Dolaren: instructions for use, analogues

Each Dolarene tablet contains 500 mg of paracetamol, which has analgesic and antipyretic properties and 50 mg of a non-steroidal anti-inflammatory drug, diclofenac sodium.

1 g Dolaren gel contains 0.1 g of anti-inflammatory compound - metisalicylate, 0.01 g of diclofenac and 0.03 g of linseed oil.

Tablets are sold in blister packs of 10 pcs., And gel in tubes of 20 and 50 g.

Indications

Dolaren is used for the complex treatment of pathologies of infectious and inflammatory genesis accompanied by fever and intense pain - tonsillitis,Middle ear( otitis) and pharyngeal mucosa( pharyngitis).

Indications for the beginning of admission:

• migraine;
• toothache for pulpitis and periodontitis;
• rheumatoid arthritis;
• inflammation of the joints in psoriasis;
• gout;
• deforming osteoarthritis;
• osteochondrosis;
• Bechterew's disease;
• myalgia;
• inflammation of the periarticular tissues( tendiditis, bursitis);
• lumbago;
• sciatica;
• inflammation of the appendages( adnexitis);
• painful menstrual period( algodismenorea);
• proctitis;
• post-traumatic pain after damage to the ligamentous apparatus, tendons and muscles( bruises and sprains);
• pain syndrome in the postoperative period.

Contraindications

Important: preparation should not be taken to persons with hypersensitivity to major or auxiliary ingredients, as well as to other non-steroidal anti-inflammatory drugs in order to avoid the development of allergic reactions.

Contraindications to the use of Dolaren:

• erosion and ulcers of the digestive tract( in acute stage);
• bleeding in the digestive tract;
• "aspirin triad"( bronchial asthma + polyps of the nose + intolerance of sacitsilatov);
• enterocolitis( in the phase of exacerbation);
• liver damage( active process);
• pathology of hemopoiesis( hematopoiesis);
• poor blood coagulation( incl. Against hemophilia);
• kidney pathology prone to progression;
• severe functional kidney failure;
• condition after aorto-coronary shunt;
• skin damage at the application site( for gel).

Note: Dolaren tablets are not given to children, and the gel is approved for use at the age of 6 years.

Diagram of reception

Tablets are intended for oral administration during or immediately after meals with a small amount of liquid.Do not chew them.

Dolaren is a remedy for symptomatic therapy.It has no effect on the cause of the disease.

Single dose - 1 tab., And the frequency of reception - 2-3 times a day .It is not recommended to continue therapy longer than 7 consecutive days.If further treatment is necessary, consult your doctor.

The gel is applied in the projection of the affected joint with light rubbing movements 2-4 times a day .Single dose - 2-4 g, which corresponds to the length of the strip in 4-8 cm. The allowed duration of therapy is 10 days.

Side effects of

Allergies to the component of the drug may cause itching, urticaria, bronchospasm and angioedema.In severe cases, anaphylactic shock develops.

Most patients suffer symptomatic therapy with this drug without complications.

On the background of Dolaren's administration, in rare cases, the following side effects may occur:

• pain in the abdominal region;
• dyspepsia disorder;
• intestinal dysfunction( constipation);
• pain behind the sternum;
• heart rhythm disturbances;
• heart palpitations;
• sleep disorders;
• appetite impairment;
• general weakness;
• violation of orientation in space;
• depression;
• increased psychoemotional excitability;
• unmotivated sense of anxiety;
• aphthous stomatitis;
• liver damage( possible hepatonecrosis);
• inflammation of the pancreas;
• inflammation of the gallbladder;
• tinnitus;
• transient incidence of hearing acuity;
• decreased clarity of visual perception;
• increased skin sensitivity to ultraviolet;
• decreased diuresis;
• kidney failure;
• protein in the urine( proteinuria);
• anemia.

Overdose

Clinical signs of poisoning when the recommended dose of Dolaren is exceeded are due to the presence of paracetamol in the preparation.

Characteristic symptoms of an overdose in the first day:

• skin blanching;
• lack of appetite;
• nausea;
• vomiting;
• pain in the abdominal region.

In the period from 12 hours to 2 days after an overdose( intake> 10 g of paracetamol), arrhythmia, tubular necrosis of the kidneys and severe hepatic insufficiency, accompanied by progressive encephalopathy, may develop.With severe poisoning, coma and death can not be ruled out.

The victim needs to immediately rinse the stomach and give inward enterosorbents( regular or white activated charcoal).When symptoms of poisoning appear, you need to call an "ambulance". Paracetamol antidote is methionine.This drug should be administered within 8-9 hours.After 12 hours, intravenous injection of acetylcysteine ​​is indicated.In a hospital, hemodialysis is used to purify the blood.

Overdosage is not possible with a gel.

Pharmacological action

Diclofenac, paracetamol and methyl salicylate present in the gel inhibit the activity of the cyclooxygenase enzyme( COX1 and COX2), which inhibits the biosynthesis and release of mediators of inflammation of pain, inflammation and heat-prostaglandins.Paracetamol affects the hypothalamic centers of thermoregulation. Flaxseed oil, also contained in the form for external use, also has moderate anti-inflammatory properties.

Once absorbed, the active components are absorbed quickly and almost completely. Diclofenac is able to penetrate into the joint fluid, thereby reducing inflammation and joint pain .Its biotransformation with the formation of active metabolites occurs in the liver.Unchanged substance and metabolic products leave the body mainly through the kidneys( a small amount - through the intestine).Paracetamol is absorbed in the small intestine, metabolized in the liver, and excreted by the kidneys.

When applied locally, the components are absorbed into the skin and quickly penetrate into the inflammation focus located in deeper tissues( articular capsule and muscles).

Interaction of Dolaren with other drugs

Diclofenac reduces the effectiveness of diuretic, hypotensive and hypnotics and promotes increased plasma concentrations of lithium and digoxin.

Parallel administration with colchicine, corticotropin, thrombolytic agents, anticoagulants and antiplatelet agents increases the risk of bleeding of different locations of .

Serum diclofenac concentration decreases with concomitant administration of acetylsalicylic acid and increases with calcium channel blockers.Nephrotoxicity of this active component is increased in combination with Cyclosporin.

Quinol antibiotics increase the likelihood of seizures.

Paracetamol potentiates the effect of anticoagulants.Poisoning when taking even small doses of it can provoke Rifampicin, Phenytoin, Phenylbutazone, tricyclic antidepressants and barbiturates.

Toxic effect on the liver weakens cimetidine and enhances Diflunisal.

Important: does not allow parallel use of paracetamol with alcoholic beverages and pharmacological agents containing ethyl alcohol.In combination with ethanol, this component often provokes the development of pancreatic inflammation and toxic liver damage.

Optional

Particular care should be taken when observing the following diseases and pathological conditions:

• bronchial asthma;
• hypertension;
• lipid metabolism disorders;
• IHD;
• heart failure( congestive form);
• alcoholic liver damage;
• chronic edema;
• diabetes mellitus;
• stomach ulcer( remission period);
• pathology of peripheral arteries;
• systemic diseases with connective tissue damage( collagenoses);
• period after extensive surgical interventions.

If Dolaren is used for more than 5-7 consecutive days, it is necessary to monitor the performance of the liver and the picture of peripheral blood.

At the time of symptomatic therapy, it is advisable to avoid the management of vehicles and work with potentially dangerous mechanisms.

Dolaren during pregnancy

Tablets can not be taken during the period of gestation and breastfeeding of a child, because when ingested, the components are absorbed into the bloodstream and exert systemic effects on the .They are able to penetrate the hemato-placental barrier, and are found in breast milk.

The gel is contraindicated in patients in the third trimester, and in I and II you need to be careful and consult a doctor who is pregnant.

Analogues of Dolaren

The structural analogue of Dolaren is a combined preparation of Panoxen, and the group one is named Next, but they are produced only in tablet form.

According to the mechanism and nature of the action, the analogs are:

• Pentalgin;
• No-shpalgin;
• Trigan-D;
• Femisol;
• Diclofenac;
• Rankof;
• Apal;
• Ithymol;
• Sarydon;
• Guevadal;
• Novalgin;
• Kalpol.

External as an alternative Dolaren can be applied gel Diclofenac or Voltaren Emulgel.

Storage and dispensing conditions from pharmacies

Do not require a doctor's prescription to purchase Dolaren.

The preparation should be stored in factory containers, in places shielded from light with low humidity at a temperature not exceeding + 25 ° С( for gel - up to + 30 ° С).

Shelf life of the tablets is 4 years from the date of issue( indicated on the package).

Keep out of the reach of children!

Plisov Vladimir, medical reviewer