Naklofen Duo;
- Ortofen;
- Orthofer;
- Rapten Duo;
- Rapten Rapid;
- Revmavek;
- Revodina retard;
- Remetane;
- Sanfinak;
- SwissJet;
- SwissJet Duo;
- Tabuk Dee;
- Feloran 25;
- Feloran retard;
- Flotak.
In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and see the available analogues for the therapeutic effect.
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