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Merxil

Category: Arthritis

Description

Diclofenac is used to treat pain or inflammation caused by arthritis or ankylosing spondylitis.

Active Ingredient: diclofenac

Diclofenac (Merxil) as known as: Abitren, Aclonac, Actinoma, Actisuny, Adefuronic, Afenac, Ainezyl, Aldoron, Alefen, Alflam, Algefit-gel, Algicler, Algifen, Algioxib, Algosenac, Allvoran, Almiral, Amofen, Analpan, Anavan, Anfenac, Anodyne, Anthraxiton, Apiclof, Aproxol, Araclof, Areston, Arthrex, Arthrotec, Artren, Artridene, Artrifenac, Artrites, Artrofenac, Aspizone, Assaren, Astefin, Atranac, Autdol, Banoclus, Batafil, Befol, Begita, Beonac, Berifen, Betafil, Betaren, Biclopan, Biofenac, Blesin, Bolabomin, C-fenac, Caflaamtil, Calmoflex, Cambia, Campal, Catafast, Cataflam, Catanac, Clafen, Clofast, Clofec, Clofenac, Clofenal, Clofenil, Clonac, Cofac, Combaren, Cordralan, Cordralan r, Cotilam, Coyenpin, Curinflam, D-fenac, Daispas, Dealgic, Decafen, Declophen, Dedlor, Dedolor, Defanac, Deflagesic, Deflam, Deflamat, Deflox, Delimon, Denaclof, Dencorub, Di retard, Diaflam, Diagesic, Diastone, Dichronic, Dichrophenon, Diclabeta, Diclac, Diclac dolo, Diclac lipogel, Diclachexal, 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Merxil Drug Information, Indications - Other Medicaments on

Merxil Drug Information Merxil forms, composition and dosages:
  • Tablet, Extended Release; Oral; Diclofenac Sodium 100 mg
Indications, usages and classification codes:

There is an additional general information about this medication active ingredient diclofenac:

Pharmacological action

NSAIDs, a derivative of phenylacetic acid, diclofenac has a pronounced anti-inflammatory, analgesic and mild antipyretic effect. The mechanism of action is associated with inhibition of COX activity - the main enzyme metabolism of arachidonic acid, which is a precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever. Analgesic effect is due to two mechanisms: peripheral (indirectly, through suppression of prostaglandin synthesis) and central (due to inhibition of prostaglandin synthesis in the central and peripheral nervous system).
Inhibits synthesis of proteoglycan in cartilage.
In rheumatic diseases, diclofenac reduces joint pain at rest and in motion, as well as morning stiffness and swelling of the joints, helps to increase range of motion; reduces post-traumatic and postoperative pain, and inflammatory edema.
Inhibits platelet aggregation. With prolonged use has a desensitizing effect.
When used topically in ophthalmology reduces swelling and pain in inflammatory processes non-infectious etiology.

Pharmacokinetics

After intake is absorbed from the gastrointestinal tract. Eating slows down the rate of absorption, extent of absorption is not changed. About 50% of the active substance is metabolized in the "first passage" through the liver. When used rectally absorption is slower. Time to reach Cmax in plasma after oral administration is 2-4 hours depending on the used dosage form, after rectal - 1 h, I.M. administration - 20 min. The concentration of active substance in plasma is a linear function of the applied dose.
Not cumulative. Plasma protein binding is 99.7% (predominantly albumin). Penetrates into synovial fluid, Cmax is achieved in 2-4 hours later than in plasma.
To a large extent metabolized to form several metabolites, among which two pharmacologically active, but to a lesser extent than diclofenac.
Systemic clearance of the active substance is about 263 ml / min. T1/2 from plasma is 1-2 h, from synovial fluid - 3-6 h. Approximately 60% of the dose was excreted as metabolites by the kidneys, less than 1% excreted in the urine as unchanged, while the rest is displayed in the form of metabolites with bile.

Why is Merxil prescribed?

Articular syndrome (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout), degenerative and chronic inflammatory diseases of musculoskeletal system (osteochondrosis, osteoarthritis, periartropatii), post-traumatic inflammation of soft tissue and musculoskeletal system (sprains, bruises). Pain in the spine, neuralgia, myalgia, arthralgia, pain and inflammation after surgery or injury, pain in gout, migraine, algomenorrhea, pain with Bursitis, proctitis, colic (biliary and renal), pain in infectious and inflammatory diseases of ENT organs.
For local use: the inhibition of miosis during surgery for cataract prevention of cystoid macular edema associated with removal and lens implantation, inflammatory eye non-infectious nature, post-traumatic inflammation in penetrating and nonpenetrating wound of the eyeball.

Dosage and administration

For oral use for adult single dose is 25-50 mg 2-3 times / 24 h. Frequency of admission depends on the dosage form employed, the severity of the disease and is 1-3 times / 24 h, rectally - 1 times / 24 h, for the treatment of acute conditions or the exacerbation of chronic edema use intramuscular in dose of 75 mg.
For children older than 6 years and adolescents daily dose is 2 mg / kg.
Topical applied at a dose of 2-4 g (depending on the size of painful area) on the affected area 3-4 times / 24 h.
When used in ophthalmology frequency and duration of administration are determined individually.
The maximum oral daily dose for adults is 150 mg.

Merxil side effects

Digestive system: nausea, vomiting, anorexia, abdominal pain and discomfort in the epigastrium, flatulence, constipation, diarrhea, and in some cases - erosive-ulcerative lesions, gastrointestinal bleeding and perforation; rarely - abnormal liver function. When rectal administration - in isolated cases were observed inflammation of the colon bleeding, exacerbation of ulcerative colitis.
From the side of the central nervous system and peripheral nervous system: dizziness, headache, agitation, insomnia, irritability, fatigue, rarely - paresthesia, visual disturbances (blurred, double vision), tinnitus, insomnia, cramps, irritability, tremors, mental disorders, depression.
Hemopoietic system: rarely - anemia, leukopenia, thrombocytopenia, agranulocytosis.
Urinary system: rarely - renal failure; in predisposed patients may be swelling.
Dermatological reactions: rarely - hair loss.
Allergic reactions: skin rash, itching, when used in the form of eye drops - itching, redness, photosensitivity.
Local reactions: in the place of I.M. introducing possible burning, in some cases - the formation of infiltration, abscess, necrosis of adipose tissue in the rectal administration may be local irritation, the appearance of mucous discharge mixed with blood, painful defecation, when used externally, in rare cases - itching, redness, rash, burning sensation, when applied topically in ophthalmology may be a transient burning sensation and / or temporary blurred vision immediately after instillation.
With long-term topical use and / or drawing on a vast surface of body are possible systemic side effects due to resorptive action of diclofenac.

Contraindications

known hypersensitivity to diclofenac sodium or to any accessory ingredient that is part of the drug diclofenac;
anamnestic information about the attacks of bronchial asthma, urticaria, acute rhinitis associated with the use of aspirin or other NSAIDs;
hemodyscrasia unknown origin;
children under 6 years
pregnancy (III trimester);
lactation
increased sensitivity to sulfite (for injection solution).
children under age 15 - tablets of 50 mg to 18 years - injection.

Using during pregnancy and breastfeeding

Use during pregnancy and lactation is possible in cases where the potential benefits for the mother exceeds than the potential risk to the fetus or newborn.

Special instructions

With extreme caution is used in diseases of liver, kidney, gastrointestinal history, dyspepsia, asthma, hypertension, heart failure, after major surgery, as well as elderly patients.
When referring to a history of allergic reactions to NSAIDs diclofenac and sulfites are used only in urgent cases. In the course of treatment requires systematic monitoring of liver function and kidney picture of peripheral blood.
Do not recommended the use for rectal patients with diseases of anorectal region or anorectal bleeding in history. Topical should be applied only to intact skin areas.
Avoid contact with diclofenac in the eye (except for eye drops), or on mucous membranes. Patients who use contact lenses, eye drops should be applied no earlier than 5 minutes after removing the lenses.
Not recommended for children under 6 years.
During the period of treatment drugs for systemic use is not recommended alcohol consumption.
During the period of treatment may decrease the speed of psychomotor reactions. With worsening blurred vision after application of eye drops should not be driving and doing other potentially danger activities.

Merxil drug interactions

At simultaneous application with diclofenac antihypertensive drugs may be weakening their actions.
There are few reports on the occurrence of seizures in patients taking both NSAIDs and antibacterial drugs quinolic series.
At simultaneous application with GCS and increased risk of side effects from the digestive system.
With simultaneous use of diuretics may decrease diuretic effect. With the simultaneous use of potassium-sparing diuretics may increase the concentration of potassium in the blood.
With simultaneous use with other NSAIDs may increase the risk of side effects.
There are reports of hypoglycemia or hyperglycemia in patients with diabetes who engaged in diclofenac together with hypoglycemic drugs.
When applied simultaneously with acetylsalicylic acid may decrease the concentration of diclofenac in plasma.
Although clinical studies have not found the influence of diclofenac on the action of anticoagulants, describes the individual cases of bleeding when used with diclofenac and warfarin.
With simultaneous use may increase digoxin, lithium, and phenytoin in blood plasma.
The absorption of diclofenac from the gastrointestinal tract is reduced by simultaneous application with kolestiraminom, to a lesser extent - with colestipol.
With simultaneous use may increase the concentration of methotrexate in plasma and increased its toxicity.
With simultaneous application of diclofenac could not affect the bioavailability of morphine, but the concentration of the active metabolite of morphine may be enhanced in the presence of diclofenac, which increases the risk of side effects metabolites of morphine, including respiratory depression.
When applied simultaneously with pentazocine described a case of great convulsions, and rifampicin - may decrease the concentration of diclofenac in plasma, with ceftriaxone - increases excretion of ceftriaxone in bile; with cyclosporine - may increase cyclosporine nephrotoxicity.

Merxil in case of emergency / overdose

Symptoms: may cause hypotension, renal failure, convulsions, gastrointestinal irritation or respiratory depression. Treatment: There is no specific antidote. In acute poisoning as soon as possible to stop drug absorption from the gastrointestinal tract. There is indicated gastric lavage, activated charcoal appointment and conduct of other symptomatic and supportive therapy. The use of forced diuresis, dialysis or blood transfusion is not justified because NSAIDs largely associated with serum proteins and possess extensive metabolism.

Storage conditions

In a dry, protected from light place, at temperature not above 25°C. Common expiration date for diclofenac: 3 years.

PLEASE, BE CAREFUL!

Be sure to consult your doctor before taking any medication!

Other articles

Merxil diseases

  • Product description
  • Safety information
  • Side effects
  • Diclofenac is used primarily for the treatment of inflammation and pain caused by conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. It is also effective in treating soft tissue inflammations due to tendinitis and bursitis, and treating dysmenorrhea (menstrual cramps). Diclofenac is an NSAID. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

    Use Diclofenac as directed by your doctor!

    • Take Diclofenac by mouth. It may be taken with food if it upsets your stomach. Taking it with food may not lower the risk of stomach or bowel problems (eg, bleeding, ulcers). Talk with your doctor or pharmacist if you have persistent stomach upset.
    • Take Diclofenac with a full glass of water (8 oz/240 mL) as directed by your doctor.
    • If you miss a dose of Diclofenac, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

    Ask your health care provider any questions you may have about how to use Diclofenac.

    Store Diclofenac at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Diclofenac out of the reach of children and away from pets.

    Do NOT use Diclofenac if:
    • you are allergic to any ingredient in Diclofenac or to bovine (cow) protein
    • you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or an NSAID (eg, ibuprofen, celecoxib)
    • you have recently had or will be having bypass heart surgery
    • you have severe kidney problems
    • you are in the last 3 months of pregnancy.

    Contact your doctor or health care provider right away if this applies to you.

    Some medical conditions may interact with Diclofenac. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

    • if you are pregnant, planning to become pregnant, or are breast-feeding
    • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
    • if you have allergies to medicines, foods, or other substances
    • if you have a history of kidney or liver problems, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers)
    • if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation
    • if you have high blood pressure, blood disorders (eg, porphyria), bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or if you are at risk for any of these diseases
    • if you have poor health, dehydration or low fluid volume, or low blood sodium levels, you smoke, drink alcohol, or have a history of alcohol abuse
    • if you are taking an antibiotic or an anti-seizure medicine. The risk of liver problems may be increased with some of these medicines.

    Some medicines may interact with Diclofenac. Tell your health care provider if you are taking any other medicines, especially any of the following:

    • Anticoagulants (eg, warfarin), aspirin, clopidogrel, corticosteroids (eg, prednisone), heparin and other blood thinners (eg, dalteparin), or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because the risk of stomach bleeding may be increased
    • Acetaminophen because the risk of liver problems may be increased
    • Probenecid because it may increase the risk of Diclofenac's side effects
    • Cyclosporine, lithium, metformin, methotrexate, oral NSAIDs (eg, ibuprofen), or quinolones (eg, ciprofloxacin) because the risk of their side effects may be increased by Diclofenac
    • Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril) or diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by Diclofenac.

    This may not be a complete list of all interactions that may occur. Ask your health care provider if Diclofenac may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

    Important safety information:
    • Diclofenac may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Diclofenac with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
    • Serious stomach ulcers or bleeding can occur with the use of Diclofenac. Taking it in high doses, for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Diclofenac with food will NOT reduce the risk of these effects. If you have severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling, contact your doctor or emergency room right away.
    • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
    • Diclofenac is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist.
    • Do not take aspirin while you are using Diclofenac unless your doctor tells you to.
    • Check with your doctor or pharmacist before you take acetaminophen while you are taking Diclofenac. The risk of liver problems may be increased.
    • Do not switch between different forms of Diclofenac (eg, enteric-coated tablets, immediate-release tablets, capsules) unless your doctor tells you to. They may not provide the same amount of medicine to your body.
    • Lab tests, including kidney function, liver function, blood electrolyte levels, complete blood cell counts, and blood pressure, may be performed while you use Diclofenac. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
    • Use Diclofenac with caution in the elderly; they may be more sensitive to its effects, especially stomach bleeding and kidney problems.
    • Diclofenac should be used with extreme caution in children; safety and effectiveness in children have not been confirmed.
    • Pregnancy and breast-feeding: Diclofenac may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Diclofenac while you are pregnant. It is not known if Diclofenac is found in breast milk. Do not breastfeed while taking Diclofenac.
  • All medicines may cause side effects, but many people have no, or minor, side effects.

    Check with your doctor if any of these most common side effects persist or become bothersome:

    Constipation; diarrhea; dizziness; drowsiness; headache; mild stomach pain or heartburn; nausea; vomiting.

    Seek medical attention right away if any of these severe side effects occur:

    Severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; persistent flu-like symptoms; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting or diarrhea; shortness of breath; sudden or unexplained weight gain; swelling of the hands, legs, or feet; symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, yellowing of the skin or eyes); unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds.

    This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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Diclofenac (Merxil) Delivery

You can order delivery of a Diclofenac (Merxil) to the France, United States, Sweden or any other country in the world. Residents of the USA can order Diclofenac (Merxil) to any city, to any address, for example to Wichita, Chicago, Brooklyn or Rochester.