Diklovit, rectal 50 mg 10 pcs.

How to take, the dosage

Rectally. Suppositories are inserted into the rectum, preferably after spontaneous bowel emptying or purging enema. After insertion of the suppository it is recommended to stay in bed for 20-30 minutes.

Adults and adolescents from 15 years of age: 1 suppository 2-3 times a day.

Dicklovit® may be used simultaneously with oral forms of diclofenac sodium. In this case, the total daily dose of diclofenac sodium should not exceed 150 mg.

In case of algodysmenorrhea (at the appearance of the first symptoms) the initial dose is 50-100 mg/day (1 suppository 1-2 times/day); if necessary the dose is increased during several menstrual cycles up to 150 mg (1 suppository 3 times/day).

Migraine attacks – 100 mg (2 suppositories) at the first signs of an attack. If necessary, repeat 100 mg (2 suppositories). If it is necessary to continue treatment on subsequent days, the daily dose should not exceed 150 mg (3 suppositories) per day.

The duration of treatment is determined by the doctor depending on the severity of the disease.

Interaction

Increases the plasma concentration of digoxin, methotrexate, lithium drugs and cyclosporine.

Decreases the effect of diuretics, against potassium-saving diuretics the risk of hyperkalemia increases; against anticoagulants, thrombolytic agents (alteplase, streptokinase, urokinase) – risk of bleeding (often from the gastrointestinal tract).

Limits the effects of hypotensive and sleeping pills.

Induces side effects of other nonsteroidal anti-inflammatory drugs and glucocorticosteroids (gastrointestinal bleeding), methotrexate toxicity and cyclosporine nephrotoxicity.

Acetylsalicylic acid reduces the blood concentration of diclofenac.

Concomitant use with paracetamol increases the risk of nephrotoxic effects of diclofenac.

Decreases the effect of hypoglycemic agents.

Cefamandole, cefoperazone, cefotetan, valproic acid and plikamycin increase the incidence of hypoprothrombinemia.

Cyclosporine and gold drugs increase the effect of diclofenac on prostaglandin synthesis in the kidneys, which increases nephrotoxicity.

Concomitant administration with ethanol, colchicine, corticotropin and St John’s wort preparations increases the risk of gastrointestinal bleeding.

Diclofenac increases the effect of drugs that cause photosensitization.

Drugs that block tubular secretion increase the plasma concentration of diclofenac, thereby increasing its toxicity.

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Special Instructions

Patients taking the drug should refrain from activities that require increased attention and rapid mental and motor reactions, drinking alcohol.

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Contraindications

Hypersensitivity (including to other NSAIDs), gastrointestinal erosive ulcers (acute phase), bleeding from the gastrointestinal tract, “aspirin” asthma, bleeding disorders,

haemostasis disorders (including hemophilia).Including hemophilia, pregnancy, children (under 15 years), lactation, rectal bleeding, hemorrhoids, trauma or inflammation of the rectum.

With caution

Anemia, bronchial asthma, congestive heart failure, arterial hypertension, coronary heart disease, edema syndrome, hepatic or renal failure, alcoholism, inflammatory

Intestinal diseases, gastrointestinal erosive-ulcerative diseases out of exacerbation, diabetes, conditions after major surgical interventions, inducible porphyria, advanced age, diverticulitis, systemic connective tissue diseases.

Side effects

The arising side effects depend on individual sensitivity, the size of the dose used and the duration of treatment.

The term “sometimes” is used when the side effects occur in 1-10% of patients, “rarely” – in 0.001-1% of patients.

Gastrointestinal tract:

Sometimes – abdominal pain, feeling of bloating, diarrhea, nausea, constipation, flatulence, increased levels of “liver” enzymes, peptic ulcer with possible complications (bleeding, perforation), gastrointestinal bleeding;

Rarely – vomiting, jaundice, melena, blood in feces, esophagus involvement, aphthous stomatitis, dry mouth and mucous membranes, hepatitis (possible fulminant course), liver necrosis, cirrhosis, hepatorenal syndrome, change of appetite, pancreatitis, cholecystopancreatitis, colitis.

Nervous system:

Sometimes – headache, dizziness;

Rarely – sleep disturbance, drowsiness, depression, irritability, aseptic meningitis (more often in patients with systemic lupus erythematosus and other systemic connective tissue diseases), seizures, weakness, disorientation, nightmares, feelings of fear.

Sensory organs:

Sometimes – tinnitus;

Rarely – blurred vision, diplopia, taste disorders, reversible or irreversible hearing loss, scotoma.

Skin:

Sometimes – skin itching, skin rash;

Rarely – alopecia, urticaria, eczema, toxic dermatitis, erythema multiforme, including erythema exudative.Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell’s syndrome), photosensitivity, petechial hemorrhages.

Urinary system:

Sometimes – fluid retention;

Rarely – nephrotic syndrome, proteinuria, oliguria, hematuria, interstitial nephritis, papillary necrosis, acute renal failure, azotemia.

Bleeding organs and immune system:

Sometimes – anemia (including hemolytic and aplastic anemia), leukopenia, thrombocytopenia, eosinophilia, agranulocytosis, thrombocytopenic purpura, worsening of infections (development of necrotizing fasciitis).

Respiratory system:

Rarely – cough, bronchospasm, laryngeal edema, pneumonitis.

Cardiovascular system:

Rarely – increase in blood pressure; congestive heart failure, extrasystole, pain in the chest.

Allergic reactions:

Rarely – anaphylactoid reactions, anaphylactic shock (usually develops rapidly), edema of the lips and tongue, allergic vasculitis.

Local reactions when rectal administration:

Rarely – irritation of the rectal mucosa, mucous discharge with blood admixture, pain during defecation, rectal bleeding.

Overdose

Symptoms: dizziness, headache, rapid breathing, confusion, in children – myoclonic convulsions, nausea, vomiting, abdominal pain, bleeding, liver and kidney function disorders.

Treatment: activated charcoal, symptomatic therapy. Forced diuresis, hemodialysis are ineffective.

Similarities

Diclac, Diclofenac-Teva, Diclo-F, Orthofen, Diclovit, Voltaren, Voltaren Emulsgel, Diclofenac, Voltaren Patch, Dicloran Plus, Orthofen, Diclofenac-Altfarm, Diclofenac-SOLofarm, Dialrapid