Язва желудка или кишечника; анамнестические сведения о приступах бронхиальной астмы, крапивнице, остром рините, связанных с применением ацетилсалициловой кислоты или других НПВП, а также любыми препаратами, подавляющими выработку простагландинов; проктит (только для суппозиториев); нарушения кроветворения; детский возраст до 14 лет; повышенная чувствительность ...
НПВС. Вольтарен содержит диклофенак натрия, вещество нестероидной структуры, оказывающее выраженное противовоспалительное, анальгезирующее и жаропонижающее действие. Основным механизмом действия диклофенака, установленным в условиях эксперимента, считается торможение биосинтеза простагландинов. Простагландины играют важную роль в генезе воспаления, боли и лихорадки.In vitro диклофенак натрия в концентрациях, эквивалентных тем, которые достигаются при лечении пациентов, не подавляет биосинтез протеогликанов хрящевой ткани. При ревматических заболеваниях противовоспалительные и анальгезирующие свойства Вольтарена обеспечивают клинический эффект, характеризующийся значительным уменьшением выраженности таких проявлений заболеваний как боль в покое и при движении, утренняя скованность и припухлость суставов, а также улучшением функционального состояния. При посттравматических и послеоперационных воспалительных явлениях Вольтарен быстро купирует боли (возникающие как в покое, так и при движении), уменьшает воспалительный отек и отек послеоперационной раны.
Показания к применению
Воспалительные и дегенеративные заболевания опорно-двигательного аппарата: ревматоидный артрит, ювенильный ревматоидный артрит, анкилозирующий спондилит, остеоартроз, спондилоартриты, остеоартрит; заболевания позвоночника, сопровождающиеся болевым синдромом; ревматические заболевания внесуставных мягких тканей; острый приступ подагры (только для таблеток, покрытых кишечно-растворимой оболочкой); посттравматические и послеоперационные болевые синдромы, сопровождающиеся воспалением и отеком; гинекологические заболевания, сопровождающиеся болевым синдромом и воспалением (например, первичная альгодисменорея, аднексит); в качестве дополнительного средства при тяжелых инфекционно-воспалительных заболеваниях уха, горла и носа, протекающих с выраженным болевым синдромом, например, при фарингите, тонзиллите, отите (за исключением таблеток ретард). Основное лечение заболевания проводят в соответствии с общепринятыми принципами, в т.ч. с применением этиотропной терапии. Изолированная лихорадка не является показанием к применению препаратаВ/м введение препарата особенно предпочтительно в начале обострений воспалительных и дегенеративных заболеваний с высокой активностью воспаления и при болевых состояниях, вызванных воспалением неревматического генеза.
Противопоказания
Язва желудка или кишечника; анамнестические сведения о приступах бронхиальной астмы, крапивнице, остром рините, связанных с применением ацетилсалициловой кислоты или других НПВП, а также любыми препаратами, подавляющими выработку простагландинов; проктит (только для суппозиториев); нарушения кроветворения; детский возраст до 14 лет; повышенная чувствительность к диклофенаку и любым другим ингредиентам препарата.
Применение при беременности и в период грудного вскармливания
Применение Вольтарена при беременности возможно только в тех случаях, когда ожидаемая польза для матери превышает потенциальный риск для плода. Препарат назначают в минимальной эффективной дозе. Так же, как и в случае применения других ингибиторов простагландин-синтетазы, эти рекомендации особенно важны в III триместре беременности (возможно подавление сократительной способности матки и преждевременное закрытие артериального протока у плода). Применение Вольтарена в форме раствора для в/м введения при беременности не рекомендуется. При необходимости назначения Вольтарена в форме раствора для в/м введения в период лактации следует решить вопрос о прекращении грудного вскармливания.
Способ применения и дозы
Внутримышечно вводят 75 мг препарата внутримышечно, затем дальнейшее лечение проводят с применением таблеток или свечей. Для детей старше 6 лет и подростков применяются только таблетки обычной продолжительности действия по 25 мг и, при необходимости, раствор для уколов. Суточная доза препарата Вольтарен - 2 мг/кг массы тела ребенка.
Побочное действие
Со стороны пищеварительной системы: Иногда - боли в эпигастральной области, тошнота, рвота, диарея, спазмы в животе, диспепсия, метеоризм, анорексия, повышение активности аминотрансфераз в сыворотке крови. Редко - желудочно-кишечное кровотечение (рвота кровью, мелена, диарея с примесью крови), язвы желудка и кишечника, сопровождающиеся или не сопровождающиеся кровотечением или перфорацией, гепатит, сопровождающийся или не сопровождающийся желтухой. В отдельных случаях - афтозный стоматит, глоссит, повреждения пищевода, возникновение диафрагмоподобных стриктур в кишечнике, расстройства со стороны дистального отдела толстой кишки, такие как неспецифический геморрагический колит, обострение язвенного колита или болезни Крона, запоры, панкреатит, молниеносный гепатит. Со стороны ЦНС и периферической нервной системы: Иногда - головная боль, головокружениеРедко - сонливость. В отдельных случаях - нарушения чувствительности, включая Парестезии, расстройства памяти, дезориентация, бессонница, раздражительность, судороги, депрессия, ощущение тревоги, ночные кошмары, тремор, психотические реакции, асептический менингит. Со стороны органов чувств: В отдельных случаях - нарушения зрения (затуманивание зрения, диплопия), нарушения слуха, шум в ушах, нарушения вкусовых ощущений. Со стороны сердечно-сосудистой системы: В отдельных случаях – ощущение сердцебиения, боли в груди, повышение АД, усугубление застойной сердечной недостаточности. Дерматологические реакции: Иногда - кожные сыпи. Редко - крапивница. В отдельных случаях – буллезные высыпания, экзема, многоформная эритема, синдром Стивенса-Джонсона, синдром Лайелла (острый токсический эпидермальный некролиз), эритродермия (эксфолиативный дерматит), выпадение волос, реакции фоточувствительности, пурпура (в т.ч. аллергическая). Со стороны мочевыделительной системы: Редко - отеки. В отдельных случаях - острая почечная недостаточность, гематурия, протеинурия, интерстициальный нефрит, нефротический синдром, папиллярный некроз. Со стороны системы кроветворения: В отдельных случаях - тромбоцитопения, лейкопения, гемолитическая анемия, апластическая анемия, агранулоцитоз. Реакции повышенной чувствительности: Редко - бронхоспазм, системные анафилактические/анафилактоидные реакции, включая гипотензию. В отдельных случаях - васкулит, пневмонит. Местные реакции: Уплотнение, боль. В отдельных случаях - абсцессы, некрозы. Перечисленные Побочное эффекты наблюдались в т.ч. при применении доз препарата и продолжительности лечения, отличающихся от рекомендуемых.
Передозировка
Типичной клинической картины, свойственной передозировке Вольтарена, не существует. Симптомы: снижение АД, почечная недостаточность, судороги, нарушения со стороны ЖКТ и угнетение дыхания. Лечение: поддерживающее и симптоматическое. Маловероятно, что форсированный диурез, гемодиализ или гемоперфузия окажутся полезными для выведения НПВП, т.к. активные вещества этих препаратов в значительной степени связываются с белками плазмы и подвергаются интенсивному метаболизму.
Взаимодействие с другими лекарственными средствами
Вольтарен может повышать концентрацию лития и дигоксина в плазме при одновременном применении с этими препаратами. Вольтарен, как и другие НПВП, может уменьшать эффект диуретиков. Одновременное применение Вольтарена с калийсберегающими диуретиками может привести к повышению уровня калия в крови (в случае такого сочетания лекарственных средств данный показатель следует часто контролировать). Одновременное применение Вольтарена с другими НПВП может повысить риск возникновения побочных эффектов. Хотя в клинических исследованиях не установлено влияния Вольтарена на действие антикоагулянтов, имеются отдельные сообщения об увеличении риска кровотечений в случаях их совместного применения. Рекомендуется тщательное наблюдение за пациентами, получающими эти препараты одновременно. Вольтарен может быть назначен совместно с пероральными гипогликемическими препаратами и при этом эффективность последних не изменяется. Однако известны отдельные сообщения о развитии в таких случаях как гипогликемии, так и гипергликемии, что обусловливало необходимость изменения дозы гипогликемических препаратов на фоне применения Вольтарена. Следует проявлять осторожность при использовании НПВП менее чем за 24 ч до начала применения или после окончания терапии метотрексатом , т.к. его уровень в крови (и, следовательно, токсичность) может повышаться. Влияние НПВП на активность простагландинов в почках может усиливать нефротоксичность циклоспорина . Имеются единичные сообщения о возникновении судорог у больных, принимавших одновременно НПВП и хинолоновые антибактериальные препараты. Не следует смешивать раствор Вольтарена, содержащийся в ампулах, с растворами других лекарственных средств для инъекций.
Особые указания
Во время применения Вольтарена необходимо тщательное медицинское наблюдение за теми больными, у которых имеются жалобы, указывающие на заболевания ЖКТ; имеющими сведения в анамнезе о язвенном поражении желудка или кишечника; страдающими язвенным колитом или болезнью Крона, а также имеющими нарушения функции печени. На фоне применения Вольтарена в любое время может возникнуть (впервые или повторно) желудочно-кишечное кровотечение или развиться изъязвление/перфорация ЖКТ, сопровождающееся или не сопровождающееся симптомами-предшественниками. Более серьезные последствия этих осложнений могут отмечаться у пациентов пожилого возраста. В тех редких случаях, когда у пациентов, получающих Вольтарен, развиваются эти осложнения, препарат должен быть отменен. При первом применении Вольтарена, так же, как и других НПВП, в редких случаях могут развиться аллергические реакции, включая анафилактические и анафилактоидные реакции. Вольтарен, благодаря своим фармакодинамическим свойствам, может маскировать проявления инфекционных заболеваний. Вольтарен, так же, как и другие НПВП, может временно ингибировать агрегацию тромбоцитов. Поэтому у пациентов с нарушениями гемостаза необходим тщательный контроль соответствующих лабораторных показателей. При длительном применении Вольтарена, как и других НПВП, показан систематический контроль картины периферической крови. Влияние на способность к вождению автотранспорта и управлению механизмами: Пациентам, у которых на фоне применения Вольтарена возникает Головокружение или другие нарушения со стороны ЦНС, включая нарушения зрения, не следует водить автомашину или управлять механизмами в период применения препарата.
Форма выпуска
Раствор для внутримышечного введения.
Условия хранения
Хранить в защищенном от света месте при температуре не выше 30°С.
Срок годности
2 года.
Условия отпуска
По рецепту.
Для описания товара использована информация от партнера 36.6
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При посттравматических и послеоперационных воспалительных явлениях Вольтарен быстро купирует боли (возникающие как в покое, так и при движении), уменьшает воспалительный отек и отек послеоперационной раны."}}]},{"id":2,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Воспалительные и дегенеративные заболевания опорно-двигательного аппарата: ревматоидный артрит, ювенильный ревматоидный артрит, анкилозирующий спондилит, остеоартроз, спондилоартриты, остеоартрит; заболевания позвоночника, сопровождающиеся болевым синдромом; ревматические заболевания внесуставных мягких тканей; острый приступ подагры (только для таблеток, покрытых кишечно-растворимой оболочкой); посттравматические и послеоперационные болевые синдромы, сопровождающиеся воспалением и отеком; гинекологические заболевания, сопровождающиеся болевым синдромом и воспалением (например, первичная альгодисменорея, аднексит); в качестве дополнительного средства при тяжелых инфекционно-воспалительных заболеваниях уха, горла и носа, протекающих с выраженным болевым синдромом, например, при фарингите, тонзиллите, отите (за исключением таблеток ретард). Основное лечение заболевания проводят в соответствии с общепринятыми принципами, в т.ч. с применением этиотропной терапии. Изолированная лихорадка не является показанием к применению препаратаВ/м введение препарата особенно предпочтительно в начале обострений воспалительных и дегенеративных заболеваний с высокой активностью воспаления и при болевых состояниях, вызванных воспалением неревматического генеза."}}]},{"id":3,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Язва желудка или кишечника; анамнестические сведения о приступах бронхиальной астмы, крапивнице, остром рините, связанных с применением ацетилсалициловой кислоты или других НПВП, а также любыми препаратами, подавляющими выработку простагландинов; проктит (только для суппозиториев); нарушения кроветворения; детский возраст до 14 лет; повышенная чувствительность к диклофенаку и любым другим ингредиентам препарата."}}]},{"id":4,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Применение Вольтарена при беременности возможно только в тех случаях, когда ожидаемая польза для матери превышает потенциальный риск для плода. Препарат назначают в минимальной эффективной дозе. Так же, как и в случае применения других ингибиторов простагландин-синтетазы, эти рекомендации особенно важны в III триместре беременности (возможно подавление сократительной способности матки и преждевременное закрытие артериального протока у плода). Применение Вольтарена в форме раствора для в/м введения при беременности не рекомендуется. При необходимости назначения Вольтарена в форме раствора для в/м введения в период лактации следует решить вопрос о прекращении грудного вскармливания."}}]},{"id":14,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутримышечно вводят 75 мг препарата внутримышечно, затем дальнейшее лечение проводят с применением таблеток или свечей. Для детей старше 6 лет и подростков применяются только таблетки обычной продолжительности действия по 25 мг и, при необходимости, раствор для уколов. 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Со стороны ЦНС и периферической нервной системы: Иногда - головная боль, головокружениеРедко - сонливость. В отдельных случаях - нарушения чувствительности, включая Парестезии, расстройства памяти, дезориентация, бессонница, раздражительность, судороги, депрессия, ощущение тревоги, ночные кошмары, тремор, психотические реакции, асептический менингит. Со стороны органов чувств: В отдельных случаях - нарушения зрения (затуманивание зрения, диплопия), нарушения слуха, шум в ушах, нарушения вкусовых ощущений. Со стороны сердечно-сосудистой системы: В отдельных случаях – ощущение сердцебиения, боли в груди, повышение АД, усугубление застойной сердечной недостаточности. Дерматологические реакции: Иногда - кожные сыпи. Редко - крапивница. В отдельных случаях – буллезные высыпания, экзема, многоформная эритема, синдром Стивенса-Джонсона, синдром Лайелла (острый токсический эпидермальный некролиз), эритродермия (эксфолиативный дерматит), выпадение волос, реакции фоточувствительности, пурпура (в т.ч. аллергическая). Со стороны мочевыделительной системы: Редко - отеки. В отдельных случаях - острая почечная недостаточность, гематурия, протеинурия, интерстициальный нефрит, нефротический синдром, папиллярный некроз. Со стороны системы кроветворения: В отдельных случаях - тромбоцитопения, лейкопения, гемолитическая анемия, апластическая анемия, агранулоцитоз. Реакции повышенной чувствительности: Редко - бронхоспазм, системные анафилактические/анафилактоидные реакции, включая гипотензию. В отдельных случаях - васкулит, пневмонит. Местные реакции: Уплотнение, боль. В отдельных случаях - абсцессы, некрозы. Перечисленные Побочное эффекты наблюдались в т.ч. при применении доз препарата и продолжительности лечения, отличающихся от рекомендуемых."}}]},{"id":6,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Типичной клинической картины, свойственной передозировке Вольтарена, не существует. Симптомы: снижение АД, почечная недостаточность, судороги, нарушения со стороны ЖКТ и угнетение дыхания. Лечение: поддерживающее и симптоматическое. Маловероятно, что форсированный диурез, гемодиализ или гемоперфузия окажутся полезными для выведения НПВП, т.к. активные вещества этих препаратов в значительной степени связываются с белками плазмы и подвергаются интенсивному метаболизму."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Вольтарен может повышать концентрацию лития и дигоксина в плазме при одновременном применении с этими препаратами. Вольтарен, как и другие НПВП, может уменьшать эффект диуретиков. Одновременное применение Вольтарена с калийсберегающими диуретиками может привести к повышению уровня калия в крови (в случае такого сочетания лекарственных средств данный показатель следует часто контролировать). Одновременное применение Вольтарена с другими НПВП может повысить риск возникновения побочных эффектов. Хотя в клинических исследованиях не установлено влияния Вольтарена на действие антикоагулянтов, имеются отдельные сообщения об увеличении риска кровотечений в случаях их совместного применения. Рекомендуется тщательное наблюдение за пациентами, получающими эти препараты одновременно. Вольтарен может быть назначен совместно с пероральными гипогликемическими препаратами и при этом эффективность последних не изменяется. Однако известны отдельные сообщения о развитии в таких случаях как гипогликемии, так и гипергликемии, что обусловливало необходимость изменения дозы гипогликемических препаратов на фоне применения Вольтарена. Следует проявлять осторожность при использовании НПВП менее чем за 24 ч до начала применения или после окончания терапии метотрексатом , т.к. его уровень в крови (и, следовательно, токсичность) может повышаться. Влияние НПВП на активность простагландинов в почках может усиливать нефротоксичность циклоспорина . Имеются единичные сообщения о возникновении судорог у больных, принимавших одновременно НПВП и хинолоновые антибактериальные препараты. Не следует смешивать раствор Вольтарена, содержащийся в ампулах, с растворами других лекарственных средств для инъекций."}}]},{"id":7,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Во время применения Вольтарена необходимо тщательное медицинское наблюдение за теми больными, у которых имеются жалобы, указывающие на заболевания ЖКТ; имеющими сведения в анамнезе о язвенном поражении желудка или кишечника; страдающими язвенным колитом или болезнью Крона, а также имеющими нарушения функции печени. На фоне применения Вольтарена в любое время может возникнуть (впервые или повторно) желудочно-кишечное кровотечение или развиться изъязвление/перфорация ЖКТ, сопровождающееся или не сопровождающееся симптомами-предшественниками. Более серьезные последствия этих осложнений могут отмечаться у пациентов пожилого возраста. В тех редких случаях, когда у пациентов, получающих Вольтарен, развиваются эти осложнения, препарат должен быть отменен. При первом применении Вольтарена, так же, как и других НПВП, в редких случаях могут развиться аллергические реакции, включая анафилактические и анафилактоидные реакции. Вольтарен, благодаря своим фармакодинамическим свойствам, может маскировать проявления инфекционных заболеваний. Вольтарен, так же, как и другие НПВП, может временно ингибировать агрегацию тромбоцитов. Поэтому у пациентов с нарушениями гемостаза необходим тщательный контроль соответствующих лабораторных показателей. При длительном применении Вольтарена, как и других НПВП, показан систематический контроль картины периферической крови. Влияние на способность к вождению автотранспорта и управлению механизмами: Пациентам, у которых на фоне применения Вольтарена возникает Головокружение или другие нарушения со стороны ЦНС, включая нарушения зрения, не следует водить автомашину или управлять механизмами в период применения препарата."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для внутримышечного введения."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в защищенном от света месте при температуре не выше 30°С."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"НПВС. 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