How often can you give Voltaren injections and instructions for using this drug

Compound

The main active ingredient is diclofenac sodium. 3 ml of the product contains up to 75 mg of this compound.

Voltaren (solution) includes the following auxiliary components:

• beckons;
• sodium hydroxide;
• propylene glycol;
• benzyl alcohol;
• water for injections;
• sodium metabisulfite, etc.

The drug is packaged in glass ampoules of 3 ml. They are placed in cardboard packs of 5 pieces.

Areas of application of Voltaren and its substitutes

Voltaren is also very effective for moderate and severe rheumatic pain accompanied by inflammation and fever, which expands the scope of its application. The pain is significantly relieved a quarter of an hour to half an hour after using the drug, especially if the drug was administered by injection. For example, the drug has proven its effectiveness in relieving swelling and reducing pain in the post-traumatic and post-operative period.

The wounds do not bother the patient as much after using Voltaren and are fully scarred. When combined with opioids, voltaren reduces the patient's need to use the latter due to its ability to quickly, sustainably and lastingly relieve pain. In addition, Voltaren reliably eliminates headaches due to migraines of various origins.

When are Voltaren and Diclofenac used?

Voltaren or diclofenac sodium are used for the following health problems:

• Diseases of the musculoskeletal system associated with inflammatory and/or degenerative processes, accompanied by limited mobility;
• Diseases of the spine, characterized by severe pain and difficulty in movement;
• Myalgia as a symptom, that is, muscle pain, including non-inflammatory nature;
• Neuralgia as a symptom, including inflammatory and non-inflammatory processes in the peripheral nervous system;
• Sciatica as a symptom of any underlying disease;
• Arthralgia as a symptom in most diseases of the musculoskeletal system of a non-infectious nature;
• Colic - biliary, renal, less often hepatic;
• Migraine, including severe attacks;
• Post-traumatic and post-operative periods with swelling and pain of penetrating, non-penetrating and surgical wounds.

Diclofenac has a wider range of applications. In particular, it is indicated locally in the following cases:

• Prevention of macular edema during lens removal and implantation;
• Inhibiting miosis or slowing pupil constriction during cataract surgery;
• Inflammatory diseases of the organs of vision not associated with infection;
• Post-traumatic conditions of the eyes after injuries.

Voltaren is not used in ophthalmology.

This is the main difference between Voltaren and diclofenac in terms of pharmacological effects. The spectrum of effects of diclofenac and voltaren, created on its basis, is similar.

Diclofenac is also used in veterinary medicine, especially in the treatment of arthritis, arthrosis, and injuries. Voltaren is prescribed less frequently for veterinary purposes. Most likely this is due to the difference in the cost of drugs.

Popular Analogues of Ketorol injections and tablets and their differences

Voltaren release forms

Voltaren is best known to patients in the form of an injection solution, packaged in glass ampoules, as well as in the form of gels applied to the skin in the area of ​​pain or inflammation. Less commonly used are tablets and rectal suppositories with this drug. Even more rarely, patches for applications and sprays sprayed externally are used. An alternative to tablets is powders for preparing a suspension. It is believed, but this has not been reliably proven clinically, that suspensions are easier to tolerate by the digestive organs than tablets.

Gels and sprays can be used for quite a long time, if this does not lead to severe allergic reactions. In case of severe reactions at the site of application of the drug, you need to select, together with your doctor and allergist, a different form of the drug or its analogue. Allergies occur not only from the active substance, but also from auxiliary components, so before replacing the drug, you need to determine the allergen itself.

Voltaren injections are not indicated for longer than two days, although traditionally injections were considered safer for the body’s excretory system. If the effect of therapy cannot be achieved within two days, voltaren injections are replaced with the same drug in a different form. In hospital or outpatient treatment under the supervision of a physician, suppositories or tablets are usually used. Gels, sprays and patches are used more often for non-acute conditions.

Diclofenac is available in the form of tablets with general and prolonged action, gels and ointments, rectal suppositories, solutions for injections, eye drops. The choice of drug form depends on the goals and therapeutic effect.

Who prescribes Voltaren

Voltaren can prescribe:

• surgeon to eliminate pain and swelling after injuries and operations;
• rheumatologist and orthopedist in the treatment and relief of symptoms of musculoskeletal diseases;
• neurologist for neuralgia caused by diseases of the spine;
• nephrologist for renal colic;
• hepatologist for hepatic or biliary colic;
• other doctors, including therapist, pediatrician. Diclofenac is also prescribed by ophthalmologists for eye injuries, before and after surgery.

What do Voltaren injections help with?

The indication for the use of this medication is intense pain. The medicine acts quickly, so it helps to quickly eliminate even intense lumbago. It is most often used for back pain caused by pinched nerve endings, when the height of the intervertebral discs affected by osteochondrosis decreases. In addition, the medication is often used in the complex treatment of disc protrusions and herniations.

Voltaren injections are prescribed to suppress inflammation and pain caused by rheumatoid arthritis. It is used to eliminate acute symptoms observed in degenerative-dystrophic pathologies of the joints, incl. osteoarthritis. The indication for prescribing this medication is inflammation of the joints, incl. arthritis caused by bacterial and fungal microflora, as well as hypothermia.

This medicine is used to relieve pain due to gout. It can be used to eliminate acute symptoms of renal and hepatic colic. Voltaren injections can be used to eliminate inflammation and pain that occurs after surgery.

As part of complex therapy, the drug is often used for migraines.

Contraindications

Voltaren has many contraindications for use. The drug cannot be used in the treatment of patients who have individual intolerance to the active or auxiliary components. The use of the medication is not recommended if the patient has erosive diseases of the gastrointestinal tract - this is due to the fact that sodium diclofenac reduces the rate of production of prostaglandins that protect the mucous membranes of the intestines and stomach. Contraindications for Voltaren injections are pregnancy and lactation.

The medication should not be used in the presence of severe renal and hepatic insufficiency. These pathological conditions are characterized by a deterioration in metabolism, which helps to slow down the removal of drug breakdown products from the body. It is not recommended to use Voltaren in the postoperative period if there is a risk of bleeding.

In addition, this medication is not used if the intervention was carried out using a machine providing artificial blood circulation and the patient was given anticoagulants.

It is not recommended to use this medicine to eliminate the symptoms of certain inflammatory bowel diseases, incl. ulcerative colitis and Crohn's syndrome. Voltaren injections are not prescribed to patients suffering from coronary heart disease and those who have previously suffered a myocardial infarction.

Cerebral atherosclerosis is a contraindication to the use of the drug. The use of the drug in the treatment of the consequences of hemorrhagic stroke, as well as transient ischemic attack, is not recommended. The medication is not prescribed for children.

After each injection, it is necessary to monitor the patient's condition.

INSTRUCTIONS FOR USE OF THE PREPARATION VOLTAREN / VOLTAREN (INFORMATION FOR SPECIALISTS)

Registration number: P No. 011889/04 dated March 30, 2005 Trade name: Voltaren International nonproprietary name (INN): diclofenac Dosage form: solution for intramuscular administration Composition: 3 ml of solution (1 ampoule) contain: active substance - diclofenac (in sodium form salt) 75 mg; excipients: mannitol, sodium disulfite, benzyl alcohol, propylene glycol, water for injection, sodium hydroxide qs Description: colorless or light yellow liquid. Pharmacotherapeutic group: nonsteroidal anti-inflammatory drug. ATX code: M01AB05.

Pharmacological properties Pharmacodynamics Voltaren contains diclofenac sodium, a non-steroidal substance that has a pronounced anti-inflammatory, analgesic and antipyretic effect. The main mechanism of action of diclofenac, established under experimental conditions, is considered to be inhibition of the biosynthesis of prostaglandins. Prostaglandins play an important role in the pathogenesis of inflammation, pain and fever. In vitro, diclofenac sodium, in concentrations equivalent to those achieved in the treatment of patients, but inhibits the biosynthesis of proteoglycans in cartilage tissue. In rheumatic diseases, the anti-inflammatory and analgesic properties of Voltaren provide a clinical effect, characterized by a significant decrease in the severity of such manifestations of diseases as pain at rest and during movement, morning stiffness and swelling of the joint, as well as an improvement in the functional state. A pronounced analgesic effect of Voltaren was noted for moderate and severe pain of non-rheumatic origin. Relief (pain occurs within 15–30 minutes. For post-traumatic and postoperative inflammatory phenomena, Voltaren quickly relieves pain, reduces inflammatory swelling and swelling of the postoperative wound. When used in combination with opioids in patients with postoperative pain, Voltaren significantly reduces the need for opioid analgesics. Clinical studies also made it possible to establish that Voltaren is able to reduce pain and reduce blood loss during primary dysmenorrhea.Voltaren, in addition, alleviates migraine attacks.

Pharmacokinetics Absorption After intramuscular (IM) administration of 75 mg of diclofenac, its absorption begins immediately. The maximum plasma concentration (Cmax), the average value of which is about 2.5 μg/ml (8 μmol/l), is reached after approximately 20 minutes. The amount of absorbed active substance is linearly dependent on the dose of the drug. The area under the concentration-time curve (AUQ) after intramuscular administration of Voltaren is approximately 2 times greater than after its oral or rectal administration, since in the latter cases about half of the amount of Diclofenac is metabolized during the “first pass” through the liver. With subsequent administrations of the drug, the pharmacokinetic parameters do not change. Provided that the recommended intervals between administrations of the drug are observed, no accumulation is observed. Distribution: Connection with serum proteins - 99.7%, mainly with albumin (99.4%). The apparent volume of distribution is 0.12–0.17 l/kg. Diclofenac penetrates into the synovial fluid, where its maximum concentration is reached 2–4 hours later than in the blood plasma. The apparent half-life from synovial fluid is 3–6 hours. 2 hours after reaching the maximum plasma concentration, the concentration of diclofemac in the synovial fluid is higher than in the plasma, and its values ​​remain higher for a period of time up to 12 hours. Metabolism The metabolism of diclofenac is carried out partly by glucuronidation of the unchanged molecule, but mainly through single and multiple hydroxylation and methoxylation, which leads to the formation of several phenolic metabolites (3'-hydroxy-, 4'-hydroxy-, 5'-hydroxy-, 4' ,5-dihydroxy- and 3'-hydroxy-4'-methoxydiclofenac), most of which are converted to glucuronide conjugates. Two phenolic metabolites are biologically active, but to a much lesser extent than diclofenac. Elimination The total systemic plasma clearance of diclofenac is 263±56 ml/min. The terminal half-life is 1–2 hours. The half-life of 4 metabolites, including two pharmacologically active ones, is also short and amounts to 1–3 hours. One of the metabolites, 3'-hydroxy-4'-methoxy-diclofenac, has a longer half-life, but this metabolite is completely inactive. About 60% of the drug dose is excreted in the urine in the form of glucuronic conjugates of the unchanged active substance, as well as in the form of metabolites, most of which are also glucuronic conjugates. Less than 1% of diclofenac is excreted unchanged. The remainder of the drug dose is excreted as metabolites in bile.

Pharmacokinetics in certain groups of patients In patients with impaired renal function, accumulation of unchanged active substance is not observed if the recommended dosage regimen is observed. When creatinine clearance is less than 10 ml/min, the calculated equilibrium concentrations of diclofenac hydroxymetabolites are approximately 4 times higher than in healthy volunteers, while the metabolites are excreted exclusively in bile. In patients with chronic hepatitis or compensated liver cirrhosis, the pharmacokinetics of diclofenac are similar to those in patients without liver disease.

Indications for use • Inflammatory and degenerative forms of rheumatic diseases: - rheumatoid arthritis; - ankylosing spondylitis; - osteoarthritis; - spondyloarthritis. • Pain syndromes from the spine. • Rheumatic diseases of extra-articular soft tissues. • Acute attack of gout. • Renal and biliary colic. • Post-traumatic and post-operative pain, inflammation and swelling. • Severe migraine attacks. Intramuscular administration of the drug is especially preferable at the beginning of exacerbations of inflammatory and degenerative rheumatic diseases with high inflammatory activity and in pain conditions caused by inflammation of non-rheumatic origin.

Contraindications • Stomach or intestinal ulcer. • Hypersensitivity to diclofenac and any other ingredients of the drug, including sodium metabisulfite. • Voltaren is contraindicated in patients whose attacks of bronchial asthma, urticaria or acute rhinitis are provoked by acetylsalicylic acid or other NSAIDs, as well as any drugs that suppress the production of prostaglandins. • Voltaren solution for injection is not prescribed to children and adolescents under the age of 18 years. • Voltaren injection solution is not prescribed during pregnancy.

With caution During the use of Voltaren, careful medical supervision is necessary for those patients who have complaints indicating diseases of the gastrointestinal tract; having a history of ulcerative lesions of the stomach or intestines; those suffering from ulcerative colitis or Crohn's disease, as well as those with impaired liver function. During the use of Voltaren, as well as other NSAIDs, the level of one or more liver enzymes may increase. Therefore, during long-term therapy with Voltaren®, monitoring liver function is indicated as a precaution. If abnormalities in liver function parameters persist or worsen, or if clinical manifestations of liver disease or other symptoms occur (for example, eosinophilia, rash, etc.), Voltaren should be discontinued. It should be borne in mind that hepatitis during the use of Voltaren can occur without prodromal phenomena. Caution is necessary when prescribing Voltaren to patients with hepatic porphyria, since the drug can provoke attacks of porphyria. Since prostaglandins play an important role in maintaining renal blood flow, special caution is required when treating patients with impaired cardiac or renal function, patients receiving diuretics, as well as patients who have a significant decrease in circulating blood plasma volume of any etiology, for example, in the period before and after major surgical interventions. In these cases, monitoring of renal function is recommended as a precautionary measure during the use of Voltaren. Discontinuation of the drug usually results in renal function returning to baseline levels. Caution should be exercised when using Voltaren in elderly patients. This is especially true in frail or low-weight elderly people; they are recommended to prescribe the drug at the minimum effective dose. Particular caution should be observed when administering Voltaren intramuscularly to patients with bronchial asthma, due to the risk of increasing the severity of symptoms of the disease. Use during pregnancy and lactation During pregnancy, the use of the drug is not recommended. If it is necessary to prescribe the drug to a nursing mother, the issue of stopping breastfeeding should be decided.

Method of administration and dosage Voltaren is administered by deep injection into the gluteal muscle. Voltaren injections should not be used for more than 2 days in a row. If necessary, treatment can be continued with Voltaren in tablets or rectal suppositories. When performing an intramuscular (IM) injection, in order to avoid damage to the nerve or other tissues, it is recommended to adhere to the following rules. The drug should be injected deep IM into the upper outer quadrant of the gluteal region. The dose is usually 75 mg (contents of 1 ampoule) once a day. 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, one injection of the drug per day (75 mg) can be combined with other dosage forms of Voltaren (tablets, rectal suppositories), and the total daily dose should not exceed 150 mg. During migraine attacks, the best result is achieved if Voltaren is administered as early as possible after the onset of the attack, IM at a dose of 75 mg (1 amp.), 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.

Side effects When assessing the frequency of occurrence, the following gradations were used: “often” - > 10%, “sometimes” - > 1–10%, “rarely” — > 0.001–1%, “in some cases” — < 0.001%. From the gastrointestinal tract: sometimes - pain in the epigastric region, nausea, vomiting, diarrhea, abdominal cramps, dyspepsia, flatulence, anorexia; rarely - gastrointestinal bleeding (vomiting blood, melena, diarrhea mixed with blood), stomach and intestinal ulcers, accompanied or not accompanied by bleeding or perforation; in some cases, aphthous stomatitis, glossitis, damage to the esophagus, the occurrence of diaphragm-like strictures in the intestine, disorders of the distal colon, such as nonspecific hemorrhagic colitis, exacerbation of ulcerative colitis or Crohn's disease, constipation, pancreatitis. From the central and peripheral nervous system: sometimes - headache, dizziness; rarely - drowsiness; in some cases - sensory disturbances, including paresthesia, memory disorders, disorientation, insomnia, irritability, convulsions, depression, anxiety, nightmares, tremor, psychotic reactions, aseptic meningitis. From the senses: in some cases - visual impairment (blurred vision, diplopia), hearing impairment, tinnitus, disturbances in the sense of taste. Dermatological reactions: sometimes - skin rashes; rarely - urticaria; in some cases - bullous rashes, eczema, erythema multiforme, Stevens-Johnson syndrome, Lyell's syndrome (acute toxic epidermolysis), erythroderma (exfoliative dermatitis), hair loss, photosensitivity reactions; purpura, incl. allergic. From the kidneys: rarely - edema; in some cases - acute renal failure, hematuria, proteinuria, interstitial nephritis; nephrotic syndrome; papillary necrosis. From the liver: sometimes - increased levels of aminotransferases in the blood serum; rarely - hepatitis, accompanied or not accompanied by jaundice; in some cases - fulminant hepatitis. From the side of the hematopoietic ristema: in some cases - thrombocytopenia, leukopenia, hemolytic anemia, aplastic anemia, agranulocytosis. Hypersensitivity reactions: rarely - bronchospasm, systemic anaphylactic / anaphylactoid reactions, including hypotension; in some cases - vasculitis, pneumonitis. From the cardiovascular system: in some cases - palpitations, chest pain, increased blood pressure (BP), worsening congestive heart failure. Other: sometimes pain, lumps at the site of intramuscular injection; in some cases - abscesses and necrosis. The listed side effects were observed, including when using doses of the drug and duration of treatment that differed from the recommended ones.

Overdose Treatment of acute NSAID poisoning includes supportive and symptomatic therapy. There is no typical clinical picture characteristic of an overdose of Voltaren. Supportive and symptomatic treatment is indicated for complications such as decreased blood pressure, renal failure, seizures, gastrointestinal disorders and respiratory depression. It is unlikely that forced diuresis, hemodialysis or hemoperfusion will be useful for eliminating NSAIDs, since the active substances of these drugs are largely bound to plasma proteins and undergo extensive metabolism.

Drug interactions Lithium, digoxin. Voltaren may increase plasma concentrations of lithium and digaxin. Diuretics. Voltaren, like other NSAIDs, can reduce the severity of the diuretic effect. The simultaneous use of potassium-sparing diuretics may lead to an increase in serum potassium levels (in the case of such a combination of drugs, this indicator should be monitored frequently). NSAIDs. Concomitant systemic use of NSAIDs may increase the incidence of adverse events. Anticoagulants. Although clinical studies have not established the effect of Voltaren on the action of anticoagulants, there are isolated reports of an increased risk of bleeding in patients taking Voltaren and these drugs simultaneously. Therefore, in the case of such a combination of drugs, careful monitoring of patients is recommended. Antidiabetic drugs. Clinical studies have established that the simultaneous use of Voltaren and antidiabetic drugs is possible, but the effectiveness of the latter does not change. However, there are isolated reports of the development in such cases of both hypoglycemia and hyperglycemia, which necessitated the need to change the dose of glucose-lowering drugs while using Voltaren. Methotrexate. Caution should be exercised when prescribing NSAIDs less than 24 hours before or after taking methotrexate, since in such cases the concentration of methotrexate in the blood may increase and its toxic effect may increase. Cyclosporine. The effect of NSAIDs on the activity of prostaglandins in the kidneys may enhance the nephrotoxicity of cyclosporine. Antibacterial agents are quinolone derivatives. There are isolated reports of the development of seizures in patients receiving concomitant quinolone derivatives and NSAIDs.

Pharmaceutical incompatibility Do not mix the Voltaren solution contained in ampoules with solutions of other drugs for injection.

Special instructions During the use of Voltaren, gastrointestinal bleeding may occur (for the first time or repeatedly) or ulceration/perforation of the gastrointestinal tract may develop, accompanied or not accompanied by precursor symptoms. More serious consequences of these complications may occur in elderly patients. In those rare cases where these complications develop in patients receiving Voltaren, the drug should be discontinued. When using Voltaren for the first time, as well as other NSAIDs, in rare cases allergic reactions may develop, including anaphylactic and anaphylactoid reactions. It is possible to develop hypersensitivity reactions to sodium disulfite, which is part of the injection solution. Voltaren, due to its pharmacodynamic properties, can mask the manifestations of infectious diseases. Voltaren, like other NSAIDs, may temporarily inhibit platelet aggregation. Therefore, in patients with hemostasis disorders, careful monitoring of relevant laboratory parameters is necessary. With long-term use of Voltaren, like other NSAIDs, systematic monitoring of peripheral blood patterns is indicated. Effect on the ability to drive a car and operate machinery Patients who experience dizziness or other disorders of the central nervous system, including visual impairment, while using Voltaren, should not drive a car or operate machinery while using the drug.

Release form Solution for injection 75 mg/3 ml in ampoules. 5 ampoules along with instructions for use are packed in a cardboard box.

Storage conditions At a temperature not exceeding 30°C. Protect from exposure to light and high temperatures. The drug should be stored out of the reach of children.

Shelf life: 2 years. The drug should not be used after the expiration date indicated on the package.

Conditions for dispensing from pharmacies By prescription.

"Novartis Pharma A G" produced by "Novartis Pharma Stein A G" Switzerland Additional information about the drug can be obtained at the address: 123104, Moscow, B. Palashevsky per., 15 tel. fax (095) 969 21 76 NOVARTIS PHARMA AG Lichtstrasse 35, CH–4002 Basel, Switzerland Manufactured by NOVARTIS PHARMA Stein AG, Switzerland

How to prick

When prescribing a drug such as Voltaren, injections are given intramuscularly. Intravenous administration is permissible only if it is necessary to quickly relieve intense pain.

Before giving an injection, the doctor must treat the ampoule with an alcohol solution, then break its edge and draw the drug into a sterile syringe.

The injection is most often performed in the gluteal region. Before manipulation, the skin must be treated with an antiseptic. If intravenous administration is necessary, the injection is performed into a vein in the elbow joint. It is recommended to use the drug at a dose of 75 mg, i.e. 1 ampoule. For some pathologies, the daily dosage can be increased to 150 mg.

How to replace Voltaren: list of analogues

The difference in price between Voltaren and diclofenac is significant; the first drug costs several times more. Therefore, patients, especially those who are short on money, prefer diclofenac, considering it a substitute for Voltaren.

Diclofenac, as an analogue of Voltaren in ampoules, may well be used in medical practice, like other dosage forms. The following medications are produced based on diclofenac:

• diklak;
• diklo-f;
• diclobene;
• flector;
• diclofenacol;
• Swissjet;
• rapten;
• diklovit;
• diclogen;
• dorosan;
• Ortofen injections;
• naklofen;
• pension;
• dicloran;
• orthoflex;
• flotak.

Popular Relenza - review of the drug and list of inexpensive analogues

The issue of replacing Voltaren with any of these drugs should be decided with your doctor, because the concentration of the active substance - diclofenac - as well as the complex of auxiliary elements vary, so the therapeutic effect may not be fully achieved.

Substituting voltaren for drugs with another active ingredient, especially, should be done only with the permission and under the supervision of a doctor. Visitors to medical chats and forums often choose whether to use Movalis or Voltaren for treatment. As a rule, a person far from medicine believes that drugs are enough to treat the same disease or have approximately the same composition. In fact, the issue of drug replacement is much more complicated.

It should be immediately noted that Movalis does not contain diclofenac; it is made on the basis of meloxicam. This is also a well-proven non-steroidal drug that fights inflammation and pain syndromes. But the pharmacological effects of this substance differ from diclofenac. Meloxicam is used for inflammation of the joints and their degenerative conditions, that is, the spectrum of action of the drug is much worse than that of diclofenac derivatives.

The following drugs are produced on its basis: amelotex, meloquitis, m-cam, arthrozan, lem, bi-xicam, genetron, mataren, mexicam, flexibon, exen-sanovel. None of the listed drugs can be considered a full replacement for Voltaren due to the difference in the effects of the substances, as well as the range of applications in medicine.

If we talk about a close alternative, then we need to consider drugs based on the same active ingredient with the same or similar auxiliary elements. It is important that the combination and concentration of active and additional substances are approximately the same.

Additional or auxiliary components contribute to better penetration of the drug into tissues, its uniform distribution there, and accumulation in order to prolong the therapeutic effect. If a patient is prescribed a course of several medications taken together, then the biological and chemical compatibility of their components must be taken into account.

Some substances accelerate the breakdown of other elements, some impede absorption, and some form toxic compounds. When selecting medications for a patient, the doctor takes into account the interaction of not only their active components, but also auxiliary ones. Therefore, the question of replacing one drug with another, even if at first glance similar, should never be done independently in order to avoid poisoning, complications or the transition of the disease to an acute or aggravated form.

How many days can you inject?

The injection is performed once a day; for intense pain, the drug is administered 2 times a day. He recommends injecting the drug for 1-2 days, after which the patient is transferred to taking oral NSAIDs.

Long-term use of the drug in solution form is not recommended due to the high risk of adverse reactions.
This medicine can be injected for no more than 5 days. What do you think are the most important factors when choosing a medical facility?

Side effect

When using Voltaren injection solution, there is a possibility of side effects from the gastrointestinal tract.

Patients often have complaints about:

• stomach ache;
• vomiting;
• nausea;
• stool disorders;
• flatulence;
• dyspepsia.

In rare cases, treatment with the drug provokes the development of cachexia. There is a possibility of gastrointestinal bleeding. The development of toxic hepatitis and exacerbation of pancreatitis is possible. Side effects of the medication can be expressed by glossitis, stomatitis and damage to the esophageal mucosa.

In addition, during treatment with Voltaren, patients often complain of attacks of dizziness.

A headache may occur.

It is extremely rare to see effects such as:

• sensory disturbance;
• depression;
• disorientation;
• tremor;
• increased anxiety;
• nightmares;
• insomnia;
• memory impairment, etc.

There have been isolated cases of the development of aseptic meningitis during the use of Voltaren. Rarely, the drug can cause short-term blurred vision, tinnitus and changes in taste.

Dermatological reactions to taking the medication are also possible, expressed:

• hives;
• skin itching;
• eczema;
• Lyell's syndrome;
• hair loss;
• increased photosensitivity;
• erythema;
• purple

In rare cases, the drug causes kidney dysfunction and swelling. Long-term use of Voltaren is associated with a risk of anemia, thrombocytopenia and agranulocytosis. Very rarely, when treated with this drug, the development of pneumonia, bronchospasm and vasculitis was observed.

If the patient is hypersensitive to the active substance of the drug, anaphylactoid reactions may occur. Rare local reactions include pain at the injection site, necrosis and abscess.

Overdose

If too high a dose of Voltaren is administered, severe dizziness and tinnitus may occur. Symptoms of overdose include gastrointestinal bleeding and seizures.

Often, when a large dose of the drug is administered, patients experience nausea and vomiting. In case of an overdose of the drug, acute renal failure and toxic liver damage may develop.

Interaction with other drugs

The administration of Voltaren can increase the blood concentration of cyclosporine, methotrexate and digoxin. Voltaren increases the toxicity of other NSAIDs, cyclosporine and methotrexate.

Simultaneous administration of ASA and Voltaren can reduce the concentration in the blood of the latter. In addition, NSAIDs reduce the effectiveness of hypoglycemic medications. The risk of bleeding from the digestive organs is increased when Voltaren is combined with colchicine, ethanol, St. John's wort and corticotropin.

pharmachologic effect

Diclofenac is a non-steroidal substance and has an active anti-inflammatory, analgesic and antipyretic effect on the human body.

The main mechanism of the therapeutic effect of the active substance is inhibition of the synthesis of prostaglandins - a group of lipids that increase the sensitivity of receptors in the brain. They themselves do not cause pain, but they increase susceptibility to other mediators, histamine and bradykinin.

Diclofenac inhibits the synthesis of cyclooxygenases (COX), which trigger the reaction of accelerated production of prostaglandins against inflammation. As a result of their action, tissue swelling, redness and pain occur.

Pharmacokinetics

After introducing the Voltaren injection solution into the muscle tissue, the active substance is absorbed into the systemic circulation within a quarter of an hour and distributed throughout the body. The highest level in the blood is observed after 20 minutes - 2.5 mcg/ml.

The complete absorption of diclofenac sodium depends on the dose received. Intramuscular injections allow you to achieve twice the content of capsules or tablets at the same dosage. In the latter treatment option, about half of the total amount undergoes primary transformation in the liver tissue. With further administrations of Voltaren injections, the pharmacokinetics remains at a constant level, i.e. There is no accumulation of diclofenac.