home > Well construction > Dicloberl or Voltaren which is better. What to choose: diclofenac or voltaren? Safe analogues of Diclofenac - tablets, ointments, injection solutions

Dicloberl or Voltaren which is better. What to choose: diclofenac or voltaren? Safe analogues of Diclofenac - tablets, ointments, injection solutions

Prohibited during pregnancy

Prohibited while breastfeeding

Forbidden to children

Has restrictions for the elderly

Has limitations for liver problems

Has limitations for kidney problems

Diclofenac is a medicinal product containing the active substance diclofenac sodium. Belongs to the group of NSAIDs. It is widely used for exacerbations of pathologies of the musculoskeletal system, in particular, rheumatoid lesions, arthritis and arthrosis, osteochondrosis, intervertebral hernia, etc.

It also actively relieves pain in neuralgia of various origins, migraines, inflammation of the dental nerve, injuries, postoperative conditions. The drug is produced in the form of tablets, solution for injection, ointment.

The broad effect of the drug is due to several effects that its active components have:

hyperthermic;
anti-inflammatory;
analgesic.

Diclofenac in any of its forms is contraindicated in pregnant women, especially in the third trimester. You can not use it during lactation and in childhood. Reception of the drug in any form is also limited in case of severe disorders of the kidneys and organs of the gastrointestinal tract.

Each form of Diclofenac has its own analogues, which, if necessary, can be replaced. But along with this, it is necessary to know how to correctly apply a specific analogue, since the features of its use may differ from those prescribed in the instructions for the main medicine.

The main analogues of Diclofenac and their cost

The price of the drug depends on the dosage form. The average cost of Diclofenac is:

Tablets - 16 rubles.
Solution for intramuscular injections - 21 rubles.
Gel 5% - 50 rubles. (depending on the amount of ointment in the tube).
Candles of 50 mg - 180 rubles.

Prices for the best analogues are described in the table.

No. p / p	Name of the drug	Release form	Qty	Average price (rubles)
1.	Diklak	Gel, 5%	100 g	354
2.	Diklovit	Gel, 1%	20 g	147
3.	Dicloran Plus	Gel	30 g	210
4.	Movalis	R/r for i/m injections	1.5 ml / 15 mg, 5 pcs.	812
5.	Xefocam	Lyophilizate for the preparation of an injection solution	8 mg, 5 vials	826
6.	Voltaren	Ampoules	75 mg, 3 ml, 5 pcs.	278
7.	Clinoril	Tablets	200 mg, 20 pcs.	170
8.	Tenoxicam (Tenox)	Tablets	5 mg, 30 pcs.	300
9.	Indomethacin	Candles rectal	100 mg, 10 pcs.	56
10.	Meloxicam	Tablets	7.5 mg, 20 pcs.	51
11.	Ketorolac	Tablets for p / o reception	10 mg, 20 pcs.	39

You can buy analogues not only in a stationary pharmacy, but also order in an online pharmacy. The main thing is to place an order on trusted, reputable resources, so as not to purchase a fake.

Substitutes in the form of ointment and gel

Below are reviews of the most popular and effective analogues of Diclofenac ointment intended for external use.

Diclac-gel

Diclak is a gel for external use from the NSAID group containing 5% diclofenac sodium. The drug is indicated for patients with:

exacerbation of rheumatic diseases;
muscle pain of various etiologies;
traumatic lesions of soft tissues.

persons with hypersensitivity to diclofenac;
pregnant women;
nursing mothers;
patients with so-called aspirin asthma;
children under 6 years old;
patients with violation of the integrity of the skin.

Note. Despite the fact that the medication is intended for external application, it should be used with extreme caution in patients suffering from porphyria, erosive and ulcerative lesions of the gastric mucosa, severe kidney and liver disorders.

The drug is applied to the skin with a thin layer, while rubbing the ointment well until it is completely absorbed. A single dose of Diclac gel is 2 g. It is necessary to treat the affected surface 2-3 times / 24 hours. The duration of therapy is determined individually.

Diclofenac-gel practically does not have any differences from Diclofenac, since it is its complete analogue. As can be seen from the previously reviewed table, only the cost of the medicine differs.

Diklovit

Diclovit is a gel containing 10 mg of diclofenac sodium. It has a pronounced anti-inflammatory, analgesic, anticoagulant effect. In parallel, it helps to reduce the feeling of heat in the affected area.

The use of Diclovit is justified for rheumatic and articular diseases, sprains, inflammatory processes in soft tissues. Gout, psoriatic arthritis, lumbago and neuralgia, Reiter's disease are also among the indications for the use of the medication in question.

Diclovit is forbidden to be used by patients with intolerance to aspirin or any other NSAIDs, poor blood clotting, renal porphyria, hepatic disorders, etc. During pregnancy and HB, the medicine can only be prescribed by a doctor and only under strict indications.

How to use Diclovit? The gel is applied in a thin layer - 2-4 g at a time. Multiplicity of application - 2-3 times a day. The ointment should be rubbed with massaging movements until completely absorbed. The maximum duration of treatment is 2 weeks. If the drug is ineffective, its further use is inappropriate.

Dicloran Plus

Dicloran Plus is an ointment from the NSAID group that relieves pain and inflammation. Indications for the use of Dicloran include:

different types of arthritis;
rheumatic lesions;
osteoarthritis;
bursitis;
muscle pain of rheumatic etiology and not only;
sprains;
bruises;
overvoltage.

Do not apply Dicloran Plus to damaged skin. The drug is not recommended for use by persons with hypersensitivity to any of its components, pregnant women, patients during lactation, children under 6 years of age, patients with polyposis sinusitis of allergic etiology.

With extreme caution, the drug is prescribed to people with bronchial asthma, severe liver and kidney diseases. Precautions in the treatment of Dicloran should be followed by elderly patients.

Application rules:

Children 6-12 years old are recommended to apply the drug in a thin layer no more than 2 times a day. For 1 approach, you can use no more than 2 g of medication.
Adult patients should adhere to the same principles for the use of Dicloran, but the frequency of applications is 3-4 times / 24 hours. The dosage can reach 4 g per 1 dose.
The gel should be applied over the entire affected area. It should be rubbed for at least 3 minutes until it is completely absorbed into the skin.

Analogues in the form of injections for intramuscular or intravenous administration

There are several effective analogues of Diclofenac of the new generation in injections. This:

Movalis.
Ksefokam.
Voltaren.

Despite the same mechanism of action of the drugs from this list, they have differences in the features of the application.

Movalis

Movalis is an Austrian non-steroidal anti-inflammatory drug. Contains the active substance meloxicam at a dose of 15 mg. Relieves inflammation, pain and relieves signs of fever. Movalis is less harmful than Diclofenac because it comes in the form of an injectable solution that is not absorbed in the stomach and is not metabolized in the liver.

The drug, unlike Diclofenac, is prescribed to eliminate mild pain in the initial stage of the development of rheumatoid arthritis, joint diseases, osteoarthritis, gout, etc. At the same time, it has more contraindications than the main drug. These include:

bronchial asthma;
ulcer or perforation of the stomach, duodenum;
intolerance to NSAIDs and the main component of the drug in particular;
bleeding of various origins;
poor blood clotting;
uncontrolled or rapidly progressive heart failure.

Injections should not be given to patients undergoing preparatory pain therapy before coronary artery bypass surgery.

Rules for the use of Movalis:

Injections are given only for 2-3 days from the start of pain therapy. After that, the medicine is administered orally, that is, inside.
Movalis is administered by deep intramuscular injection. The initial dosage is 7.5 mg. The maximum daily dose is 15 mg. The drug can be administered at a time, or divided into 2 applications - depending on the severity of the pain syndrome. Movalis should not be administered intravenously.

The drug differs from Diclofenac in composition, contraindications and application features. Movalis is released only by prescription.

Xefocam

The active ingredient is lornoxicam. Ksefokam is an NSAID that has anti-inflammatory, antipyretic, analgesic effects. The drug is suitable for short-term treatment of mild to moderate pain during exacerbation of rheumatoid arthritis, gout, osteoarthritis and other diseases of the musculoskeletal system.

Ksefokam is contraindicated in women during pregnancy and lactation, as well as in patients with hypersensitivity to lornoxicam, hypersensitivity to other NSAIDs, hemorrhagic diathesis, bleeding disorders, severe hepatic, cardiac, renal disorders, asthma, hypertension, anemia. Intramuscular administration of the solution to patients taking anticoagulants is strictly unacceptable.

Rules for the introduction of the drug:

With intravenous administration of Xefocam, the procedure should last at least 15 seconds. Intramuscular administration of the solution lasts at least 5 seconds.
The initial dose of the drug ranges from 8 to 16 mg.
For maintenance therapy, the patient is given 8 mg of Xefocam twice a day.

Important! In order to avoid an overdose, you can not use more than 16 mg of the drug per day!

Diclofenac and Xefocam are analogues only in terms of therapeutic effect. The compositions, prices, features of their use are completely different, as well as the side effects and symptoms of overdose caused by them.

Voltaren

Voltaren is an NSAID containing sodium diclofenac 25 mg per 1 ml. Released in the form of a solution for intramuscular and intravenous injections of 3 ml in each ampoule (75 mg of diclofenac).

Under the influence of the active component, prostaglandins are bound and their synthesis is inhibited. Due to this, the anti-inflammatory and antipyretic effect of the drug is achieved. Voltaren also has pronounced analgesic properties, so it is used as an anesthetic after minor surgical interventions, with periodic pain in women, cephalalgia.

The remaining indications for the appointment of Voltaren in the form of injections are identical to those for the "classic" Diclofenac. The same applies to contraindications to the use of the drug.

Features of use and dosage (children over 6 years old and adults):

The drug is administered intramuscularly at a dose of 75 mg once. After that, if such a need arises, treatment is recommended using suppositories or tablets.
Voltaren for children over 6 years of age is administered at the rate of 2 mg of the drug per 1 kg of body weight.

Other effective diclofenac generics

Other forms of non-steroidal anti-inflammatory drugs are no less often prescribed. In this case, you can replace Diclofenac with Clinoril or Tenoxicam.

Clinoril

Clinoril is a non-steroidal anti-inflammatory drug based on sulindac (200 mg per 1 tablet). It has antipyretic, analgesic effect. Quickly eliminates inflammation, alleviates the general condition of the patient with pain of various etiologies.

Clinoril will be effective for:

lesions of the lumbosacral spine;
arthropathies;
rheumatoid arthritis;
gout;
various forms of arthrosis;
ankylosing spondylitis;
dorsalgia;
sciatica;
lumbago, combined with sciatica;
unspecified enthesopathy, etc.

You should not take pills with exacerbation of peptic ulcer, asthma attacks, pregnancy, lactation, intolerance to NSAIDs, gastrointestinal bleeding. Do not prescribe Clinoril to children under 6 years of age.

Tablets are taken orally, before meals. The initial dosage is 200 g. The frequency of use is 1-2 times a day. The duration of therapy should not exceed 7 days.

For children, Clinoril is prescribed mainly for exacerbation of rheumatoid arthritis. The dosage for two-year-old babies and older children is calculated as follows: 4.5 or 6 mg per 1 kg of body weight. The daily dosage of the drug is divided into 2 doses.

Composition, price, possibility of use in childhood - these are the main characteristics that distinguish Clinoril from Diclofenac.

Tenoxicam

Tenoxicam is an NSAID used for elevated body temperature, pain of various origins, inflammatory processes in the joints. Specific indications for prescribing the drug are:

gout;
myalgia;
osteoarthritis;
rheumatoid arthritis;
myositis;
neuralgia;
bursitis;
pain in the spine caused by rheumatism, sciatica or trauma.

Tenoxicam is not used for bleeding from the gastrointestinal tract, erosions or ulcers on the gastric mucosa, allergies to NSAIDs, intolerance to tenoxicam as a substance, severe liver, kidney, heart failure. It is strictly unacceptable to prescribe medicine to women during the gestational and lactation period.

The cheapest substitutes

Cheaper anti-inflammatory drugs, compared to Diclofenac, are Indomethacin, Meloxicam and Ketorolac.

Indomethacin

Indomethacin is a non-steroidal agent that contains the active substance of the same name. It is released in the form of suppositories for rectal administration, solution and tablets.

The drug in any form is prescribed for inflammatory diseases of the musculoskeletal system of rheumatic and non-rheumatic origin, pain syndrome of various etiologies, elevated body temperature, provoked by inflammation.

Indomethacin is not prescribed for patients with hypersensitivity to its components, asthma, intolerance to NSAIDs, gastric ulcer or duodenal ulcer, bleeding of any etiology, bleeding disorders, severe diseases of the kidneys, heart, liver. During pregnancy and lactation, as well as in children under 14 years of age, Indomethacin is not prescribed.

Therapy scheme:

When taken internally. Adult patients are prescribed 25 mg of the drug 2-3 times a day. With the ineffectiveness of therapy, the dose is increased to 50 mg three times a day. The maximum allowable dosage is 200 mg. Tablets are taken after meals.
Severe pain may require intramuscular injection of Indomethacin. Under such circumstances, it is used at a dose of 60 mg 1-2 times a day. The duration of treatment is from 1 to 2 weeks.
For rectal administration, 50-100 mg of Indomethacin is prescribed 1-2 times a day. As maintenance therapy, the dosage of the drug remains the same, but it is used only at night.

The main differences between Indomethacin and Diclofenac are the composition and cost. This tool is cheaper than the main drug, regardless of the form of release.

Meloxicam

Meloxicam is an anti-inflammatory drug based on the active substance of the same name (7.5 mg / 1 tab.). Stops inflammation, fever, pain syndrome. It is indicated for patients suffering from rheumatic or non-rheumatic pains, arthritis, spondylitis, degenerative joint pathologies. The drug is widely used for symptomatic treatment of cephalalgia, menstrual pain and pain of other origin.

Note. Although Meloxicam has an anti-inflammatory and antipyretic effect, it does not affect the course of the underlying disease.

The drug is safer than Diclofenac, and this is its main difference from the main drug (not counting the price and composition). It can be used during pregnancy or lactation, but with extreme caution. Children under 15 years of age, patients with gastrointestinal bleeding, stomach ulcers or duodenal ulcers, low blood viscosity, diseases of the cardiovascular system, kidneys or liver, the drug is not prescribed.

You need to take the tablets only with meals 1 time per day. The minimum dose is 7.5 mg. With the ineffectiveness of the treatment, the dosage is doubled. The duration of therapy is determined for each patient individually.

Ketorolac

Non-steroidal agent with analgesic and anti-inflammatory effect. It is released in the form of tablets and injections. It is prescribed for intense pain syndrome, including cephalalgia and pain in the lower abdomen in women during menstruation. It is widely used for various injuries, toothache, rheumatic pain, neuralgia, sciatica, etc.

Not used in children under 16 years of age, patients diagnosed with hypovolemia, urticaria, rhinitis, dehydration. It is unacceptable to take Ketorolac to patients who have had a hemorrhagic stroke, as well as to patients with severe disorders of renal function. Do not prescribe for liver disease.

Ketorolac is taken orally after meals or given as an IM injection. The dose for 1 dose is 10 mg (1 tablet) or 1 ampoule with injection solution.

Tablets are allowed to be taken no more than 4 times a day with an interval between applications of at least 4-6 hours. Ketorolac is intended for short-term use only!

When choosing a replacement, the doctor must take into account the safety of medicines, the frequency of dosages used and the duration of the therapeutic course. Diclofenac analogues may be structural or similar in clinical action. Neuropathologists, rheumatologists, traumatologists prefer drugs from the group of non-steroidal anti-inflammatory drugs.

Characteristic features of non-steroidal anti-inflammatory drugs

Diclofenac is a derivative of phenylacetic acid used in pharmacological preparations in the form of a sodium salt. The mechanism of action of a non-steroidal anti-inflammatory drug is based on its ability to block the cyclooxygenase (COX) enzyme, which stimulates the production of pain and inflammation mediators prostaglandins and bradykinins from arachidonic acid, as well as bioactive compounds of prostacyclin and thromboxane. The use of Diclofenac in tablets, ointments, parenteral solutions has a diverse effect on the human body:

decrease in the severity of pain syndrome;
relief of the inflammatory process and swelling;
elimination of fever.

In medical practice, analogues of Diclofenac are distinguished by composition and therapeutic effect. Such a classification is necessary for the quick selection of an NSAID replacement if it is intolerable or if an excessive number of side effects occur. Structural analogues of Diclofenac include Diclogen, Ortofen, Dicloberl, Voltaren, Diklak, Naklofen. They are of interest, first of all, to patients, since the cost of drugs can vary significantly. For example, the price of Ortofen ointment is rubles, and you will have to pay at least 200 rubles for a package of Voltaren gel.

Structural analogs of Diclofenac

Analogues of Diclofenac on the rendered action

If a doctor prescribes an expensive structural analogue of Diclofenac, then you should not suspect him of any self-interest. The high price is often due to the high quality of the additional and active ingredients included in the ointment or tablets. Such a drug will be better absorbed and provoke fewer side effects.

Rheumatologists, traumatologists, neuropathologists rarely replace Naklofen with Diclogen or Dicloberl. In case of intolerance to Diclofenac or its low effectiveness in the treatment of any diseases, they include other non-steroidal anti-inflammatory drugs in therapeutic regimens that are similar in pharmacological action:

These analogues of Diclofenac have few differences in instructions for use, price, consumer reviews. But there is also a difference in action, which is caused by the biochemical properties of the active ingredients. In vitro studies have found that all NSAIDs inhibit the production of prostaglandins to varying degrees. So far, the relationship between their anti-inflammatory and analgesic properties and the degree of suppression of mediators has not been proven.

Diclofenac and its analogues are characterized by the presence of similar chemical and pharmacological activity. Most of them are weak organic acids that are quickly absorbed in the digestive tract. All NSAIDs in the systemic circulation bind to albumin and are evenly distributed in tissues. Allocate non-steroidal anti-inflammatory drugs of the following groups:

short-lived (less than 6 hours);
long-lived (more than 6 hours).

To replace Diclofenac, the doctor may prescribe both a short-lived and long-lived analogue. This is due to the fact that there is no clear relationship between the duration of the drug in the human body and the severity of the therapeutic effect. Almost all NSAIDs rapidly accumulate in the synovial fluid of the joints, and then are metabolized in hepatocytes (liver cells) in the process of glucuronization, forming biologically active and inactive conjugates. They are evacuated by the kidneys by about 65-80%.

Comparison of clinical effects of analogues

Diclofenac and its analogues stop the inflammatory process mainly at the stage of exudation, when fluid from small blood vessels is released into the tissue or body cavity. The most effective are Diclofenac, Indomethacin, Phenylbutazone, which reduce collagen synthesis.

According to the degree of anti-inflammatory action, all NSAIDs are significantly inferior to glucocorticosteroids, which can inhibit the production of prostaglandins.

During clinical trials that were conducted to compare the effectiveness of non-steroidal anti-inflammatory drugs, the features of individual representatives of this group of drugs were revealed:

antipyretic activity was identical for all NSAIDs, and they reduced only subfebrile temperature values, in contrast to the hypothermic agent Chlorpromazine;
the antiaggregation effect was based on the inhibition of cyclooxygenase in platelets and the suppression of the synthesis of the proaggregant thromboxane. The greatest antiaggregatory activity is characteristic of acetylsalicylic acid, and it is much lower in Diclofenac and its other analogues;
the immunosuppressive effect is moderate in all NSAIDs with prolonged use and is based on their ability to reduce capillary permeability, hinder the contact of cells that trigger an allergic reaction with antigens.

All NSAIDs effectively eliminate pain syndrome of moderate intensity, localized in muscle, joint, tendon tissues. To eliminate severe visceral pain, it is usually practiced to prescribe drugs with morphine - narcotic analgesics. But Diclofenac, Metamizole, Perekoxib, Ketoprofen successfully cope with such intense discomfort.

Even “neglected” joint problems can be cured at home! Just remember to rub it on once a day.

These NSAIDs are actively used to relieve renal colic, often associated with urolithiasis. The active ingredients of the drugs inhibit the production of prostaglandins in the renal structures, slow down the renal circulation and the formation of urine, and this causes a decrease in pressure in the paired organs. Unlike narcotic analgesics, Diclofenac and its analogues do not provoke drug addiction and euphoria, they do not have the ability to suppress the respiratory center.

With a course of taking any non-steroidal anti-inflammatory drugs, especially in elderly and senile patients, chronic heart failure may worsen. The probability of development of events according to such a negative scenario is 10 times higher compared to the refusal to take NSAIDs.

The most popular analogues from the NSAID group

Often, the use of injection solutions and tablets of Diclofenac causes side effects. Doctors try to prevent the negative effects of treatment by adjusting dosages individually for each patient. NSAIDs are not initially prescribed to people with a history of erosive and hyperacid gastritis, ulcerative lesions of the gastrointestinal tract, since a course of Diclofenac will provoke acute painful relapses.

To prevent ulceration of the mucous membranes of the digestive system, neuropathologists and traumatologists include proton pump blockers in the therapeutic regimens of patients, which include the active ingredients lansoprazole, omeprazole, pantoprazole, esomeprazole. Sometimes even such preventive measures are not enough: there are pains in the epigastric region, gastrointestinal bleeding, bouts of vomiting. Doctors immediately cancel Diclofenac and use other, safer NSAIDs to treat the patient.

In the United States, a randomized clinical trial was conducted in which 1309 patients, mostly women, took part. The average age of the volunteers was 64 years, and the duration of the chronic disease was about 9 years. One group of patients took Meloxicam, and the second group was treated with Diclofenac, Naproxen, Piroxicam, Ibuprofen. The results of the study showed that treatment with Meloxicam was successful in 66.8% of people, and the use of Diclofenac and analogues brought relief in only 45% of volunteers.

Meloxicam

Meloxicam is a derivative of enoliconic acid. The non-steroidal anti-inflammatory drug has a positive effect on the intensity of pain, has an antipyretic effect, and is well tolerated by patients. After penetration into the systemic circulation, Meloxicam binds to proteins, while 40-50% accumulates in the synovial fluid, which is actively used in the treatment of pathologies of the musculoskeletal system. For NSAIDs, a long elimination period is characteristic - about 20 hours, therefore, to achieve a therapeutic effect, a single dose or parenteral administration is sufficient. Meloxicam is a safer analogue of Diclofenac, Naproxen, Piroxicam. It does not interact with other drugs:

cytostatics;
antihypertensive drugs;
diuretics;
cardiac glycosides;
b-blockers.

When prescribing, the doctor takes into account the cumulative effect of Meloxicam, the creation of the maximum therapeutic concentration in the bloodstream. In order to achieve a rapid therapeutic effect, intramuscular administration of NSAIDs in the amount of 15 mg is practiced in the first 3 days. After that, the patient is recommended oral administration of tablet forms.

Ibuprofen

The results of a recent study of sales of non-steroidal anti-inflammatory drugs revealed that Ibuprofen ointment and tablets are in the widest demand among the population. The advantage of this NSAID is the budgetary cost. The price for one package is rubles, which makes the drug extremely attractive to pharmacy buyers. But the advantages of Ibuprofen do not include safety of use. Undesirable consequences of treatment with this analogue of Diclofenac are such pathological conditions:

bronchospasm;
decreased clarity of vision;
psycho-emotional instability;
hepatitis;
dyspeptic disorders.

But with a competent dosing regimen, Ibuprofen has a pronounced analgesic, anti-inflammatory and antipyretic effect. NSAIDs are widely used in pediatrics as an etiotropic and symptomatic remedy for viral and bacterial respiratory infections, juvenile arthritis.

With the combination of oral and local preparations of Ibuprofen in JA, a significant prolongation of the therapeutic effect is achieved, which makes it possible to reduce single and daily dosages, as well as the duration of treatment.

Nimesulide

At the State Institute of Rheumatology of the Russian Academy of Medical Sciences in Moscow, a comparative study of the therapeutic efficacy of Nimesulide (Nise) and Diclofenac tablet forms was conducted with the participation of 90 volunteers. Its aim was to establish the rate of onset of analgesic and anti-inflammatory effects in patients with acute gouty arthritis. The duration of admission was 7 days, during which the condition of patients was constantly monitored. According to the results of comparing the clinical efficacy of stopping a gout attack, the advantage of Nimesulide was revealed. Indications for its use:

osteoarthritis;
rheumatoid, gouty, juvenile arthritis;
bursitis, tendinitis;
myalgia, algomenorrhea, toothache, arthralgia, headache;
pain that occurs in the postoperative period.

Suspensions, tablets and rectal suppositories are prescribed for adults and children to reduce body temperature during febrile conditions provoked by the penetration of infectious agents into the body.

Overview of analogues from the NSAID group

Most often, side effects of drugs appear after their parenteral administration, so doctors quickly select a replacement for Diclofenac with an analogue in ampoules. It is not advisable to include Voltaren or Ortofen injectable solutions in the therapeutic schemes of patients. These drugs have a composition identical to Diclofenac. The safest analogues from the NSAID group:

Meloxicam (from 120 rubles);
Movalis (from 650 rubles);
Ksefokam (about 700 rubles);
Ketorol (from 120 rubles);
Ketonal (from 250 rubles).

It is strictly forbidden to replace Diclofenac without prior consultation with your doctor. Despite the similarity of the shown action, all analogues differ in the frequency of application and dosing regimen. Each drug has its own characteristics of use and characteristic contraindications.

If, after applying Diclofenac ointment, allergic rashes occur on the skin, then analogues from the NSAID group do not necessarily become a substitute for an external agent. These can be warming gels, balms with chondroprotectors and even glucocorticosteroids. The greatest anti-inflammatory efficiency is typical for such drugs:

For the treatment and prevention of DISEASES OF THE JOINTS and SPINE, our readers use the method of fast and non-surgical treatment recommended by the leading rheumatologists of Russia, who decided to oppose pharmaceutical lawlessness and presented a medicine that REALLY TREATS! We got acquainted with this technique and decided to bring it to your attention. Read more.

ointment Ibuprofen (from 30 rubles);
Nise gel (from 220 rubles);
gel Amelotex (from 240 rubles);
Ketonal cream (about 320 rubles);
ointment Indomethacin (from 75 rubles).

Diclofenac ointment analogs are well absorbed by the skin and quickly penetrate into inflammatory foci, creating a therapeutic concentration in the synovial fluid of the joints, muscle and soft tissues.

When choosing analogues of Diclofenac, the doctor must take into account the selectivity of the drug. This factor does not determine efficacy, but influences toxicity values. The course of short-lived NSAIDs (Ibuprofen) is better tolerated by patients than the use of Indomethacin, Naproxen, Piroxicam.

How to forget about pain in the joints?

Joint pain limits your movement and life...
You are worried about discomfort, crunching and systematic pain ...
Perhaps you have tried a bunch of medicines, creams and ointments ...
But judging by the fact that you are reading these lines, they did not help you much ...

Want to get the same treatment, ask us how?

Analogues of Diclofenac injections: price, reviews

Among the many medicines that belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs), the drug Diclofenac is the most popular among doctors and patients.

He is able to deal with three ailments at once: relieve fever, anesthetize and resist the inflammatory process in the body. The advantage is its relatively low price, as well as the variety of forms of release.

The best effect is given by injections of Diclofenac, which can have an analgesic and antipyretic effect in a matter of minutes.

Intramuscular injections of Diclofenac have:

pronounced anti-inflammatory effect,
moderate antipyretic effect,
fast analgesic effect.

Diclofenac can be used as an independent drug, and in combination therapy with other drugs. Here we covered in detail the topic of non-steroidal anti-inflammatory drugs for joints.

Release form and composition

Diclofenac, due to its popularity and wide range of applications, has several forms of release, suitable for various clinical cases.

Release forms of Diclofenac:

Solution for injection: solution for intramuscular injection, has a transparent color and a slight smell of benzyl alcohol. One ampoule (3 ml of solution) contains 75 mg of diclofenac sodium. Auxiliary substances that are part of the ampoule: benzyl alcohol and water. The drug is available in a carton box containing ampoules of 3, 5 or 10 ml.
Tablets: Tablets for oral administration. Round, covered with a light orange or white shell, sold in blisters.

One tablet contains 25 or 50 mg diclofenac sodium. The drug is produced in 10, 20, 30, 50 or 100 pieces per package.

Rectal suppositories: oval suppositories, covered with a white film, sold in a cardboard box. One suppository contains 25, 50 or 100 mg of diclofenac. Auxiliary substances are: witepsol, aerosil, propylene glycol. Suppositories are produced in packs of 10.

Ointment: 1% ointment has a light white, slightly transparent color and a specific smell. One gram of ointment contains 10 mg of diclofenac. Auxiliary substances are: nipazole, polyethylene oxide, pilenglycol and nipagin. The ointment is available in tubes packed in a cardboard box of 40 and 60 g.

Gel: The 5% and 1% topical gel is clear or nearly clear in color and has a slight odor. One gram of gel contains 50 mg of diclofenac. The product is available in tubes packed in a cardboard box of 50 or 100 g.

Eye drops: clear liquid drops in a plastic tube with an applicator. 1 ml of solution contains 1 mg of diclofenac. Excipients are: sodium, propylene glycol, disodium salt, water. Drops are sold in a 5 ml carton.

There are also mixed types of Diclofenac, for example, with paracetamol or a vitamin complex.

Indications for use

The drug Diclofenac is an effective drug widely used in modern medicine. It helps to relieve pain in case of injuries and damage to muscle groups, as well as diseases of the joints and the musculoskeletal system. Read about gelatin for joints, how to drink, doctors' reviews, contraindications here.

It has a high anti-inflammatory effect, reduces high body temperature and improves the general condition of the body. More often, treatment with this remedy is carried out with the help of ointments or gels, as well as tablets.

The characteristics of the injection solution indicate that Diclofenac injections are prescribed for inflammatory processes.

osteoarthritis,
injury,
arthritis,
rheumatism,
ankylosing spondylitis,
joint disease,
pain syndromes of the musculoskeletal system,
bruises,
radiculitis.

Contraindications

Diclofenac is a fairly serious medication, with contraindications and side effects, which is why doctors do not recommend using the drug without a doctor's prescription and injecting yourself.

It is worth carefully studying these points, and understanding that, in addition to unconditional contraindications, there are cases when diclofenac injections can bring a small, but still, harm to the body.

in childhood,
with peptic ulcers,
with pathologies with blood,
with hemorrhoids,
hypersensitivity to the components of the drug,
pregnant women.

With caution, injections should be used by people suffering from the following symptoms:

high blood pressure,
allergy,
heart failure,
asthma,
pathology of the kidneys and liver.

Analogues of the drug for injections Diclofenac

Today, almost any drug can be replaced by a similar drug, with similar pharmacological properties and a similar composition.

In the case of Diclofenac, almost all non-steroidal anti-inflammatory drugs can be suitable for such drugs.

There are both domestic and foreign analogues for injection. The main differences are in price, quality and names.

You can replace Diclofenac injections with the following means:

Popular analogues of Diclofenac in ampoules

More often, doctors and the patient use Naklofen or Movalis to replace Diclofenac. This is due to the popularity of these drugs in the Russian pharmaceutical market, their availability, similar to the low price.

In terms of their pharmacological properties, they differ little from Diclofenac sodium and are successfully used in medicine for injections of patients with various inflammatory diseases.

Naklofen

This drug is an exact analogue of Diclofenac, and therefore has the same properties. It helps to significantly reduce pain and morning stiffness, fights swelling of the joints, relieves fever.

The use of Naklofen injections helps to normalize the condition of a patient with different diagnoses.

The most common of them:

rheumatism,
inflammation of the musculoskeletal system,
pain syndrome due to spasm,
colic in the kidneys
post-traumatic syndrome.

Injections with a solution of Naklofen are administered deep intramuscularly at a dose of 75 mg once. The total daily amount of Naklofen in the human body should not exceed 150 mg. For acute pain, the course of treatment is about two weeks.

Movalis

Another analogue of Diclofenac known on the Russian market, which is usually prescribed at the first stage of the disease in acute inflammatory and pain syndromes, is movalis.

With the advent of relief, injections can be replaced with other forms of Movalis (tablets, ointments, suppositories) for a further course of treatment.

Movalis injections are prescribed for:

Injections are prescribed in the form of intramuscular injections into the gluteal muscle. The daily dose of Movalis usually does not exceed 15 mg, and it must be applied once a day, which indicates a long-term analgesic effect. Injections are given for about three days, after which therapy is continued with other dosage forms or drugs.

Sometimes injections are excluded from use, and the patient prefers the use of tablets, despite their less pronounced effect.

Tablets that can replace Diclofenac

Naproxen: used as an analgesic, antipyretic, mainly in inflammatory processes of the musculoskeletal system. The average price of rubles. Production - Russia
Olfen: help relieve pain in inflammatory syndromes, diseases of the musculoskeletal system and soft tissues. The average cost of tablets is rubles. Production - Switzerland.
Ortofen: used for inflammation and diseases of the joints, rheumatism, relieves pain from bruises and injuries. The average price is 40 rubles. Production - Russia.

More often, the patient is attracted by the low cost of the drug, therefore, of the analogues of Diclofenac, Ortofen tablets are the most popular.

Gels and ointments - analogues

A good alternative to Diclofenac in the form of an ointment and gel is its exact analogue Diclak gel. The composition of this drug includes the same diclofenac sodium, as well as water, alcohol, hypromellose and flavored oil.

Diclac gel is an analgesic, anti-inflammatory, antirheumatic agent. At the same time, it has a small list of contraindications and, in this regard, is a popular remedy.

The gel helps to suppress the synthesis of prostaglandins, which are the cause of pain and inflammation in the body. Read about medicines for back pain, injections here.

Candles - analogues

Diclofenac suppositories also belong to non-steroidal anti-inflammatory drugs, and have contraindications, as well as serious side effects.

For many, these indicators become a serious problem, and the patient is forced to look for a more gentle analogue, but at the same time not inferior in efficiency.

Analogues of Diclofenac suppositories include:

Is there a need to select an analogue of Diclofenac injections?

The injected solution is well tolerated by the body and quickly copes with its main duties. In addition, the price of Diclofenac injection solution is much lower than foreign and even Russian analogues. On average, it is 50 rubles.

These indicators are the undoubted advantage of Diclofenac over other NSAIDs, and indicate that patients have practically no reason to choose alternative drugs to combat the disease.

The only exceptions are those patients who have contraindications.

Consumer reviews on the use of analogues

“I always had Diclofenac in the form of an ointment at home. It helped well for various pains, sprains and bruises, but it has expired. There was no such drug in the nearest pharmacy, and I bought Diclogen. Its smell is very sharp and unpleasant, and the effect is weak.

“I used Diclofenac tablets, ointment and gel. Better than them, hardly anything can help with various neuralgia. I tried Voltaren for myself, but was disappointed.

“I have been using Movalis solution for many years. It is more gentle, has fewer contraindications. But Diclofenac is cheaper and available in any pharmacy, so sometimes you have to buy it.”

A big minus of diclofenac is the effect on the stomach. Movalis, for example, has a much lesser effect on him, but at the same time it costs more. So far, I have adapted to inject diclofenac only for the first 3 days during an exacerbation, and then put only Elbon three times a week. Such a scheme is easily tolerated and inexpensive.

Copying of material is possible only with an active link to the site.

Diclofenac for osteochondrosis

Almost 80% of the adult population of the planet experienced painful and unpleasant sensations in the neck and back. Unfortunately, this is a natural manifestation of the inevitable aging of the body - osteochondrosis. The disease makes itself felt in different ways: from simple discomfort to excruciating pain in the spine, which becomes unbearable with every attempt to move.

This disease is treated with anti-inflammatory nonsteroidal medicines, one of the groups of which is Diclofenac.

Diclofenac for osteochondrosis is on the list of the most important and vital drugs. It is made from phenylacetic acid. It has a powerful anti-inflammatory, analgesic and antipyretic effect. The active substance is diclofenac sodium.

It is forbidden to take Diclofenac:

Diclofenac injections

Children under 6 years old;
During pregnancy and lactation;
In the presence of any diseases of the gastrointestinal tract;
With bronchial asthma, urticaria, rhinitis;
In case of allergy to acetylsalicylic acid (aspirin).

This drug is made in various forms: tablets, suppositories, ointments, gels, suppositories, drops and ampoules.

Diclofenac injections

Diclofenac solution is a clear liquid with a subtle benzyl alcohol odor. Diclofenac injections have a powerful anti-inflammatory and antipyretic effect. According to patients, treatment with injections quickly helps to cope with the complications that occur with cervical osteochondrosis (hearing loss, severe migraine, tinnitus, etc.).

Pain is relieved within a few minutes after the injection.

Please note that the name of Diclofenac in injections can be different: Dicloberl, Naklofen, Doloxen. In case of side effects (nausea, sleep disturbances, dizziness, migraine, irritability, bloating, blurred vision, diarrhea or constipation), Diclofenac in injections is replaced with its analogues:

Artrozan and Meloxicam injections have a large number of side effects that apply to many body systems. Naproxen is the most gentle analogue of Diclofenac, but it has a weaker effect and is considered a "soft" drug.

Mild illness

In the treatment of thoracic and cervical osteochondrosis, Diclofenac is injected up to 2 times a day, injecting 75 mg of the drug. The duration of the course is 4-5 days. The drug is administered intramuscularly. After the end of the course, if the patient does not improve, the injections are replaced with Diclofenac tablets.

Complicated forms of the disease

In complicated forms of development of osteochondrosis (severe, unbearable pain, paresis of the legs, disruption of the pelvic organs, etc.), in a hospital, a neurologist prescribes a blockade with injections of Diclofenac. The blockade is carried out in combination with taking this remedy orally, in the form of tablets.

diclofenac tablets

Diclofenac for cervical osteochondrosis, as well as thoracic and lumbar osteochondrosis, is produced in various modifications: film-coated, enteric or sugar coated, in the form of dragees or instant tablets. This fairly inexpensive medicine perfectly relieves painful manifestations in the muscles and joints. It also reduces inflammation.

Attention! Tablets should be taken only after meals. Diclofenac in tablets is the strongest irritant for the gastric mucosa. As a result of its exposure, ulcers can form in the stomach and bleeding can begin. To exclude such consequences, drugs to protect the stomach (Misoprostol, Omeprazole, Phosphalugel or Almagel) are prescribed simultaneously with Diclofenac tablets.

If side effects occur (migraine, nausea, vomiting, bloating, diarrhea or constipation, irritability, sleep disturbance, lethargy, blurred vision, loss of appetite), Diclofenac analogs are prescribed in tablets. This:

diclofenac tablets

Voltaren
Clofezon
Naklofen SR
Sulindak
Diclofenac sandoz
Indomethacin
Tenoxicam
Piroxicam

Sulindac is not as dangerous to the stomach as Indomethacin, but it is more toxic to the liver.

If the patient has an allergic reaction to anti-inflammatory non-steroidal drugs and sulfites, Diclofenac is taken only in especially severe, exceptional cases.
During the course of taking Diclofenac, it is better to refrain from driving vehicles (since it significantly reduces the motor response and level of attention).
It is forbidden to take alcohol during the treatment with Diclofenac.
A long-term course of treatment requires strict monitoring of the functions of the kidneys and liver, as well as blood composition.

Ointments and gels with Diclofenac

There is an option to use Diclofenac externally. Almost all people who are friends with sports, who love an active lifestyle, have experienced sprains or muscles. Well, painful sensations in the joints of patients with osteochondrosis simply poison their lives. Ointments and gels with Diclofenac significantly reduce pain, reduce swelling and have an anti-inflammatory effect.

Ointment with Diclofenac. This is a white ointment with a specific aroma. It is applied externally. A thin layer (2-4 grams) should be applied to the site of inflammation with gentle massage movements. Ointment with Diclofenac has undeniable advantages:

It has excellent penetrating power (very easily absorbed)
It acts transdermally - penetrating through the pores of the skin, it accumulates in the tissues and the joint capsule, which has a good effect in the treatment of osteochondrosis (protects the joints from swelling, removes morning stiffness, significantly improves motor function)
Able to dissolve bruises on the skin (tissue hyperemia)

In case of side effects (rash on the skin, burning, redness), you can replace Diclofenac ointments with similar ones:

Ointment Ortofen (Diclofenac)

Voltaren
Ketoprofen
Indomethacin
Phenylbutazone (Butadione)
Ortofen
Clofezon

The safest ointment among analogues is Clofezon. The most powerful is Indomethacin (but it is also the most dangerous in terms of effects). Indomethacin can cause serious damage to the body, it is used only in the most extreme, very severe cases.

Gels are considered more effective than ointments in terms of anti-inflammatory actions and analgesic effects. According to many patients, gels are more convenient to use, as they are absorbed much faster and do not leave streaks on clothes.

Gel with Diclofenac is produced in aluminum tubes of 30, 40 or 50 gr. It has a white, perhaps slightly yellowish tint. Just like ointments, the gel has a good anti-inflammatory effect, perfectly reduces swelling and pain, and increases joint mobility. In the event of an allergy, the Diclofenac gel can be replaced with its analogues:

Voltaren Emulgel

Naklofen
Naproxen
Dicloran
Ketoprofen
Diklobene
Etofenamate
Voltaren Emulgel
Piroxicam

Ketoprofen and Piroxicam have the strongest effect on the site of inflammation. The most gentle gel is Naproxen, it causes less harm to the body.

Ointments and gels with Diclofenac for osteochondrosis are recommended to be used before exercise. They help patients painlessly start active exercises.

If you do not suffer from osteochondrosis, but are going to use Diclofenac ointment or gel constantly, be sure to consult your doctor. Any use of drugs that include Diclofenac is fraught with the appearance of various, sometimes very dangerous side effects, so a doctor's control is required.

Pain that occurs after surgery, against the background of pathologies of the musculoskeletal system, migraines bring significant discomfort to everyday life. To eliminate them, in the arsenal of physicians there is a wide selection of drugs that have different composition, pharmacological properties and contraindications.

Therapeutic effect

Positive feedback injections "Voltaren" earned due to rapid pain relief and non-hormonal origin.

After intramuscular administration, the active substance, diclofenac sodium, quickly penetrates into all tissues and body fluids. Bypasses the blood-brain and placental barriers, passes into breast milk. The therapeutic effect is observed after 10-15 minutes. If intravenous use is necessary, the result is felt instantly.

In both cases, the substance enters the liver, where it forms metabolites (chemical compounds). 3-4 hours after the injection, half of the dose is excreted from the body through the kidneys.

List of indications

People claim that the drug is used mainly for exacerbations of pathologies of the musculoskeletal system. Many are interested in instructions and reviews about Voltaren injections. The list of indications includes:

arthritis, including rheumatoid;
gout attack;
osteoarthritis;
spondylarthrosis;
osteochondrosis;
intervertebral hernia;
inflammation of the pelvic organs;
symptoms of renal, hepatic colic;
headaches, migraines;
the presence of swollen postoperative scars.

According to the patients and doctors themselves, injections are effective in most inflammatory processes that occur in the body, so the range of application of Voltaren is much wider.

Who are forbidden

Patients are often scared away by the extensive list of contraindications indicated in the instructions for the use of Voltaren injections. Reviews of doctors say that with proper use, the risk is minimal.

The drug should not be injected into children, pregnant and lactating women.

The list of prohibitions includes the following pathologies:

cerebral atherosclerosis;
ischemic attacks;
myocardial infarction, stroke;
operations performed with the use of an artificial blood circulation device;
the risk of bleeding;
ulcerative lesions of the digestive tract, Crohn's disease;
renal, hepatic, heart failure;
individual intolerance to the components.

Interaction

Most patients do not know - Voltaren injections treat or anesthetize. Reviews indicate that people prescribe a medication for themselves to eliminate uncomfortable conditions, without thinking about its effect on the body.

The injected solution blocks the enzyme cyclooxygenase, thereby eliminating inflammation, pain and redness. The concomitant use of other drugs can interfere with this process and can be dangerous.

Undesirable combinations include Voltaren injections and the use of:

acetamphetamine, cyclosporine, tacrolimus (have a negative effect on the kidneys);
salicylic acid (there is a risk of increased side effects);
quinolones (convulsions occur);
cardiac glycosides (the risk of developing digitalis intoxication increases);
antacids (the concentration of the active substance in the blood increases);
insulin (sugar decreases);
corticotropin, colchicine, preparations containing calcium (negative effect on the digestive system);
anticoagulants (increased risk of bleeding).

Given this information, it is better to refuse self-medication.

Side effects and overdose

Patient reviews about Voltaren injections rarely contain information about a deterioration in well-being. If the medicine was prescribed by a doctor, taking into account contraindications and additional medication, then the risk of side effects is small.

During treatment, you may experience:

cholestatic jaundice;
toxic liver damage (increased levels of AST, ALT);
inflammation of the meninges;
confusion;
hallucinations;
depression;
double vision and blurred vision;
increased heart rate;
pressure reduction;
heart failure;
erythema;
hair loss;
the appearance of watery rashes on the skin;
gastritis, pancreatitis;
loss of appetite or complete aversion to food;
weight loss;
bronchospasm, inflammation of the pulmonary alveoli;
internal bleeding;
impotence (rare);
inflammation of the kidneys and their papillae, development of organ failure;
stomatitis and more.

If the recommended dosages are exceeded, severe abdominal pain, nausea, and vomiting appear. The side effects get worse. The patient needs to call a doctor to prescribe symptomatic therapy. If the dose is exceeded many times, and the patient's condition worsens, call an ambulance.

Reviews of doctors about injections of "Voltaren" report that people practicing self-medication had multiple negative reactions.

To reduce this risk, they need to know that during therapy:

it is forbidden to combine it with other drugs from the nonsteroidal group;
dosages should be observed and long courses should be avoided;
the first dose should be minimal to exclude allergic reactions;
laboratory monitoring of indicators indicating the state of the liver and kidneys is necessary (in case of prolonged use);
inhibition of the nervous system may be observed, therefore, people whose activities are associated with increased concentration of attention, it is better to refuse to use the drug.

The bulk of patients using Voltaren are elderly people. Doctors warn that this category of people should be treated only under the supervision of specialists.

Dosages

Therapy is prescribed in short courses, not exceeding 5 days. Although the reviews of doctors and patients about Voltaren injections indicate the possibility of a longer use, if it is really necessary, the possible risks should still be taken into account.

On average, patients receive 1-2 ampoules (75 and 150 mg) of the drug per day intramuscularly. According to indications, the solution is injected into a vein.

Average cost and analogues

The medicine is released in a cardboard box containing 5 ampoules of 3 ml. Each contains 75 mg of the drug. The average cost per pack is 230-250 rubles, depending on the region of residence.

The most popular analogue of Voltaren is Diclofenac. It is produced by many pharmaceutical companies. The release form is identical. This is a box with 5 ampoules of 3 ml solution. The price starts from 9 rubles per pack.

Many are interested in which is better - Voltaren or Diclofenac (injections). Reviews of patients and doctors differ here. Some believe that an expensive drug is of better quality and rarely causes complications. Others see no difference. Doctors attribute the higher cost of Voltaren to the degree of purification. The higher it is, the less foreign impurities enter the drug, and it is better tolerated by the body.

In practice, everything is individual. Older people often prefer cheaper medicine.

Terms of sale and storage rules

The instructions for the drug indicate that you can buy it with a doctor's prescription. Reviews of Voltaren injections and analogues report free dispensing from pharmacies.

Purchased products are stored at temperatures up to 30 degrees for no more than 2 years from the date of production. After the expiration date, the ampoules are discarded.

Instruction

Among NSAIDs, Diclofenac or Voltaren are popular. They have similar compositions and therapeutic effects: they eliminate pain, stabilize body temperature, and stop inflammatory processes.

Characteristics of drugs

Medicines are non-steroidal anti-inflammatory drugs.

Diclofenac

The tool stops inflammation, anesthetizes, has an antipyretic effect. The main active component is the compound of the same name. In addition, there are also auxiliary substances. Forms of release of the drug are as follows:

Tablets. Round, yellowish-orange. 1 tablet contains 25 mg diclofenac sodium.
Solution for intramuscular injections. Pale yellow, clear liquid with a slight odor. 1 ml of solution contains 25 mg of the active ingredient.
Ointment. White substance with a weak specific aroma. 1 g of ointment contains 10 mg of diclofenac sodium.
Gel. Homogeneous creamy mass with a slight odor. 1 g of gel contains 10 mg of the main component.
Rectal suppositories. They are torpedo-shaped and white. 1 candle contains 100 mg of diclofenac.
Eye drops. Clear colorless solution. 1 ml of the preparation contains 1 mg of the active substance.

Diclofenac has no effect on the progression of the disease. The drug is prescribed for symptomatic treatment, relief of inflammation, reducing the intensity of the pain syndrome.

Indications for the use of Diclofenac are as follows:

Headaches and toothaches, pain syndrome with migraine, cancer, lumbago, myalgia, arthralgia, neuralgia, sciatica, as well as accompanying postoperative and post-traumatic recovery.
Degenerative and inflammatory diseases of the musculoskeletal system. This applies to Bechterew's disease, arthritis of various etiologies, osteoarthritis, bursitis, tendovaginitis.
Inflammatory processes in the pelvic area.
Algodysmenorrhea.
Infectious and inflammatory diseases of the ENT organs: pharyngitis, tonsillitis, otitis media, influenza, colds.

The action of the main component of the drug diclofenac is reduced to the suppression of the activity of the enzyme cyclooxygenase. This compound, when catalyzed, converts arachidonic acid into various active substances that cause inflammatory reactions: prostaglandins, thromboxane, leukotriene, prostacyclin. Due to the reduction in the number of such components in the focus of inflammation, the agent has the following properties:

reduces the intensity of the pain syndrome, which develops due to irritation of nerve endings by inflammatory mediators;
eliminates hyperemia in the area of inflammation;
reduces tissue edema, which appears due to the fact that inflammatory mediators affect the walls of blood vessels with increased permeability and contribute to the release of fluid from a part of the blood into the space between cells;
reduces the intensity of agglutination of platelets, so that blood clotting decreases.

In addition, in the treatment of joint diseases, stiffness of movements gradually decreases.

Voltaren

Voltaren is an anti-inflammatory agent from the NSAID group. The active ingredient is diclofenac. There are also auxiliary connections. The drug is available in the following forms:

Tablets. Round, yellowish. Tablets are available with a dosage of diclofenac of 25 and 50 mg.
Tablets with prolonged action. Also round and yellow. In 1 tablet 100 mg of the main component.
Solution for intramuscular injections. The liquid is either colorless or light yellow. In 1 ampoule 75 mg of diclofenac sodium.
Suppositories are rectal. They have the shape of a white torpedo. They produce suppositories with a dosage of the main component of 25, 50 and 100 mg.
Spray for external use. The liquid is yellowish, transparent, has a mint flavor. In 1 dose of spray 8 mg of active substance.
The patch is transdermal. It is a creamy rectangle 10x7 cm. This area accounts for 15 mg of the active substance. If the size of the patch is 10x14 cm, then the concentration of diclofenac is 30 mg.

Voltaren is prescribed only for symptomatic therapy for pain and inflammatory processes.

It is used in the following cases:

joint diseases: arthritis of various etiologies, spondylitis, rheumatism, osteoarthritis, osteochondrosis;
spine diseases: sciatica, lumbago, sciatica, arthralgia, neuralgia, myalgia;
pathology of extra-articular tissues: tendovaginitis, bursitis, rheumatic diseases;
exacerbation of gout;
colic in diseases of the kidneys and liver;
pain after surgery or injury;
inflammatory processes in the pelvic organs;
migraine;
inflammatory diseases of the ENT organs: pharyngitis, otitis media, tonsillitis, residual pneumonia.

The drug has analgesic, anti-inflammatory and antipyretic effects.

What is the difference and similarities between Diclofenac and Voltaren?

Voltaren is the trade name for a drug manufactured by a Swiss company. Diclofenac is the international name for all medicines whose main active ingredient is the compound of the same name. The production of such drugs is carried out in different countries.

As for the release forms, they are the same, but there are several differences. Diclofenac can be purchased in the form of eye drops, and Voltaren additionally has a special patch. Another type of drug is Voltaren Emulgel. It has a gel oil structure. Thanks to this, the product is easily absorbed into the skin, providing a faster effect.

Voltaren and Diclofenac have the same contraindications for use:

gastritis and peptic ulcer of the stomach and intestines;
thyroid pathology;
diseases of the pancreas;
inflammatory processes in the intestines;
bronchial asthma;
diseases of the heart and blood vessels in severe form;
renal and liver failure;
individual poor tolerance of drugs, their individual components or all drugs from the NSAID group.

Both drugs are also not suitable for pregnant women, as well as during breastfeeding. For rectal suppositories, additional contraindications are irritable bowel syndrome, complicated hemorrhoids and proctitis.

Non-steroidal anti-inflammatory drugs are widely used in medical practice for the treatment of many diseases. The use of non-steroidal anti-inflammatory drugs in osteochondrosis is also relevant, as well as in the treatment of arthritis of various origins, as symptomatic agents in the treatment of infectious diseases, as well as for other therapeutic purposes.

Medicines of this group are quite widely represented on the pharmaceutical market, including non-prescription drugs. Non-steroidal anti-inflammatory drugs are actively prescribed in inpatient settings and in the treatment of outpatient patients.

The mechanism of action of drugs

This pharmacological group includes a huge number of drugs. Non-steroidal anti-inflammatory drugs (NSAIDs) are classified according to the degree of anti-inflammatory activity and chemical affiliation:

a. acids: indolacetic acid preparations (Indomethacin), salicylic (Acetylsalicylic acid), phenylacetic acid preparations (Diclofenac), pyrazolidine (Phenylbutazone), propionic acid preparations (Naproxen, Ketoprofen, Ibuprofen), oxicams (Piroxicam, Meloxicam);

b. drugs of non-acidic origin: sulfonamide preparations (Celecoxib, Nimesulide), alkanones (Nabumeton).

2. Means with little pronounced anti-inflammatory activity: pyrazolone (Metamizol, Propyphenazone), heteroarylacetic acid preparations (Ketorolac), anthranilic acid preparations (Ethofenamate), para-aminophenol preparations (Paracetamol).

The mechanism of action of non-steroidal anti-inflammatory drugs is the inhibition of cyclooxygenase, which is an obligatory participant in the synthesis of prostaglandins. Prostaglandins are substances with high biological activity:

cause vasodilation of a local nature, stimulate exudative processes, provoke edematous phenomena and migration of leukocytes;
reduce the threshold of pain sensitivity;
increase the sensitivity of the thermoregulation center to pyrogenic substances that are formed in the body as a result of the vital activity of bacteria and viruses.

There are two types of cyclooxygenase - COX-1 and COX-2. Depending on the selectivity of the action on cyclooxygenase, drugs are divided into COX-1 selective and COX-2 selective. In addition to the inhibition of cyclooxygenase, there are several other effects that have pharmacological significance in the mechanism of action of non-steroidal anti-inflammatory drugs:

They stabilize the membranes of lysosomes and inhibit the processes of peroxidation in cells. These mechanisms protect the cell from destruction.
Reduce the synthesis of ATP, which reduces the energy supply of the inflammatory process.
They disrupt the normal conduction of nerve impulses in the spinal cord. This provides an analgesic effect.
They inhibit the aggregation of neutrophils. This reduces the intensity of the inflammatory process.

Main pharmacological effects

The mechanism of action of drugs provides the presence of several pharmacological properties: anti-inflammatory, analgesic effect, antipyretic, antiaggregatory, immunosuppressive effect. All nonsteroidal drugs are very well absorbed in the digestive tract, metabolized in the liver and excreted by the kidneys.

Indications for prescribing drugs

The main indications for the appointment of non-steroidal anti-inflammatory drugs are:

NSAIDs are widely prescribed for the treatment of most diseases manifested by pain and fever. However, it should be remembered that these funds are not as safe as it seems at first glance.

Like other drugs that can have a pharmacological effect, NSAIDs have contraindications for use and can cause adverse reactions with prolonged use. As a result, it is not recommended to use non-steroidal anti-inflammatory drugs on your own for more than three days!

Contraindications and adverse reactions

Non-steroidal anti-inflammatory drugs are not used to treat patients with erosive and ulcerative lesions of the stomach and intestines, in violation of hematopoiesis, severe liver disease, renal failure, pregnancy. Also, drugs are extremely contraindicated in case of individual intolerance to NSAIDs.

With prolonged use of NSAIDs or in case of exceeding the recommended dosages, the development of undesirable reactions is possible:

If symptoms occur that indicate the appearance of adverse reactions, you should immediately consult a doctor to decide whether to replace the drug or correct therapy.

The use of NSAIDs in osteochondrosis

Non-steroidal anti-inflammatory drugs for osteochondrosis are prescribed to relieve pain, in some cases - to eliminate signs of inflammation. NSAIDs compare favorably with hormonal preparations in that they have a milder effect and exhibit less adverse reactions.

Osteochondrosis is almost always accompanied by three main symptoms - pain, inflammation and swelling. Non-steroidal drugs can eliminate these symptoms and alleviate the patient's condition. In the acute period, drugs are prescribed in the form of intramuscular injections, since the bioavailability of injectables is much higher. As a rule, intramuscular NSAIDs are prescribed for short courses of three to seven days. After the injection course, the doctor may decide to prescribe drugs in the form of tablets. In addition, in some cases, with osteochondrosis, external agents containing a non-steroidal anti-inflammatory component are prescribed in the form of an ointment, cream or gel.

With an exacerbation of osteochondrosis or in the event of the onset of symptoms of the disease for the first time, it is not recommended to prescribe treatment on your own. You should seek advice from a doctor who will competently select therapy, taking into account individual characteristics and existing contraindications.

Diclofenac, Voltaren

The drug belongs to the drugs that have a pronounced anti-inflammatory and analgesic effect. Diclofenac is available in the form of a solution for injection, tablets, suppositories for rectal use, ointment and gel for external use. The main indication for the use of the drug are inflammatory and degenerative diseases of the musculoskeletal system.

In the acute phase of osteochondrosis, Diclofenac is administered intramuscularly for three to five days. Then the patient is transferred to oral administration of the drug, which can be combined with the use of external forms of Diclofenac. Long-term use of the drug is possible in the absence of contraindications to the use of the drug: erosive and ulcerative diseases of the digestive tract, hematopoietic disorders, hypersensitivity to the components of the drug, renal failure, acute inflammatory liver disease, heart failure and other pathological conditions. The drug is dispensed from pharmacies by prescription. Self-administration of the drug without prior consultation with a doctor is not recommended!

Diclofenac is produced by many manufacturers under different trade names: Voltaren, Diclogen, Ortofen. The price of the drug depends on the manufacturer, form of release and can vary over a wide range.

Meloxicam, Movalis

Meloxicam has a pronounced analgesic and anti-inflammatory effect. The drug is available in the form of tablets, solution for intramuscular injections, rectal suppositories, external medicines. Most often, Meloxicam, like Diclofenac, is prescribed for diseases of the musculoskeletal system of an inflammatory and degenerative nature.

With osteochondrosis, the use of Meloxicam in injectable form is indicated, followed by a transition to oral administration. The Meloxicam treatment regimen is slightly different from Diclofenac therapy in terms of the duration of the course of treatment. The course of treatment with Meloxicam is somewhat shorter. Meloxicam differs from Diclofenac in that it rarely exhibits adverse reactions from the kidneys and digestive tract.

The drug is produced by several Russian and foreign manufacturers under the trade names: Movalis, Merlox, Meloxicam DS, Meloflex.

Aceclofenac, Aertal

Recently, drugs containing Aceclofenac as an active ingredient have been quite popular among neurologists. The active substance has a pronounced anti-inflammatory, analgesic and antipyretic effect. Since the drug is highly absorbable, the use of minimal dosages is required to achieve a therapeutic effect. In this regard, side effects in Aertal therapy are mild or absent altogether.

The drug is available in the form of tablets, powder for suspension for oral administration and cream for external use.

Also, anti-inflammatory non-steroidal drugs can be part of combination drugs for the treatment of various diseases and relief of acute symptoms.

Cure osteoarthritis without drugs? It's possible!

Get the free book "Step-by-Step Plan for Restoring Mobility of the Knee and Hip Joints in Osteoarthritis" and start recovering without expensive treatment and operations!

Get a book

Safe analogues of Diclofenac - tablets, ointments, injection solutions

Despite the high therapeutic efficacy of Diclofenac, in some patients, taking it causes undesirable side effects. When choosing a replacement, the doctor must take into account the safety of medicines, the frequency of dosages used and the duration of the therapeutic course. Diclofenac analogues may be structural or similar in clinical action. Neuropathologists, rheumatologists, traumatologists prefer drugs from the group of non-steroidal anti-inflammatory drugs.

Characteristic features of non-steroidal anti-inflammatory drugs

decrease in the severity of pain syndrome;
relief of the inflammatory process and swelling;
elimination of fever.

In medical practice, analogues of Diclofenac are distinguished by composition and therapeutic effect. Such a classification is necessary for the quick selection of an NSAID replacement if it is intolerable or if an excessive number of side effects occur. Structural analogues of Diclofenac include Diclogen, Ortofen, Dicloberl, Voltaren, Diklak, Naklofen. They are of interest, first of all, to patients, since the cost of drugs can vary significantly. For example, the price of Ortofen ointment is 30-40 rubles, and you will have to pay at least 200 rubles for a package of Voltaren gel.

If a doctor prescribes an expensive structural analogue of Diclofenac, then you should not suspect him of any self-interest. The high price is often due to the high quality of the additional and active ingredients included in the ointment or tablets. Such a drug will be better absorbed and provoke fewer side effects.

Meloxicam;
Nimesulide;
Ketoprofen;
Ketorolac;
Metamizole;
Perekoxib;
Phenylbutazone;
Indomethacin;
ibuprofen;
acetylsalicylic acid;
Piroxicam.

short-lived (less than 6 hours);
long-lived (more than 6 hours).

Comparison of clinical effects of analogues

According to the degree of anti-inflammatory action, all NSAIDs are significantly inferior to glucocorticosteroids, which can inhibit the production of prostaglandins.

During clinical trials that were conducted to compare the effectiveness of non-steroidal anti-inflammatory drugs, the features of individual representatives of this group of drugs were revealed:

antipyretic activity was identical for all NSAIDs, and they reduced only subfebrile temperature values, in contrast to the hypothermic agent Chlorpromazine;
the antiaggregation effect was based on the inhibition of cyclooxygenase in platelets and the suppression of the synthesis of the proaggregant thromboxane. The greatest antiaggregatory activity is characteristic of acetylsalicylic acid, and it is much lower in Diclofenac and its other analogues;
the immunosuppressive effect is moderate in all NSAIDs with prolonged use and is based on their ability to reduce capillary permeability, hinder the contact of cells that trigger an allergic reaction with antigens.

With a course of taking any non-steroidal anti-inflammatory drugs, especially in elderly and senile patients, chronic heart failure may worsen. The probability of development of events according to such a negative scenario is 10 times higher compared to the refusal to take NSAIDs.

The most popular analogues from the NSAID group

In the United States, a randomized clinical trial was conducted in which 1309 patients, mostly women, took part. The average age of the volunteers was 64 years, and the duration of the chronic disease was about 9 years. One group of patients took Meloxicam, and the second group was treated with Diclofenac, Naproxen, Piroxicam, Ibuprofen. The results of the study showed that treatment with Meloxicam was successful in 66.8% of people, and the use of Diclofenac and analogues brought relief in only 45% of volunteers.

Meloxicam

cytostatics;
antihypertensive drugs;
diuretics;
cardiac glycosides;
b-blockers.

Ibuprofen

The results of a recent study of sales of non-steroidal anti-inflammatory drugs revealed that Ibuprofen ointment and tablets are in the widest demand among the population. The advantage of this NSAID is the budgetary cost. The price for one package is 30-50 rubles, which makes the drug extremely attractive to pharmacy buyers. But the advantages of Ibuprofen do not include safety of use. Undesirable consequences of treatment with this analogue of Diclofenac are such pathological conditions:

bronchospasm;
decreased clarity of vision;
psycho-emotional instability;
hepatitis;
dyspeptic disorders.

With the combination of oral and local preparations of Ibuprofen in JA, a significant prolongation of the therapeutic effect is achieved, which makes it possible to reduce single and daily dosages, as well as the duration of treatment.

Nimesulide

osteoarthritis;
rheumatoid, gouty, juvenile arthritis;
bursitis, tendinitis;
myalgia, algomenorrhea, toothache, arthralgia, headache;
pain that occurs in the postoperative period.

Joint treatment More >>

Overview of analogues from the NSAID group

Meloxicam (from 120 rubles);
Movalis (from 650 rubles);
Ksefokam (about 700 rubles);
Ketorol (from 120 rubles);
Ketonal (from 250 rubles).

ointment Ibuprofen (from 30 rubles);
Nise gel (from 220 rubles);
gel Amelotex (from 240 rubles);
Ketonal cream (about 320 rubles);
ointment Indomethacin (from 75 rubles).

When choosing analogues of Diclofenac, the doctor must take into account the selectivity of the drug. This factor does not determine efficacy, but influences toxicity values. The course of short-lived NSAIDs (Ibuprofen) is better tolerated by patients than the use of Indomethacin, Naproxen, Piroxicam.

Diclofenac or Voltaren is one of the most versatile drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs), simultaneously controlling various pathogenetic mechanisms of the disease, simultaneously providing anti-inflammatory, analgesic, antipyretic and antithrombotic effects.

Diclofenac or Voltaren are often used in rheumatology to reduce pain, in diseases of the musculoskeletal system, joint diseases, in the genesis of which inflammation plays a key role. Voltaren and Diclofenac are successfully used in surgery, gynecology, dentistry, traumatology, sports medicine, etc. But how do they differ from each other and what is the reason for the widespread use of these drugs in many areas of medicine?

Active ingredient in preparations

Preparations are divided into 2 large groups - monocomponent and combined agents. As part of monocomponent preparations, there is 1 main active ingredient. Under the combined means understand the presence in the composition of 2 or more active substances that complement each other or neutralize some, more negative effects of another component. This can be seen in the example of drugs with diclofenac and glucosamine, where the first relieves the inflammatory process, and the second stimulates the processes of good regeneration of the gastric mucosa, preventing erosive and ulcerative lesions of the gastrointestinal tract.

So, Voltaren or Diclofenac, which is better? These drugs are monocomponent. The active drug substance of these drugs is sodium diclofenac, and their differences are only in the name of the drugs and the country of manufacture. Diclofenac is a domestic remedy, and Voltaren is its imported counterpart. Another 1 difference is the price, which Voltaren has an order of magnitude higher.

Diclofenac in the composition of both drugs has a number of properties due to which they act more efficiently and have taken a leading place in terms of frequency of prescription for acute and chronic pain syndromes - these are:

chemical nature - drugs are lipophilic organic acids with low acidity, which easily bind to plasma proteins (albumin) by 95-99.7% and are transported to the site of inflammation, where vascular permeability is increased and low pH is present;
short plasma half-life - 1-2 hours;
good penetration into the articular cavities with a maximum concentration at the site of inflammation after 2-4 hours;
the minimum withdrawal period of 3-6 hours, which allows to achieve a pronounced clinical effect and ensures good tolerability.

Release form

Preparations with diclofenac are available in various dosage forms, depending on this, the speed and duration of action on the inflammatory process will differ. It is worth noting that food intake slows down the rate of absorption of diclofenac, but this does not affect its amount.

What is the difference in dosage forms? It consists in the duration and speed of the onset of the analgesic effect. With oral administration, the analgesic effect occurs after 1-3 hours, rectal - after 30 minutes. External use in the form of gels and ointments for an hour helps to obtain a high concentration of the agent in the area of inflammation, which gives a more pronounced analgesic effect than the drug in tablets. But after 2-3 hours, local application of the drug gives a weakening of the analgesic effect, in comparison with tablets. After 3 hours, the analgesic effect of the tablets is 1.5 times stronger than that of the topical application of the drug.

How is this effect different? This difference is due to the central effect of the drug on the antinociceptive system. This is a set of nervous structures of the central nervous system, which affects the functioning of the nociceptive (pain) system.

Applying Voltaren injections with parenteral administration (intramuscularly), the analgesic effect can be achieved after 20 minutes. The drug does not accumulate if Voltaren injections are given 2-4 times a day, depending on the doctor's prescription. The pharmacokinetics of the drug remains stable with repeated administration in ampoules.

The drug can be produced in the form of:

tablets;
prolonged action tablets;
suppositories;
sachet;
gel;
ointments;
solution for injection.

A variety of forms and methods of drug administration into the body allows you to choose an individual, the most effective and tolerable dose of the drug.

Mechanism of action in the body

The active substance diclofenac sodium in both presented preparations has a complex effect on the inflammatory process, inhibiting the activity of cyclooxygenase and blocking inflammatory changes. Cyclooxygenase (COX) is a biologically active substance (BAS) that controls the transformation of arachidonic acid into prostaglandins, prostacyclin and thromboxane.

The main mechanism of action of diclofenac, which has both effective and toxic effects, is the suppression of the activity of 2 COX isoforms. The first form of cyclooxygenase is a structural biologically active substance that is constantly present in most tissues of the body and regulates the physiological effects of prostaglandins that perform the function of maintaining homeostasis (determining the cytoprotective properties of gastric mucus or maintaining the tone of the arterioles of the kidneys). The second isoform of cyclooxygenase is BAS, which is synthesized by the cells of the inflammatory response in the foci of tissue damage. In most tissues, the enzyme is absent, but its level increases significantly against the background of the development of inflammation. The second isoform synthesizes prostaglandins, which act as mediators of inflammation and pain.

Diclofenac belongs to the group of non-selective NSAIDs, which means that the drug acts immediately on both COX isoforms, thus providing:

therapeutic effect - analgesic and anti-inflammatory effects, blocking COX 2;
pathological effect on the gastrointestinal tract by blocking COX 1, which has a negative effect on the body with prolonged use of the drug.

Unlike other NSAIDs, which block the activity of COX 1 to a greater extent, diclofenac approximately equally inhibits the activity of both isoforms of cyclooxygenase, and therefore, when using the drug, the incidence of severe gastrointestinal lesions is relatively lower.

The therapeutic effect of the drug

The drug Diclofenac has been used in medical practice since 1974. Its pronounced anti-inflammatory activity immediately attracted the attention of scientists. Diclofenac has established itself as a highly effective drug for:

acute or chronic musculoskeletal pain against the background of diseases of the musculoskeletal system - osteoarthritis, rheumatoid arthritis, spondyloarthritis, nonspecific back pain, gout;
with local inflammation of soft tissues of a rheumatic nature - tendinitis, bursitis, tendovaginitis, etc .;
acute injuries that are associated with damage or inflammation;
pain in the postoperative period in the form of an anesthetic component;
renal and biliary colic;
migraines;
pain associated with cancer;
pain on the background of gynecological diseases.

One of the main therapeutic actions is analgesic, which reduces the intensity of pain by suppressing the inflammatory activity of prostaglandins and a complex effect on the mechanisms of pain perception at the central and peripheral levels. In the treatment with Diclofenac in the brain, there is an increase in the content of tryptophan metabolites, which reduce the intensity of pain.

Contraindications for taking NSAIDs

All drugs of the NSAID group cause such complications in the gastrointestinal tract as dyspepsia, ulcers, bleeding and iron deficiency anemia due to damage to the small intestine. Exacerbate existing inflammatory bowel disease.

With existing diseases of the cardiovascular system, taking the drug can cause destabilization of hypertension, the development of heart failure and cardiovascular complications.

The popularity of the drug over the past 30 years has served to increase the number of so-called generic or analogue drugs that do not meet the standards of bioavailability, pharmacokinetics and purity. At the same time, the effect of generic drugs is much lower. To achieve a positive effect, it is necessary to increase the dose of the drug. This leads to an increase in the number of adverse reactions when using such drugs.

Side effects are reduced with local application of the analog drug. This method involves the introduction of the agent directly into the site of inflammation, while the level of the drug in the blood serum is much lower, and at the site of inflammation is an order of magnitude higher. This allows you to use the drug in smaller doses and minimize the risk of complications.

Articles on topic:

Symptoms and treatments for chronic pain syndrome Chronic pain is extremely common and underestimated. According to the Russian Association for the Study of Pain, the prevalence of chronic pain syndromes in Russia varies from 13.8% to 56.7%, averaging 34.3 cases per 1	Causes of bedsores, treatment methods and necessary prevention Consider how to treat bedsores (lat. Decubitus) depending on the stage of their development and location. Let's figure out which pharmaceutical preparations and proven folk remedies will help to cope with the problem in the elderly, than to smear weeping, dry and purulent
What to choose: diclofenac or voltaren? Prohibited in pregnancy Prohibited in breastfeeding Prohibited in children Has restrictions for the elderly Has restrictions for liver problems Has restrictions for kidney problems Diclofenac is a medicine containing an active	Oral antidiabetic drugs When oral antidiabetic drugs are used Type 2 diabetes requires constant monitoring of blood sugar levels. For normalization, hypoglycemic drugs are used, which are available in tablets. Thanks to them, a person is able to lead a normal life without fear for health. Even if

Popular

2022-02-26 12:59:13	Joint hypermobility in children: causes, symptoms, treatment methods, prevention
2022-02-26 12:59:13	Treatment of neurosensory (sensoneural) hearing loss
2022-02-26 12:59:13	Joint hypermobility - what is it, how to treat?
2022-02-26 12:59:13	Causes, Symptoms and Treatment of Osteoporosis Definition of Osteoporosis
2022-02-26 12:59:13	Comparison of modern anti-obesity drugs
2022-02-26 12:59:13	Can metrogilom cure Giardia?
2022-02-26 12:59:13	Sphincteritis of the rectum: causes, symptoms and treatment of sphincter spasm
2022-02-26 12:59:13	insomnia treatment insomnia treatment
2022-02-26 12:59:13	Hormone replacement therapy with testosterone preparations Hormone replacement therapy in men drugs
2022-02-26 12:59:13	Viral pneumonia (J12) Viral pneumonia x-ray

New

2022-02-26 12:59:13	Calcium antagonists: list of drugs, action, indications
2022-02-26 12:59:13	Leg vein surgery
2022-02-26 12:59:13	Features of the development of osteoporosis in men and methods of treatment
2022-02-26 12:59:13	Aertal or nimesil What is better aertal or dexalgin
2022-02-26 12:59:13	Visual impairment in hypertension
2022-02-26 12:59:13	Fatigue and its manifestations
21.02.2022	Fragrant potatoes with sour cream in the oven: hearty and tasty How much turmeric should be added to potatoes
21.02.2022	We bake a cheese pie in a slow cooker quickly and easily
21.02.2022	Easter with almonds and orange caramel
21.02.2022	Eggplant without frying for the winter recipes
21.02.2022	Let's fill a crystal glass: with what they drink brut champagne
21.02.2022	Eggplant "Spark" - an old recipe