Difelene Thai Nakorn Patana Treatment Treatment of inflammation and osteoarthritis, rheumatism (10 tablets)

Dosage form Box of 10 tablets
Specifications Diclofenac sodium
Ingredient Thai Nakorn Patana (VN)

Ingredient

Composition information	Content
Diclofenac sodium	50mg

Uses

indications

Difelene is indicated in the following cases:

Treatment of inflammation and forms of osteoarthritis, rheumatism, stiff spine and chronic osteoarthritis. The drug has anti -inflammatory, analgesic and fever effect. Diclofenac is a strong active inhibitor of cyclooxygenase, thus significantly reducing the formation of prostaglandin, prostacycline and thromboxan are intermediate substances of the inflammatory process. DiClofenac also regulates the Lipoxygenase path and platelet's convergence.

Like other nonsteroidal anti -inflammatory drugs, diclofenac causes gastrointestinal tract damage due to decrease in prostaglandin, which leads to mucin inhibitors (substances that protect the gastrointestinal tract). Prostaglandin plays a role in maintaining kidney perfusion. The nonsteroidal anti -inflammatory drugs inhibit prostaglandin should cause interstitial nephritis, glomerulonephritis, papillitis and nephrotic syndrome especially in people with kidney disease or chronic heart failure. For this patient, nonsteroidal anti -inflammatory drugs can increase acute renal failure and acute heart failure.

pharmacokinetics

diclofenac is easily absorbed through the digestive tract after drinking. The drug is absorbed faster if you are hungry.

diclofenac attaches greatly to plasma proteins, especially albumin (99%). About 50% of oral dose is metabolized through the liver for the first time and bioavailability in the blood circulation is approximately 50% of the bioavailability of intravenous injection. The maximum concentration of drugs in plasma appears 2 hours after drinking, the concentration in the fluid is the highest level after drinking for 4 to 6 hours. The effect of the drug appears 60 - 120 minutes after drinking.

Half life in plasma is about 1-2 hours. Half life eliminated from the epidemic epidemic is 3 - 6 hours.

approximately 60% of the dose is discharged through the kidneys in the form of metabolites and part of the activity and less than 1% in the form of intact drugs, the rest is discharged through bile and feces.

absorption, metabolism and elimination seems to not depend on age. If the dosage and distance between the drug use are followed by instructions, the drug is not accumulated, even if the kidney and liver function is reduced.

Before taking Difelene Thai Nakorn Patana Treatment Treatment of inflammation and osteoarthritis, rheumatism (10 tablets)

How to use

Take oral use.

Dosage

Take 1 capsule/time, 2-3 times daily right after eating or according to the physician's instructions. Specifically:

osteoarthritis

Take 1 capsule/time x 3 times/day.

Long -term treatment: 1 tablet/time x 2 times/day.

rheumatoid arthritis (rheumatism)

Take 2 - 4 capsules/day divided into several times. Do not drink more than 4 tablets (200mg)/day.

Long -term treatment should take a dose of 2 capsules/day 2 times.

Stiff spine inflammation

Take 1 capsule/time x 2 to 3 times/day.

Pain relief

Take 1 capsule/time x 3 times/day.

Pain relief in cancer

Take 2 capsules/time x 2 times/day.

To minimize the risk of adverse events, difelene is needed at the lowest daily doses to be effective in the shortest possible time.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Diclofenac acute poisoning is mainly more serious side effects.

What to do when using an overdose of the drug recommended

Causes vomiting or gastric lavage. Next is symptomatic and supportive treatment.

After gastric vomiting and active carbon can be used to reduce the absorption of the drug in the gastrointestinal tract and in the liver cycle.

Diuretics to treat Diclofenac poisoning is a suspicious measure because the drug is attached to plasma proteins, but the diuretic can also be helpful but if used, it must closely monitor water -electrolyte balance because there may be severe electrolytes and water retention disorders.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Difelene, you may experience unwanted effects (ADR).

Heart thrombosis: Clinical and epidemiological trials show that the use of diclofenac is related to increased risk of cardiovascular thrombosis (such as myocardial infarction or stroke), especially when using diclofenac at high doses (150mg/day) and prolonged (see more warning and cautious).

Common, ADR> 1/100

headache, restlessness, epigastric pain, nausea, vomiting, diarrhea, bloating, anorexia, indigestion, increased transaminase, tinnitus.

Uncommon, 1/1000

edema, allergies (especially bronchospasm in patients with asthma), anaphylaxis, including hypotension, rhinitis, urticaria. Abdominal pain, pepper bleeding, causing ulcers to progress. Sometimes insomnia, irritability, loss of ice, mild hearing disorders, dizziness, dizziness, itching, depression, sleeping, fuzzy look.

Rare, ADR

edema, rash, stevens-johnson syndrome, hair loss, sterile meningitis, leukopenia, platelet, neutrophils, eosinophilia, granulocytosis, bloody blood, gallbladder disorders, blonde/hepatitis, hepatitis, hematitis, acute kidney failure, interstitial nephritis, nephrotic syndrome.

Instructions for handling ADR

When there is a symptom of allergies to Diclofenac, the drug must be stopped immediately. Treatment of side effects is symptomatic and supportive treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Difelene drugs are contraindicated in the following cases:

Patients with sodium diclofenac, aspirin or other nonsteroidal anti -inflammatory drugs and any ingredients of the drug.

People with asthma or bronchospasm, bleeding, cardiovascular disease, severe kidney failure or severe liver failure.

Progressive stomach ulcer.

Patients are taking anticoagulant drugs.

The contact lenses.

Children under 12 years old.

The person who has a circulating volume due to the diuretic or kidney failure, glomerular filtration speed

People with adhesive diseases (the risk of sterile meningitis. It should be noted that all cases of aseptic meningitis are in a history of an autoimmune disease, as a factor that is susceptible to the disease).

Patients with congestive heart failure (from degree to IV according to the function of heart failure according to the New York Heart Association - NYHA), ischemic heart disease, peripheral artery disease, cerebrovascular disease.

Precautions when using

People with a history of ulcer, bleeding or puncture of the digestive tract.

Patients with kidney failure, liver failure, lupus erythematosus.

Patients with hypertension or water condition or edema.

People with a history of liver disease, need to monitor regular liver function when long -term treatment with diclofenac.

The infected person.

People with a history of coagulation disorders, bleeding.

Need to examine science labels for people with visual disorders when using diclofenac.

Heart thrombosis

Non -steroid anti -inflammatory drugs (NSAIDs), non -aspirin, using systemic sugar can increase the risk of cardiovascular thrombosis, including muscle infarction and stroke, which can lead to death. This risk can appear early in the first few weeks of taking the drug and can increase over time.

The risk of cardiovascular thrombosis is recorded mainly at high doses.

Doctors need to periodically evaluate the appearance of cardiovascular events, even if the patient does not have previous cardiovascular symptoms. Patients should be warned of symptoms of serious cardiovascular events and need to visit the doctor as soon as they appear.

To minimize the risk of adverse events, difelene is needed at the lowest daily doses to be effective in the shortest possible time.

Careful consideration when using diclofenac for patients with risk factors for cardiovascular events (such as hypertension, increased serum lipid, diabetes, tobacco addiction).

The ability to drive and operate machinery

No reports are recorded.

Pregnancy

There are no complete studies that have been strictly controlled on the use of drugs for pregnant women. Diclofenac should not be used for pregnant women during pregnancy, especially in the last 3 months due to the risk of inhibiting uterine contractions, causing increased circulatory pressure without recovery, renal failure in the fetus.

Pregnant women: Do not use any drugs that inhibit the synthesis of prostaglandin, including diclofenac because of the embryo inhibition.

Breastfeeding period

diclofenac is excreted in breast milk very little, there is no data on breastfed babies. Nursing mothers can use diclofenac if needed nonsteroidal anti -inflammatory drugs.

Drug interaction

diclofenac may increase or inhibit the effects of some other drugs.

Do not use diclofenac in combination with:

Oral and heparin anticoagulant: The risk of severe bleeding. Diclofenac in plasma, while increasing the risk of stomach bleeding. Poisoning level. If forced to use simultaneously, it is necessary to monitor the patient carefully to promptly detect signs of lithium poisoning and must monitor the lithium concentration in the blood on a regular basis. Lithi dose must be adjusted during and after treatment with diclofenac. Digoxin concentration is required and need to reduce the dose of digoxin if used simultaneously both drugs. Methotrexate in plasma leads to an increase in poisoning.

Can use diclofenac with the following drugs but must monitor the patient closely:

Cyclosporin: The risk of cyclosporin poisoning, regular monitoring of the patient's kidney function. Beta blockers, diuretics). diclofenac.

Probenecid may doubling Diclofenac concentration if used simultaneously. This can have good clinical effects in people with joint disease but can occur diclofenac poisoning, especially in people with impaired renal function.

Effect of waste uric acid - urinary is not affected. If necessary, reduce the diclofenac dose.

Storage

Store at a temperature not exceeding 30 ° C.

Other drugs

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