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Nise or airtal which is better. Aertal or nimesil What is better aertal or dexalgin

Celebrex is a non-steroidal anti-inflammatory drug (NSAID) in capsule form created by the pharmaceutical company Pfizer. According to the mechanism of action, it belongs to the selective inhibitors of cyclooxygenase type II (COX-2).

Also, the drug has an antipyretic effect. According to the chemical structure, the drug belongs to the group of coxibs.

The price of one capsule with a dosage of 100, 200 or 400 mg in Moscow pharmacies costs 50 rubles. The highest daily dose of the active substance (Celecoxib) is 400 mg and it will cost 50–100 rubles. In pharmacies, Celebrex is dispensed by prescription.

It is used to relieve or relieve various types of pain, including relief of postoperative, musculoskeletal, back pain, as well as for the symptomatic treatment of osteoarthritis, ankylosing spondylitis, rheumatoid arthritis and primary dysmenorrhea.

Increasingly, people are looking for something to replace the medicine - why?

By inhibiting COX-2 with little effect on COX-1, Celebrex effectively relieves pain and inflammation without causing significant damage to the gastrointestinal tract (GIT).

Although, among coxibs, this drug is the least dangerous in terms of the cardiovascular system (CVS), it still increases the risk thrombotic events at a daily dose of more than 400 mg and with long-term use. In diseases of the cardiovascular system, the drug is contraindicated.

If we consider Celebrex from all sides, then today it is one of the safest NSAIDs, but very expensive, this is the first reason why many are looking for cheaper drug analogues.

Consumers are often afraid of possible side effects (mainly from the CCC), deducted from the instructions and do not start taking the medicine. However, those who have already taken it, as a rule, do not notice dangerous side effects, but sometimes they complain of poor effectiveness and a rapid decline in the effect with regular use.

Thus, Celebrex is one of the most expensive NSAIDs, which makes many people look for alternatives.

All analogues of the drug - a complete review

As the closest analogue of Celebrex (according to the active substance - Celecoxib), Dilax is on sale - capsules of 100 and 200 mg. Manufacturers: KRKA-RUS, KRKA.

Similar in chemical structure

Coxibs are selective COX-2 inhibitors. These include:

Arcoxia (Etoricoxib) - tablets from Merck Sharp & Dohme B.V;
Dynastat (Parecoxib) - lyophilisate from Pfizer

These drugs, like Celebrex, can provoke cardiovascular diseases and their complications.

Analogues for indications and effects on the body

Medicines that, according to the instructions for use, are used in similar cases, namely for inflammation, as well as for joint and other pains.

Meloxicam - the main component - a selective COX-2 inhibitor, like celecoxib, belongs to oxicam, can also increase the risk of thrombosis.

Contains in preparations:

Nimesulide is a COX inhibitor, mainly COX-2. Refers to sulfonanilide. Preparations containing this substance:

Nimesil - powder for suspension from Guidotti / Menarini Group;
Nise - gel, tablets from Dr. Reddy's Laboratories;
Nemulex - granules for the preparation of a suspension from the company Sotex;
Nimesan - tablets from the company Shreya Life Sciences.

The same indications have non-selective COX inhibitors of different chemical structures. They are often the most effective, but can damage the gastrointestinal mucosa.

TOP 18 best non-selective COX inhibitors that act similar to Celebrex:

Our choice

The best analogues that can replace Celebrex, given the feedback from consumers, should be considered the following:

The most affordable analogues

Without a prescription, drugs based on Indomethacin, Diclofenac and Ibuprofen are dispensed. They are also the cheapest analogues of Celebrex:

Indomethacin. The highest daily dose (with prolonged oral use - 75 mg) will cost from 3 rubles.
Diklak. The highest daily dose (150 mg) will cost from 10 rubles.
Ibuprofen. The highest daily dose (2400 mg) will cost from 10 rubles.

Domestic analogues

List of NSAIDs produced in Russia:

disinterested opinion

We studied the reviews about Celebrex and its many analogues and this is the picture that emerges.

Comparison with other drugs

Let's analyze what is better than Celebrex or its analogues based on price, side effects and other factors:

A very large number of people suffer from such an unpleasant disease as intercostal neuralgia. This disease is caused by compression or irritation of the nerves passing between the ribs. The main symptom of this pathology is excruciating and intense pain, which increases with deep breathing, coughing and movement. It is worth noting that intercostal neuralgia, the medical treatment of which can only be prescribed by a qualified general practitioner or neurologist, is a rather serious disease.

If a person has severe pain in the intercostal region, then he needs to consult an experienced doctor. Indeed, under the guise of this disease, completely different pathologies can be hidden. For example, it may be a heart disease or renal colic. The doctor, after conducting the necessary examination, will be able to prescribe the correct treatment, which will help the patient return to work and normal life faster.

Self-medication can be dangerous - almost all drugs have a lot of contraindications and various side effects, and with this disease, drugs can not always completely eliminate pain. Only a qualified specialist can determine which drugs and in what dosage form are suitable for a particular patient, and also prescribe the necessary duration of drug therapy.

In order for the medication to be effective, it is worth following the general recommendations. So, approximately in the first three days of illness, when the pain is especially strong, it is better for the patient to refrain from going to work and observe bed rest. It is necessary to lie on the shield, that is, on a very flat and hard surface. High pillows should also be avoided.

Painkillers are an effective treatment in a variety of forms.

Of course, first of all, the patient needs drugs that can relieve him of pain. For this purpose, non-steroidal anti-inflammatory drugs are usually used. In pharmacies, the range of such drugs is huge, but you should not buy them on your own or on the recommendations of a pharmacist. Only a doctor can prescribe the appropriate drug.

As a rule, with very severe pain, doctors prescribe intramuscular injections of painkillers such as Ketonal, Ketorol or Analgin. All of them relieve pain very quickly, however, the effect lasts only a few hours. The doctor usually prescribes a whole course of such injections - five or ten procedures. It is impossible to use such drugs for a longer time, as they can cause an exacerbation of diseases of the stomach, for example, ulcers or gastritis.

Sometimes drugs such as Ketonal can also be prescribed in the form of rectal suppositories. This dosage form is quite acceptable for elderly patients, as it gives long-term pain relief and acts quickly.

Non-steroidal anti-inflammatory drugs are also used in the form of ointments or gels. These can be drugs such as Nise, Ketonal, Diclofenac, Voltaren. A small amount of ointment is applied in a thin layer to the part of the body where pain is felt. As a local treatment, plasters with a medicinal substance applied to them, for example, Ketonal thermo, are sometimes used. Such a patch, on the recommendation of a doctor, can be glued to a sore spot at night.

The doctor may prescribe painkillers in the form of tablets. It can be drugs such as Analgin, Nise, Movalis or Baralgin. They are usually taken three times a day after meals, adhering to the recommended dose. The course of such treatment, as a rule, is not long, since long-term use of these drugs can cause serious health problems, primarily with the gastrointestinal tract. There are also more modern medicines that are distinguished by a prolonged (that is, long-term) effect. These include, for example, Melox forte, which is enough to take only once a day.

Vitamins help to cope with neuralgia

Vitamins for a disease such as intercostal neuralgia must be taken. This is especially true of B vitamins, such as B6, B1 and B12. Many experienced doctors prescribe intramuscular injections of these drugs to patients. Injections of vitamins B1 and B6 must be alternated, for example, B1 should be injected on even days, and B6 on odd days. Sometimes doctors advise patients to drink multivitamins instead of injections.

Novocaine blockade - rapid relief of pain

Sometimes, in order to relieve acute pain, a neuropathologist can give his patient a novocaine blockade. This method allows you to save the patient from discomfort very quickly. It consists in the fact that the affected nerve is chipped with novocaine. True, such a procedure is not shown to everyone.

Medicines containing snake and bee venom

Quite effective are medicines that contain the venom of bees or snakes. But they also have contraindications: diseases of the liver and kidneys, lactation, pregnancy, heart disease, fever, or individual intolerance to the components. You can use such medicines only after consulting your doctor.

The drugs, the action of which is based on the venom of bees, include an ointment called Apizartron. They make it in Germany. It has not only analgesic, but also anti-inflammatory effect.

The ointment, which is called Viprosal, contains viper venom. It is used externally to help relieve pain and inflammation. It also contains components such as camphor and fir oil, which are also quite effective in neuralgia.

Other medicines will enhance the effect of treatment

Less often, with intercostal neuralgia, muscle relaxants and tranquilizers are used. These drugs help relieve muscle spasm, soothe the patient, give him the opportunity to relax and unwind. Usually, doctors use Sibazon in tablets; in more severe cases, Relanium is administered intramuscularly. Only a doctor has the right to prescribe such drugs, since they are released strictly by prescription. Muscle relaxants can also reduce the severity of pain, but the side effects of drugs determine the need for medical supervision of the therapy.

Often, pepper plaster is used to relieve pain. It is glued to the painful area, while the skin must be dry, clean and without any damage. A contraindication for this method is an allergy to the components of the patch.

So, to be treated for intercostal neuralgia, of course, is worth it. In order to regain health as soon as possible, it is necessary to strictly adhere to the recommendations given by the doctor. After all, self-medication can lead to much more serious diseases than neuralgia.

Means Aertal is considered one of the best in its group. But today, many fans of Aertal resort to its substitutes, because analogues are sometimes cheaper by more than half. The drug is produced by Almiral from Spain, which determines its high price.

The selection of one of the numerous analogues of the drug will save on treatment, getting the same effect from taking pills, injecting or using an ointment.

Tablet substitutes for Aertal

Aertal, belonging to the group of non-steroidal anti-inflammatory drugs, was created on the basis of aceclofenac, a substance that has a strong analgesic and antipyretic effect. In the patient's body, it inhibits the synthesis of prostaglandins, thereby creating a positive effect. Indications for the use of the drug are the following conditions:

toothache;
soreness as a consequence of humeroscapular periarthritis;
lumbago;
rheumatic lesions of soft tissues;
osteoarthritis, ankylosing spondylitis, rheumatoid arthritis.

Analogues of Aertal in tablets are used for the same diseases and contain the same bioactive substance as the original drug. The low cost of medicines is explained by the fact that they are all produced in the territory of the Russian Federation.

It is necessary to consider in more detail Aertal's generics of Russian manufacture. The main ones among them are:

Asinak;
Actinac;
Asephil;
Diclotol;
Infenak;
Tronak and others.

Each of the medicines is available in tablet form. 1 tablet contains 100 mg of aceclofenac. A feature of the substance is the ability to accumulate in the fluid of the joint bag, due to which the effect of taking drugs is prolonged at times.

Since these analogues of Aertal practically repeat its composition and have identical actions with it, then other characteristics of the funds are the same. For example, it is forbidden to take any medicine for pathologies of the gastrointestinal tract, in cases of an excess of potassium and calcium in the blood, as well as for children under 18 years of age.

Analogues in the form of a solution for injections

People who hope to purchase liquid forms of Aertal encounter analogues quite often. This is due to the fact that the original drug in the form of a solution for injection is not directly produced.

If a medication is prescribed in injections, it is necessary to pay attention to the Acephen remedy, created on the basis of aceclofenac. The solution is sold in ampoules, each milliliter contains 150 mg of the bioactive component.

The tool is highly effective, but at the same time it has many side effects, among which are quite serious. These are gastritis, pancreatitis, stomatitis, intestinal bleeding, eczema, insomnia, edema, leg cramps and much more.

If, while taking Acephen, patients experience hypersensitivity to its components and the manifestation of side effects, doctors recommend replacing the drug with Aertal's generics based on other substances, while in tablet form. These are medicines that include meloxicam, a last-generation inhibitor that acts on cyclooxygenase.

It is necessary to pay attention to the following drugs:

Voltaren;
Diclofenac;
Ketanov;
Diclopar;

Their cost is quite high, but the risk of getting a negative reaction of the body due to taking the medicine is reduced several times.

Any of the described means is contraindicated for use in diseases of the gastrointestinal tract, during pregnancy and breastfeeding.

Substitutes in the form of ointment and cream

Medicines from the NSAID group are often used by patients in the form of external creams and gels for rubbing the affected areas of the body. What can replace Aertal ointment?

A fairly large number of external agents have been created that can eliminate pain, expand blood vessels and stop the inflammatory process. These are the following non-hormonal drugs:

Veral;
Diclogel;
Diclofenac;
Indomethacin;
Revmalin.

Any ointment, like a gel, has a very small number of side effects. Drugs are tolerated by patients much better than drugs intended for oral administration. All that can bother a person is minor headaches and skin reactions. The cream is allowed to be used by people with pathologies of the digestive system, since the bioactive substance does not penetrate into the bloodstream, exerting a local effect on the affected area.

Analogues in powder form

People who have problems with swallowing and are unable to use Aertal in tablets use the drug in the form of a suspension. The powder, which contains 100 mg of aceclofenac, dissolves in water and is taken once to relieve severe pain and improve overall well-being. The drug is prohibited for use by patients with fructose intolerance, because the composition of the suspension includes sorbitol, which can provoke disorders of the gastrointestinal tract.

If you need to use the generic Aertal in the form of a powder, you need to pay attention to Movalis. You can also buy Nise, but it is sold in the pharmacy chain in the form of a ready-made suspension.

Sucrose is excluded from the additional composition of Movalis, which makes it possible for people with diabetes and negative reactions to this component to use it.

Whatever the cost and characteristics of Aertal's substitutes, it is recommended to use them only as directed by a doctor.

Uncontrolled treatment with drugs of this group can cause serious harm to health. Only a specialist can determine whether the replacement of the drug Aertal with cheaper generics is justified.

The inflammatory process in almost all cases accompanies rheumatic pathology, significantly reducing the patient's quality of life. That is why one of the leading directions in the treatment of joint diseases is anti-inflammatory treatment. Several groups of drugs have this effect: non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids for systemic and local use, in part, only as part of complex treatment, chondroprotectors.

In this article, we will consider the group of drugs listed first - NSAIDs.

Non-steroidal anti-inflammatory drugs (NSAIDs)

This is a group of drugs whose effects are anti-inflammatory, antipyretic and analgesic. The severity of each of them in different drugs is different. These drugs are called non-steroidal because they differ in structure from hormonal drugs, glucocorticoids. The latter also have a powerful anti-inflammatory effect, but at the same time they have the negative properties of steroid hormones.

Mechanism of action of NSAIDs

The mechanism of action of NSAIDs is non-selective or selective inhibition (inhibition) of varieties of the COX enzyme - cyclooxygenase. COX is found in many tissues of our body and is responsible for the production of various biologically active substances: prostaglandins, prostacyclins, thromboxane and others. Prostaglandins, in turn, are mediators of inflammation, and the more of them, the more pronounced the inflammatory process. NSAIDs, inhibiting COX, reduce the level of prostaglandins in tissues, and the inflammatory process regresses.

Scheme of prescription of NSAIDs

Some NSAIDs have a number of fairly serious side effects, while other drugs in this group are not characterized as such. This is due to the peculiarities of the mechanism of action: the effect of drugs on various types of cyclooxygenase - COX-1, COX-2 and COX-3.

COX-1 in a healthy person is found in almost all organs and tissues, in particular, in the digestive tract and kidneys, where it performs its most important functions. For example, prostaglandins synthesized by COX are actively involved in maintaining the integrity of the gastric and intestinal mucosa, maintaining adequate blood flow in it, reducing the secretion of hydrochloric acid, increasing pH, secretion of phospholipids and mucus, stimulating cell proliferation (reproduction). Drugs that inhibit COX-1 cause a decrease in the level of prostaglandins not only in the focus of inflammation, but throughout the body, which can lead to negative consequences, which will be discussed below.

COX-2, as a rule, is absent in healthy tissues or is found, but in small quantities. Its level rises directly during inflammation and in its very focus. Drugs that selectively inhibit COX-2, although they are often taken systemically, act specifically on the focus, reducing the inflammatory process in it.

COX-3 is also involved in the development of pain and fever, but it has nothing to do with inflammation. Separate NSAIDs act on this particular type of enzyme and have little effect on COX-1 and 2. Some authors, however, believe that COX-3, as an independent isoform of the enzyme, does not exist, and it is a variant of COX-1: these questions need to be conducting additional research.

Classification of NSAIDs

There is a chemical classification of non-steroidal anti-inflammatory drugs, based on the structural features of the molecule of the active substance. However, biochemical and pharmacological terms are probably of little interest to a wide range of readers, so we offer you another classification, which is based on the selectivity of COX inhibition. According to her, all NSAIDs are divided into:
1. Non-selective (affect all types of COX, but mainly COX-1):

Indomethacin;
Ketoprofen;
Piroxicam;
Aspirin;
Diclofenac;
Acyclofenac;
Naproxen;
Ibuprofen.

2. Non-selective, affecting equally COX-1 and COX-2:

Lornoxicam.

3. Selective (inhibit COX-2):

Meloxicam;
Nimesulide;
Etodolac;
Rofecoxib;
Celecoxib.

Some of the above drugs have practically no anti-inflammatory effect, but have a greater analgesic (Ketorolac) or antipyretic effect (Aspirin, Ibuprofen), so we will not talk about these drugs in this article. Let's talk about those NSAIDs, the anti-inflammatory effect of which is most pronounced.

Briefly about pharmacokinetics

Non-steroidal anti-inflammatory drugs are used orally or intramuscularly.
When taken orally, they are well absorbed in the digestive tract, their bioavailability is about 70-100%. They are better absorbed in an acidic environment, and a shift in the pH of the stomach to the alkaline side slows down absorption. The maximum concentration of the active substance in the blood is determined 1-2 hours after taking the drug.

When administered intramuscularly, the drug binds to blood proteins by 90-99%, forming functionally active complexes.

They penetrate well into organs and tissues, especially into the focus of inflammation and synovial fluid (located in the joint cavity). NSAIDs are excreted from the body in the urine. The elimination half-life varies widely depending on the drug.

Contraindications to the use of NSAIDs

Preparations of this group are undesirable for use in the following conditions:

individual hypersensitivity to components;
, as well as other ulcerative lesions of the digestive tract;
leuko- and thrombopenia;
heavy and;
pregnancy.

Main side effects of NSAIDs

These are:

ulcerogenic effect (the ability of drugs of this group to provoke the development of the gastrointestinal tract);
dyspeptic disorders (discomfort in the stomach, and others);
bronchospasm;
toxic effects on the kidneys (violation of their function, increased blood pressure, nephropathy);
toxic effects on the liver (increased activity in the blood of hepatic transaminases);
toxic effects on the blood (decrease in the number of formed elements up to aplastic anemia, manifested);
prolongation of pregnancy;
(skin rash, anaphylaxis).

The number of reports of adverse reactions of drugs of the NSAID group received in 2011-2013

Features of NSAID therapy

Since the drugs of this group, to a greater or lesser extent, have a damaging effect on the gastric mucosa, most of them must be taken without fail after a meal, drinking plenty of water, and, preferably, with the parallel use of drugs to maintain the gastrointestinal tract. As a rule, proton pump inhibitors act in this role: Omeprazole, Rabeprazole and others.

Treatment with NSAIDs should be carried out for the shortest possible time and at the lowest effective doses.

Persons with impaired renal function, as well as elderly patients, as a rule, are prescribed a dose below the average therapeutic dose, since the processes in these categories of patients are slowed down: the active substance both has an effect and is excreted for a longer period.
Consider the individual drugs of the NSAID group in more detail.

Indomethacin (Indomethacin, Metindol)

Release form - tablets, capsules.

It has a pronounced anti-inflammatory, analgesic and antipyretic effect. Inhibits aggregation (sticking together) of platelets. The maximum concentration in the blood is determined 2 hours after ingestion, the half-life is 4-11 hours.

Assign, as a rule, inside 25-50 mg 2-3 times a day.

The side effects listed above are quite pronounced for this drug, so at present it is used relatively rarely, giving way to other, safer drugs in this regard.

Diclofenac (Almiral, Voltaren, Diklak, Dicloberl, Naklofen, Olfen and others)

Release form - tablets, capsules, injection, suppositories, gel.

It has a pronounced anti-inflammatory, analgesic and antipyretic effect. Rapidly and completely absorbed in the gastrointestinal tract. The maximum concentration of the active substance in the blood is reached after 20-60 minutes. Almost 100% absorbed with blood proteins and transported throughout the body. The maximum concentration of the drug in the synovial fluid is determined after 3-4 hours, the half-life of it from it is 3-6 hours, from the blood plasma - 1-2 hours. Excreted in urine, bile and feces.

As a rule, the recommended adult dose of diclofenac is 50-75 mg 2-3 times a day by mouth. The maximum daily dose is 300 mg. The retard form, equal to 100 g of the drug in one tablet (capsule), is taken once a day. With intramuscular injection, a single dose is 75 mg, the frequency of administration is 1-2 times a day. The drug in the form of a gel is applied in a thin layer on the skin in the area of inflammation, the frequency of application is 2-3 times a day.

Etodolak (Etol Fort)

Release form - capsules of 400 mg.

The anti-inflammatory, antipyretic and analgesic properties of this drug are also quite pronounced. It has moderate selectivity - it acts mainly on COX-2 in the focus of inflammation.

Rapidly absorbed from the gastrointestinal tract when taken orally. Bioavailability does not depend on food intake and antacids. The maximum concentration of the active substance in the blood is determined after 60 minutes. 95% binds to blood proteins. The plasma half-life is 7 hours. It is excreted from the body mainly with urine.

It is used for emergency or long-term therapy of rheumatological pathology:, as well as in the case of pain syndrome of any etiology.
It is recommended to take the drug 400 mg 1-3 times a day after meals. If prolonged therapy is necessary, the dose of the drug should be adjusted once every 2-3 weeks.

Contraindications are standard. Side effects are similar to those of other NSAIDs, however, due to the relative selectivity of the drug, they appear less frequently and are less pronounced.
Reduces the effect of some antihypertensive drugs, in particular ACE inhibitors.

Aceclofenac (Aertal, Diclotol, Zerodol)

Available in the form of tablets of 100 mg.

A worthy analogue of diclofenac with a similar anti-inflammatory and analgesic effect.
After oral administration, it is rapidly and almost 100% absorbed by the gastric mucosa. With the simultaneous intake of food, the rate of absorption slows down, but its degree remains the same. It binds to plasma proteins almost completely, spreading throughout the body in this form. The concentration of the drug in the synovial fluid is quite high: it reaches 60% of its concentration in the blood. The average elimination half-life is 4-4.5 hours. It is excreted mainly by the kidneys.

Of the side effects, dyspepsia, increased activity of hepatic transaminases, dizziness should be noted: these symptoms are quite common, in 1-10 cases out of 100. Other adverse reactions are much less common, in particular, in less than one patient per 10,000.

It is possible to reduce the likelihood of side effects by prescribing the minimum effective dose to the patient as soon as possible.

It is not recommended to take aceclofenac during pregnancy and lactation.
Reduces the antihypertensive effect of antihypertensive drugs.

Piroxicam (Piroxicam, Fedin-20)

Release form - tablets of 10 mg.

In addition to anti-inflammatory, analgesic and antipyretic effects, it also has an antiplatelet effect.

Well absorbed in the gastrointestinal tract. Simultaneous ingestion of food slows down the rate of absorption, but does not affect the degree of its effect. The maximum concentration in the blood is observed after 3-5 hours. The concentration in the blood is much higher with intramuscular administration of the drug than after taking it orally. 40-50% penetrates into the synovial fluid, found in breast milk. Undergoes a number of changes in the liver. Excreted with urine and feces. The half-life is 24-50 hours.

The analgesic effect is manifested within half an hour after taking the pill and persists for a day.

Dosages of the drug vary depending on the disease and range from 10 to 40 mg per day in one or more doses.

Contraindications and side effects are standard.

Tenoxicam (Texamen-L)

Release form - powder for solution for injection.

Apply intramuscularly at 2 ml (20 mg of the drug) per day. In acute - 40 mg 1 time per day for 5 days in a row at the same time.

Enhances the effects of indirect anticoagulants.

Lornoxicam (Xefocam, Larfix, Lorakam)

Release form - tablets of 4 and 8 mg, powder for solution for injection containing 8 mg of the drug.

The recommended oral dose is 8-16 mg per day for 2-3 times. The tablet should be taken before meals with plenty of water.

Intramuscularly or intravenously administered 8 mg at a time. Multiplicity of injections per day: 1-2 times. The solution for injection must be prepared immediately before use. The maximum daily dose is 16 mg.
Elderly patients do not need to reduce the dosage of lornoxicam, however, due to the likelihood of adverse reactions from the gastrointestinal tract, persons with any gastroenterological pathology should take it with caution.

Meloxicam (Movalis, Melbek, Revmoxicam, Recox, Melox and others)

Release form - tablets of 7.5 and 15 mg, injection of 2 ml in an ampoule containing 15 mg of the active substance, rectal suppositories, also containing 7.5 and 15 mg of Meloxicam.

Selective COX-2 inhibitor. Less often than other drugs of the NSAID group, it causes side effects in the form of kidney damage and gastropathy.

As a rule, in the first few days of treatment, the drug is used parenterally. 1-2 ml of the solution is injected deep into the muscle. When the acute inflammatory process subsides a little, the patient is transferred to the tablet form of meloxicam. Inside, it is used regardless of food intake, 7.5 mg 1-2 times a day.

Celecoxib (Celebrex, Revmoxib, Zycel, Flogoxib)

Release form - capsules of 100 and 200 mg of the drug.

A specific COX-2 inhibitor with a pronounced anti-inflammatory and analgesic effect. When used in therapeutic doses, it practically does not have a negative effect on the mucosa of the gastrointestinal tract, since it has a very low degree of affinity for COX-1, therefore, it does not cause a violation of the synthesis of constitutional prostaglandins.

As a rule, celecoxib is taken at a dosage of 100-200 mg per day in 1-2 doses. The maximum daily dose is 400 mg.

Side effects are rare. In the case of long-term use of the drug in a high dosage, ulceration of the mucous membrane of the digestive tract, gastrointestinal bleeding, agranulocytosis and.

Rofecoxib (Denebol)

The release form is a solution for injection in 1 ml ampoules containing 25 mg of the active substance, tablets.

Highly selective COX-2 inhibitor with pronounced anti-inflammatory, analgesic and antipyretic properties. Virtually no effect on the mucous membrane of the gastrointestinal tract and kidney tissue.

Be wary appoint women in the 1st and 2nd trimesters of pregnancy, during lactation, persons suffering or severe.

The risk of developing side effects from the gastrointestinal tract increases when taking high doses of the drug for a long time, as well as in elderly patients.

Etoricoxib (Arcoxia, Exinef)

Release form - tablets of 60 mg, 90 mg and 120 mg.

Selective COX-2 inhibitor. It does not affect the synthesis of gastric prostaglandins, it does not affect the function of platelets.

The drug is taken orally, regardless of the meal. The recommended dose directly depends on the severity of the disease and varies between 30-120 mg per day in 1 dose. Elderly patients do not need to adjust the dosage.

Side effects are extremely rare. As a rule, they are noted by patients taking etoricoxib for 1 year or more (for serious rheumatic diseases). The range of adverse reactions that occur in this case is extremely wide.

Nimesulide (Nimegesic, Nimesil, Nimid, Aponil, Nimesin, Remesulide and others)

Release form - tablets of 100 mg, granules for suspension for oral administration in a sachet containing 1 dose of the drug - 100 mg each, gel in a tube.

A highly selective COX-2 inhibitor with a pronounced anti-inflammatory, analgesic and antipyretic effect.

Take the drug inside 100 mg twice a day, after meals. The duration of treatment is determined individually. The gel is applied to the affected area, gently rubbing into the skin. Multiplicity of application - 3-4 times a day.

When prescribing Nimesulide to elderly patients, dose adjustment of the drug is not required. The dose should be reduced in case of severe impairment of the patient's liver and kidney function. May have a hepatotoxic effect, inhibiting liver function.

During pregnancy, especially in the 3rd trimester, it is strongly not recommended to take nimesulide. During lactation, the drug is also contraindicated.

Nabumeton (Synmeton)

Release form - tablets of 500 and 750 mg.

Non-selective COX inhibitor.

A single dose for an adult patient is 500-750-1000 mg during or after a meal. In especially severe cases, the dose may be increased to 2 grams per day.

Side effects and contraindications are similar to those of other non-selective NSAIDs.
It is not recommended to take during pregnancy and lactation.

Combined non-steroidal anti-inflammatory drugs

There are drugs containing two or more active substances from the NSAID group, or NSAIDs in combination with vitamins or other drugs. The main ones are listed below.

Dolaren. Contains 50 mg diclofenac sodium and 500 mg paracetamol. In this preparation, the pronounced anti-inflammatory effect of diclofenac is combined with the bright analgesic effect of paracetamol. Take the drug inside 1 tablet 2-3 times a day after meals. The maximum daily dose is 3 tablets.
Neurodiclovitis. Capsules containing 50 mg of diclofenac, vitamin B1 and B6, and 0.25 mg of vitamin B12. Here, the analgesic and anti-inflammatory effect of diclofenac is enhanced by B vitamins, which improve metabolism in the nervous tissue. The recommended dose of the drug is 1-3 capsules per day in 1-3 doses. Take the drug after meals with plenty of fluids.
Olfen-75, produced in the form of a solution for injection, in addition to diclofenac in an amount of 75 mg, also contains 20 mg of lidocaine: due to the presence of the latter in the solution, injections of the drug become less painful for the patient.
Fanigan. Its composition is similar to that of Dolaren: 50 mg diclofenac sodium and 500 mg paracetamol. It is recommended to take 1 tablet 2-3 times a day.
Flamidez. Very interesting, different drug. In addition to 50 mg of diclofenac and 500 mg of paracetamol, it also contains 15 mg of serratiopeptidase, which is a proteolytic enzyme and has a fibrinolytic, anti-inflammatory and anti-edematous effect. Available in the form of tablets and gel for topical use. The tablet is taken orally, after a meal, with a glass of water. As a rule, appoint 1 tablet 1-2 times a day. The maximum daily dose is 3 tablets. The gel is used externally, applying it to the affected area of the skin 3-4 times a day.
Maxigesic. A drug similar in composition and action to Flamidez, described above. The difference lies in the manufacturing company.
Diplo-P-Pharmeks. The composition of these tablets is similar to the composition of Dolaren. The dosages are the same.
Dolar. Same.
Dolex. Same.
Oksalgin-DP. Same.
Cinepar. Same.
Diclocaine. Like Olfen-75, it contains diclofenac sodium and lidocaine, but both active ingredients are in half the dosage. Accordingly, it is weaker in action.
Dolaren gel. Contains diclofenac sodium, menthol, linseed oil and methyl salicylate. All these components to some extent have an anti-inflammatory effect and potentiate the effects of each other. The gel is applied to the affected areas of the skin 3-4 times a day.
Nimid forte. Tablets containing 100 mg of nimesulide and 2 mg of tizanidine. This drug successfully combines the anti-inflammatory and analgesic effects of nimesulide with the muscle relaxant (muscle relaxing) effect of tizanidine. It is used for acute pain caused by spasm of skeletal muscles (popularly - with infringement of the roots). Take the drug inside after eating, drinking plenty of fluids. The recommended dose is 2 tablets per day in 2 divided doses. The maximum duration of treatment is 2 weeks.
Nizalid. Like nimid forte, it contains nimesulide and tizanidine in similar dosages. The recommended doses are the same.
Alit. Soluble tablets containing 100 mg of nimesulide and 20 mg of dicycloverine, which is a muscle relaxant. It is taken orally after a meal with a glass of liquid. It is recommended to take 1 tablet 2 times a day for no longer than 5 days.
Nanogan. The composition of this drug and the recommended dosages are similar to those of the drug Alit described above.
Oksigan. Same.

Osteoarthritis, rheumatoid arthritis and other diseases of the joints and spine, occurring with pain and inflammation.

Peculiarities: all drugs in this group act on a similar principle and cause three main effects: analgesic, anti-inflammatory and antipyretic.

In different drugs, these effects are expressed to varying degrees, so some drugs are better suited for the long-term treatment of joint diseases, others are mainly used as painkillers and antipyretics.

The most common side effects: allergic reactions, nausea, abdominal pain, erosion and ulcers of the mucous membrane of the gastrointestinal tract.

Main contraindications: individual intolerance, exacerbation of peptic ulcer of the stomach and duodenum.

Important information for the patient:

Drugs that have a pronounced analgesic effect and a significant number of side effects (diclofenac, ketorolac, nimesulide and others) can only be used as directed by a doctor.

Among non-steroidal anti-inflammatory drugs, a group of so-called "selective" drugs is distinguished, which are less likely to have side effects from the gastrointestinal tract.

Even over-the-counter pain relievers cannot be used long-term. If they are required frequently, several times a week, it is necessary to be examined by a doctor and treated according to the recommendations of a rheumatologist or neurologist.

In some cases, long-term use of this group of drugs requires additional intake of proton pump inhibitors that protect the stomach.

Trade name of the drug	Price range (Russia, rub.)	Features of the drug, which is important for the patient to know
Active substance: Diclofenac
Voltaren(Novartis)		A powerful pain reliever, mainly used for back and joint pain. It is undesirable to use for a long time, as the drug has numerous side effects. May adversely affect liver function, cause headache, dizziness and tinnitus. Contraindicated in "aspirin" asthma, disorders of hematopoiesis and blood coagulation processes. Do not use during pregnancy, breastfeeding and children under 6 years of age.
Diclofenac(various manufacturers)
Naklofen(Krka)
Ortofen(various manufacturers)
Rapten Rapid(Stada)
Active substance: Indomethacin
Indomethacin(various manufacturers)	11,4-29,5	It has a powerful anti-inflammatory and analgesic effect. However, it is considered quite outdated, as it leads in the likelihood of developing a variety of side effects. It has many contraindications, including the III trimester of pregnancy, the age of up to 14 years.
Metindol retard(Polfa)	68-131,5
Active substance: diclofenac + paracetamol
Panoksen(Oxford Laboratories)	59-69	A powerful two-component pain reliever. It is used to reduce severe pain and inflammation in arthritis, osteoarthritis, osteochondrosis, lumbago, dental and other diseases. Side effects - like diclofenac. Contraindications are inflammatory bowel disease, severe hepatic, renal and heart failure, the period after coronary artery bypass grafting, progressive kidney disease, active liver disease, pregnancy, breastfeeding, childhood.
Active substance: Tenoxicam
Texamen(Mustafa Nevzat Ilach Sanai)	186-355	It has a powerful analgesic and anti-inflammatory effect, the antipyretic effect is less pronounced. A distinctive feature of the drug is a long duration of action: more than a day. Indications are radicular syndrome in osteochondrosis, osteoarthritis with inflammation in the joints, neuralgia, muscle pain. Has a number of side effects. Contraindicated in bleeding from the gastrointestinal tract, pregnancy and during breastfeeding.
Active substance: Ketoprofen
artrosilene(Dompe Pharmaceuticals)	154-331	A drug with a pronounced analgesic and anti-inflammatory effect. Does not adversely affect the condition of the articular cartilage. Indications for use are symptomatic therapy of various arthritis, osteoarthritis, gout, headache, neuralgia, sciatica, muscle pain, post-traumatic and postoperative pain, pain syndrome in oncological diseases, painful periods. It causes many side effects and has many contraindications, including the III trimester of pregnancy and breastfeeding. In children, age restrictions depend on the trade name of the drug.
Quickcaps(Medana pharma)	161-274
Ketonal (Lek. d.d.)	93-137
Ketonal duo(Lek. d. d.)	211,9-295
Oki (Dompe Pharmaceuticals)	170-319
Flamax(Sotex)	86,7-165,8
Flamax forte(Sotex)	105-156,28
Flexen(Italfarmaco)	97-397
Active substance: Dexketoprofen
Dexalgin(Berlin-Chemie/Menarini)	185-343	New powerful drug of short-term action. The analgesic effect occurs 30 minutes after taking the drug and lasts from 4 to 6 hours. Indications for use are acute and chronic inflammatory diseases of the musculoskeletal system (rheumatoid arthritis, spondylitis, arthrosis, osteochondrosis), pain during menstruation, toothache. Side effects and contraindications are similar to those of other drugs. In general, with short-term use according to indications and at recommended doses, it is well tolerated.
Active substance: Ibuprofen
Ibuprofen(various manufacturers)	5,5-15,9	It is most often used as an antipyretic drug and a remedy for relieving headaches. However, in large doses it can also be used for diseases of the spine, joints and to relieve pain after bruises and other injuries. Side effects from the gastrointestinal tract, hematopoietic organs, as well as headache, dizziness, insomnia, increased blood pressure and a number of other undesirable reactions are possible. It has many contraindications. Can not be used in the III trimester of pregnancy and while breastfeeding, in the I and II trimester it must be used with caution, only on the advice of a doctor. cha.
Burana (Orion Corporation)	46,3-98
Ibufen (Polfa, Medana pharma)	69-95,5
Moment (Berlin-Chemie/Menarini)	71,6-99,83
Nurofen(Reckitt Benckiser)	35,65-50
Nurofen Ultracap(Reckitt Benckiser)	116-122,56
Nurofen Express(Reckitt Benckiser)	102-124,4
Nurofen Express Neo(Reckitt Benckiser)	65-84
Faspik(Zambon)	80-115
Active substance: ibuprofen + paracetamol
Ibuklin(Dr. Reddy's)	78-234,5	Combined preparation containing two analgesic and antipyretic substances. It works more powerful than the same drugs taken separately. It can be used for pain in the joints and spine, injuries. However, it does not have a very pronounced anti-inflammatory effect, therefore, it is not recommended for long-term treatment in rheumatic diseases. It has many side effects and contraindications. Do not use in children under 12 years of age, as well as in the III trimester of pregnancy and while breastfeeding.
Brustan(Ranbaxi)	60-121
Next(Pharmstandard)	83-137
Active substance: Nimesulide
nise(Dr. Reddy's)	111-225	Selective analgesic drug, mainly used for back and joint pain. May also relieve period pain, headaches and toothaches. It has a selective effect, therefore it has less negative effect on the gastrointestinal tract. However, it has a number of contraindications and side effects. It is contraindicated during pregnancy and lactation; in children, age restrictions depend on the trade name of the drug.
Nimesulide(various manufacturers)	65-79
Aponil(Medochemi)	71-155,5
Nemulex(Sotex)	125-512,17
Nimesil(Berlin-Chemie/Menarini)	426,4-990
Nimika (IPKA)	52,88-179,2
Nimulid(Panacea Biotek)	195-332,5
Active substance: Naproxen
Nalgezin(Krka)	104-255	A powerful drug. It is used to treat arthritis, osteoarthritis, adnexitis, exacerbation of gout, neuralgia, sciatica, pain in the bones, tendons and muscles, headache and toothache, pain in cancer and after surgery. It has quite a few contraindications and can cause a variety of side effects, so long-term treatment is possible only under the supervision of a physician.
Naproxen(Pharmstandard)	56,5-107
Naproxen-acry (Akrikhin)	97,5-115,5
Active substance: Naproxen + esomeprazole
Vimovo(AstraZeneca)	265-460	Combination preparation containing naproxen with analgesic and anti-inflammatory action and proton pump inhibitor esomeprazole. Developed in the form of tablets with sequential delivery of substances: the shell contains immediate-release magnesium esomeprazole, and the core contains sustained-release enteric-coated naproxen. As a result, esomeprazole is released in the stomach before naproxen dissolves, which protects the gastric mucosa from the possible negative effects of naproxen. Indicated for symptomatic relief in the treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis in patients at risk of gastric and duodenal ulcers. Despite good protective properties against the stomach, it can cause a number of other side effects. Contraindicated in severe liver, heart and kidney failure, gastrointestinal and other bleeding, cerebral hemorrhage and a number of other diseases and conditions. Not recommended in the III trimester of pregnancy, while breastfeeding and children under 18 years of age.
Active substance: Amtolmetin guacil
Nizilat(Dr. Reddy's)	310-533	A new non-steroidal anti-inflammatory drug with a minimal negative effect on the gastric mucosa. Despite a number of possible side effects, it was generally well tolerated by patients (including long-term use for 6 months). It can be used both for rheumatic diseases (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout, etc.), and for the treatment of pain syndromes of other origin. It has a lot of contraindications. Not applicable during pregnancy, breastfeeding and under the age of 18 years.
Active substance: Ketorolac
Ketanov(Ranbaxi)	214-286,19	One of the most potent analgesics. Due to the large number of contraindications and side effects, it should be used occasionally and only in cases of very severe pain.
Ketorol(Dr. Reddy's)	12,78-64
Ketorolac(various manufacturers)	12,1-17
Active substance: Lornoxicam
Xefocam(Nycomedes)	110-139	It has a pronounced analgesic and anti-inflammatory effect. Indicated for short-term treatment of pain, including rheumatic diseases (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout, etc.). It has many side effects and contraindications.
Xefokam Rapid(Nycomedes)	192-376
Active substance: Aceclofenac
Aertal(Gideon Richter)	577-935	It has a good anti-inflammatory and analgesic effect. It contributes to a significant reduction in the severity of pain, morning stiffness, swelling of the joints, does not adversely affect cartilage tissue. It is used to reduce inflammation and pain in lumbago, toothache, rheumatoid arthritis, osteoarthritis and a number of other rheumatological diseases. Causes many side effects. Contraindications are similar to those of Panoxen. Do not use during pregnancy, lactation and in children under 18 years of age.
Active substance: Celecoxib
Celebrex(Pfizer, Searl)	365,4-529	One of the most selective (selectively acting) drugs of this group, which has a minimal negative effect on the gastrointestinal tract. Indications for use are symptomatic treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis, back pain, bone and muscle pain, postoperative, menstrual and other types of pain. May cause swelling, dizziness, cough, and a number of other side effects. It has many contraindications for use, including class II-IV heart failure, clinically significant coronary heart disease, peripheral arterial disease and severe cerebrovascular disease. Not applicable during pregnancy, breastfeeding and under the age of 18 years.
Active substance: Etoricoxib
Arcoxia(Merck Sharp & Dome)	317-576	Potent selective drug. The mechanism of action, side effects and contraindications is similar to celecoxib. Indications for use are osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and acute gouty arthritis.
Active substance: Meloxicam
Amelotex(Sotex)	52-117	A modern selective drug with a pronounced anti-inflammatory effect. Indications for use are pain and inflammatory syndrome in osteoarthritis, osteochondrosis, rheumatoid arthritis and ankylosing spondylitis. It is not usually used for antipyretic purposes and for the treatment of other types of pain. It can cause a variety of side effects, but the negative effect on the gastrointestinal tract is less than that of non-selective drugs in this group. It has many contraindications, including pregnancy, lactation and children under 12 years of age.
Artrozan(Pharmstandard)	87,7-98,7
Bi-xicam(Veropharm)	35-112
Meloxicam(various manufacturers)	9,5-12,3
Mirloks(Polfa)	47-104
Movalis(Boehringer Ingelheim)	418-709
Movasin(Synthesis)	73,1-165

Remember, self-medication is life-threatening, consult a doctor for advice on the use of any medications.

Which is better: Nimesil or Aertal?

Comparison of drugs

Both drugs are designed to relieve inflammation and relieve pain in various diseases.

Aertal

The drug is intended to relieve inflammation and alleviate the condition in patients with rheumatic diseases. Aceclofenac, the main active ingredient of Aertal, has an effect on the peripheral nervous system. In this case, pain is relieved and joint stiffness is reduced due to the long stay of the body in one position.

The active substance helps well with osteochondrosis, arthritis, rheumatism and other disorders. Often, patients are prescribed the drug in two forms: for external and internal use. In this case, the therapy is complex and most effective.

Nimesil

This drug, like the previous one, has a directed effect on the removal of inflammatory processes of various kinds. Nimesil is prescribed to relieve pain and alleviate the general condition.

Nimesil is used for such pains:

Comparison of drugs

Comparison of Nimesil or Aertal for some parameters is presented in the table below:

Medication Review - Aertal

Aertal is a drug that belongs to anti-inflammatory drugs.

Auxiliary ingredients: liquid paraffin, methyl parahydroxybenzoate, emulsion wax, propyl parahydroxybenzoate, water.

The drug contains an active substance - aceclofenac, which inhibits the activity of the acyclooxygenase enzyme, reduces the synthesis of inflammatory cytokines.

Due to the high activity of this component in soft tissues and the peripheral nervous system, aceclofenac eliminates pain, relieves swelling and morning stiffness in rheumatic diseases.

After taking the drug orally, it is rapidly absorbed in the gastrointestinal tract and reaches its maximum concentration in one and a half to three hours. Aceclofenac has a high degree of binding to plasma proteins, has a high concentration in the synovial fluid. The drug is excreted by the kidneys.

Indication

With osteoarthritis;
Pain in the spine;
Rheumatic diseases;
Lumbago;
Toothache;
Periarthritis humeroscapular;
Osteoarthritis;
Alkylosing spondylitis;
Rheumatoid arthritis;
To relieve pain in inflammatory diseases.

Dosage

The doctor should prescribe the dose of treatment and the course of therapy for each patient individually, depending on the nature of the disease and its complexity. Usually prescribed to patients one tablet twice a day.

Side effects

When taking this drug in patients, the following side effects were noted:

On the part of the gastrointestinal tract: indigestion, stomach pain, nausea, increased liver enzymes, impaired stool. Perhaps the development of pancreatitis, stomatitis, ulcerative lesions of the mucous membranes of the gastrointestinal tract, gastric bleeding.

CNS: irritability, headaches, convulsions, memory loss, dizziness, changes in taste, insomnia, hearing loss, vision loss, tremor. Rarely - aseptic meningitis, edema, renal failure.

CCC: palpitations, ischemic disease, blood pressure disorders, leukopenia, heart failure, thrombocytopenia, agranulocytosis.

Allergic reactions: itching, skin rash, bronchospasm, eczema, urticaria, erythroderma, sometimes anaphylactic shock.

This drug is contraindicated

Individual intolerance to the components of the drug.

Disease of the gastrointestinal tract during the period of exacerbation or suspicion of ulcerative lesions of the mucous membranes of the gastrointestinal tract, impaired kidneys, hematopoiesis, impaired blood clotting.

You can not prescribe the drug to pregnant women and nursing mothers, children under 18 years of age.

With extreme caution, you need to take the remedy for people with bronchial asthma, impaired kidney function, liver, gastrointestinal disease, coronary heart disease, high blood pressure, impaired cerebral circulation, patients who suffer from diabetes, elderly patients, patients who drink alcohol and smoke.

It should also be taken with caution by patients whose work is directly related to the management of dangerous mechanisms or driving a car, since the drug can cause dizziness.

Interaction

When taken simultaneously with digoxin, lithium preparations, phenytoin, there is a risk of developing their plasma concentrations.

Aertal may reduce the activity of diuretics.

When taken together with potassium preparations, there is a risk of developing hyperkalemia, hypercaluria.

When taken simultaneously with cyclosporine, the nephrotic effect of cyclosporine may be enhanced.

The drug can change the level of glucose in the blood, so patients with diabetes mellitus require dose adjustment of hypoglycemic drugs.

The drug can increase the plasma concentrations of methotrexate, so it is necessary to observe the interval between doses, it should be at least a day.

When co-administered with acetylsalicylic acid, it may reduce plasma concentrations of aceclofenac.

Simultaneous reception with anticoagulants and antiageants increases the risk of bleeding.

Aertal can increase the ulcerogenic effect of glucocorticosteroids and other anti-inflammatory drugs.

Overdose

In patients taking the drug in high doses, the following side effects were noted:

headache, nausea, abdominal pain, vomiting. Shown: rinse the stomach, take sorbents. symptomatic treatment.

Storage

It should be stored in a protected place from light, at temperature hail.

Cheap analogues and substitutes for the drug aertal in tablets, ointments, powders and ampoules

The drug aertal of Spanish production refers to anti-inflammatory nonsteroidal drugs based on aceclofenac. The drug is an effective analgesic, its use is practiced as an antipyretic drug.

Average prices in pharmacies are 325–850 rubles.

Aertal should not be used during pregnancy, lactation, children under 18 years of age. There are other contraindications.

There are many pain medications that have an identical mechanism of action, but the active ingredient may vary. Close substitutes and cheap analogues of the drug often help out patients when it is impossible to be treated with aertal.

Analogues of Russian production

The table includes synonyms for aertal from among non-steroidal anti-inflammatory drugs from a domestic manufacturer.

It has identical indications and contraindications, is available in tablets.

On sale there is a gel, rectal suppositories, tablets, injection solution.

A remedy is used for diseases of the joints and the musculoskeletal system, accompanied by pain and inflammation.

The scope includes the treatment of rheumatoid arthritis, arthropathy, arthrosis, bursitis, spondylitis, tendinitis, radiculopathy.

Ukrainian substitutes

Aertal analogues of Ukrainian production have a different composition of the drug, but the same indications for use.

The list contains medicines that will tell you how to replace the drug:

Revmoxicam. The best and cheapest drug for the treatment of rheumatological pathologies and joint diseases. At the heart of the drug is meloxicam. The average price is 110–245 rubles.
Fort Gel. Non-steroidal anti-inflammatory drug with ketoprofen at the heart of the drug. It is used topically to eliminate pain from bruises, injuries, and rheumatic diseases. The average price is 55–70 rubles.
Diclofenac Sodium. An inexpensive Ukrainian close substitute for aertal with the active ingredient diclofenac. Available in the form of ointment, gel, cream, powder for dilution, suppositories, tablets, suspensions.

Anesthetic and anti-inflammatory drug with antipyretic function. The average price is 20–110 rubles.

Belarusian generics

Modern Belarusian generics of aertal should be considered, which can act as an effective replacement for a cheap analgesic and anti-inflammatory drug for rheumatic and other diseases.

It is used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, humeroscapular periarthritis, to relieve pain.

Sold in capsules.

Indications for use: diseases of the joints, rheumatoid arthritis, ankylosing spondylitis.

The drug line includes various forms of release from tablets to powders and suppositories.

Tablets, gel or suspension is used in the treatment of rheumatic and articular diseases, as well as to relieve acute pain.

The cheapest synonym for aertal with the active substance of the same name.

Available in tablets, you can also find a gel, ointment, cream, powder for injection, suspension.

The drug is used for pain relief, fever reduction, as an anti-inflammatory agent.

Can be used in the 2nd and 3rd trimesters of pregnancy, children from 3 months, while breastfeeding.

Other foreign analogues

Below are the best imported drugs from the group of non-steroidal anti-inflammatory drugs.

Asinak. The drug is used to treat inflammatory diseases of the musculoskeletal system. The composition of the drug includes aceclofenac. The country of origin is India. The average price is 315–380 rubles.
Aceclone. A popular analogue of aertal from the category of drugs with aceclofenac is cheaper. Indications are as follows: various types of arthritis, ankylosing spondylitis, gout, osteoarthritis. The drug is produced in India. The average price is 185–450 rubles.
Zerodol. Aceclofenac tablets. Antirheumatic non-steroidal agent, with anti-inflammatory and antipyretic function. The country of origin is India. The average price is 90-150 rubles.
Voltaren. Emulgel based on the potassium salt of diclofenac, which has a pronounced analgesic and anti-inflammatory effect. Swiss medicine with various forms of release: gel, patch, ointment, tablets, injections in ampoules, suppositories, spray. The average price is 210–650 rubles.
Movalis. The drug treats arthrosis, arthritis and other rheumatological diseases of the musculoskeletal system and blood vessels. Tablets, injections and suspension contain meloxicam in the base. The medication is produced in Greece, Germany, Austria. The average price is 205–920 rubles.
Nimesil. One of the best inexpensive imported analogues of airtal with nimesulide in the base. There are many forms of release: cream, gel, tablets, ointment, powder for making a drink, solution for injection, suspension, spray, drops, vaginal and rectal suppositories.

Means of Italian or German production. The average price is 25–690 rubles.

Despite the free vacation in the pharmacy, self-selection of medicines is not recommended. In order to permanently get rid of the pain and eliminate not the symptom of the disease, but its cause, you need to see a doctor.

Non-steroidal anti-inflammatory drugs of systemic action

All drugs in this group act on a similar principle and cause three main effects: analgesic, anti-inflammatory and antipyretic.

Main indications:

Osteochondrosis, osteoarthritis, rheumatoid arthritis and other diseases of the joints and spine, occurring with pain and inflammation.

Features: all drugs in this group act on a similar principle and cause three main effects: analgesic, anti-inflammatory and antipyretic.

The most common side effects: allergic reactions, nausea, abdominal pain, erosion and ulceration of the mucous membrane of the gastrointestinal tract.

Main contraindications: individual intolerance, exacerbation of peptic ulcer of the stomach and duodenum.

Important information for the patient:

Drugs that have a pronounced analgesic effect and a significant number of side effects (diclofenac, ketorolac, nimesulide and others) can only be used as directed by a doctor.

Among non-steroidal anti-inflammatory drugs, a group of so-called "selective" drugs is distinguished, which are less likely to have side effects from the gastrointestinal tract.

In some cases, long-term use of this group of drugs requires additional intake of proton pump inhibitors that protect the stomach.

Anti-inflammatory drugs for the joints (NSAIDs): an overview of the means

In this article, we will consider the group of drugs listed first - NSAIDs.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Mechanism of action of NSAIDs

Scheme of prescription of NSAIDs

Classification of NSAIDs

1. Non-selective (affect all types of COX, but mainly COX-1):

2. Non-selective, affecting equally COX-1 and COX-2:

3. Selective (inhibit COX-2):

Briefly about pharmacokinetics

Non-steroidal anti-inflammatory drugs are used orally or intramuscularly.

When taken orally, they are well absorbed in the digestive tract, their bioavailability is about %. They are better absorbed in an acidic environment, and a shift in the pH of the stomach to the alkaline side slows down absorption. The maximum concentration of the active substance in the blood is determined 1-2 hours after taking the drug.

When administered intramuscularly, the drug binds to blood proteins by 90-99%, forming functionally active complexes.

Contraindications to the use of NSAIDs

Preparations of this group are undesirable for use in the following conditions:

Main side effects of NSAIDs

ulcerogenic effect (the ability of drugs of this group to provoke the development of ulcers and erosions of the gastrointestinal tract);
dyspeptic disorders (discomfort in the stomach, nausea, and others);
bronchospasm;
toxic effects on the kidneys (violation of their function, increased blood pressure, nephropathy);
toxic effects on the liver (increased activity in the blood of hepatic transaminases);
toxic effects on the blood (decrease in the number of formed elements up to aplastic anemia, a violation of blood coagulation, manifested by bleeding);
prolongation of pregnancy;
allergic reactions (skin rashes, itching, anaphylaxis).

The number of reports of adverse reactions of drugs of the NSAID group received in the years

Features of NSAID therapy

Treatment with NSAIDs should be carried out for the shortest possible time and at the lowest effective doses.

Persons with impaired renal function, as well as elderly patients, as a rule, are prescribed a dose below the average therapeutic dose, since the metabolic processes in these categories of patients are slowed down: the active substance both has an effect and is excreted for a longer period.

Consider the individual drugs of the NSAID group in more detail.

Indomethacin (Indomethacin, Metindol)

Release form - tablets, capsules.

Assign, as a rule, pomg inside 2-3 times a day.

The side effects listed above are quite pronounced for this drug, so at present it is used relatively rarely, giving way to other, safer drugs in this regard.

Diclofenac (Almiral, Voltaren, Diklak, Dicloberl, Naklofen, Olfen and others)

Release form - tablets, capsules, injection, suppositories, gel.

It has a pronounced anti-inflammatory, analgesic and antipyretic effect. Rapidly and completely absorbed in the gastrointestinal tract. The maximum concentration of the active substance in the blood is reached in minutes. Almost 100% absorbed with blood proteins and transported throughout the body. The maximum concentration of the drug in the synovial fluid is determined after 3-4 hours, the half-life of it from it is 3-6 hours, from the blood plasma - 1-2 hours. Excreted in urine, bile and feces.

As a rule, the recommended adult dose of diclofenac is mg 2-3 times a day orally. The maximum daily dose is 300 mg. The retard form, equal to 100 g of the drug in one tablet (capsule), is taken once a day. With intramuscular injection, a single dose is 75 mg, the frequency of administration is 1-2 times a day. The drug in the form of a gel is applied in a thin layer on the skin in the area of inflammation, the frequency of application is 2-3 times a day.

Etodolak (Etol Fort)

Release form - capsules of 400 mg.

The anti-inflammatory, antipyretic and analgesic properties of this drug are also quite pronounced. It has moderate selectivity - it acts mainly on COX-2 in the focus of inflammation.

It is used for emergency or long-term therapy of rheumatological pathology: osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, as well as in case of pain syndrome of any etiology.

Contraindications are standard. Side effects are similar to those of other NSAIDs, however, due to the relative selectivity of the drug, they appear less frequently and are less pronounced.

Reduces the effect of some antihypertensive drugs, in particular ACE inhibitors.

Aceclofenac (Aertal, Diclotol, Zerodol)

Available in the form of tablets of 100 mg.

A worthy analogue of diclofenac with a similar anti-inflammatory and analgesic effect.

After oral administration, it is rapidly and almost 100% absorbed by the gastric mucosa. With the simultaneous intake of food, the rate of absorption slows down, but its degree remains the same. It binds to plasma proteins almost completely, spreading throughout the body in this form. The concentration of the drug in the synovial fluid is quite high: it reaches 60% of its concentration in the blood. The average elimination half-life is 4-4.5 hours. It is excreted mainly by the kidneys.

Of the side effects, dyspepsia, nausea, diarrhea, pain in the abdomen, increased activity of hepatic transaminases, dizziness should be noted: these symptoms are quite common, in 1-10 cases out of 100. Other adverse reactions are much less common, in particular, stomach ulcers - less than one patient in 10,000.

It is possible to reduce the likelihood of side effects by prescribing the minimum effective dose to the patient as soon as possible.

It is not recommended to take aceclofenac during pregnancy and lactation.

Reduces the antihypertensive effect of antihypertensive drugs.

Piroxicam (Piroxicam, Fedin-20)

Release form - tablets of 10 mg.

In addition to anti-inflammatory, analgesic and antipyretic effects, it also has an antiplatelet effect.

The analgesic effect is manifested within half an hour after taking the pill and persists for a day.

Dosages of the drug vary depending on the disease and range from 10 to 40 mg per day in one or more doses.

Contraindications and side effects are standard.

Tenoxicam (Texamen-L)

Release form - powder for solution for injection.

Apply intramuscularly at 2 ml (20 mg of the drug) per day. In acute gouty arthritis - 40 mg 1 time per day for 5 days in a row at the same time.

Enhances the effects of indirect anticoagulants.

Lornoxicam (Xefocam, Larfix, Lorakam)

Release form - tablets of 4 and 8 mg, powder for solution for injection containing 8 mg of the drug.

Elderly patients do not need to reduce the dosage of lornoxicam, however, due to the likelihood of adverse reactions from the gastrointestinal tract, persons with any gastroenterological pathology should take it with caution.

Meloxicam (Movalis, Melbek, Revmoxicam, Recox, Melox and others)

Release form - tablets of 7.5 and 15 mg, injection of 2 ml in an ampoule containing 15 mg of the active substance, rectal suppositories, also containing 7.5 and 15 mg of Meloxicam.

Selective COX-2 inhibitor. Less often than other drugs of the NSAID group, it causes side effects in the form of kidney damage and gastropathy.

Celecoxib (Celebrex, Revmoxib, Zycel, Flogoxib)

Release form - capsules of 100 and 200 mg of the drug.

As a rule, celecoxib is taken at a dosage of mg per day in 1-2 doses. The maximum daily dose is 400 mg.

Side effects are rare. In the case of long-term use of the drug in a high dosage, ulceration of the mucous membrane of the digestive tract, gastrointestinal bleeding, agranulocytosis and thrombocytopenia are possible.

Rofecoxib (Denebol)

The release form is a solution for injection in 1 ml ampoules containing 25 mg of the active substance, tablets.

Highly selective COX-2 inhibitor with pronounced anti-inflammatory, analgesic and antipyretic properties. Virtually no effect on the mucous membrane of the gastrointestinal tract and kidney tissue.

With caution appoint women in the 1st and 2nd trimesters of pregnancy, during lactation, persons suffering from bronchial asthma or severe renal failure.

The risk of developing side effects from the gastrointestinal tract increases when taking high doses of the drug for a long time, as well as in elderly patients.

Etoricoxib (Arcoxia, Exinef)

Release form - tablets of 60 mg, 90 mg and 120 mg.

Selective COX-2 inhibitor. It does not affect the synthesis of gastric prostaglandins, it does not affect the function of platelets.

The drug is taken orally, regardless of the meal. The recommended dose directly depends on the severity of the disease and varies within mg per day in 1 dose. Elderly patients do not need to adjust the dosage.

Nimesulide (Nimegesic, Nimesil, Nimid, Aponil, Nimesin, Remesulide and others)

Release form - tablets of 100 mg, granules for suspension for oral administration in a sachet containing 1 dose of the drug - 100 mg each, gel in a tube.

A highly selective COX-2 inhibitor with a pronounced anti-inflammatory, analgesic and antipyretic effect.

During pregnancy, especially in the 3rd trimester, it is strongly not recommended to take nimesulide. During lactation, the drug is also contraindicated.

Nabumeton (Synmeton)

Release form - tablets of 500 and 750 mg.

Non-selective COX inhibitor.

A single dose for an adult patient is 000 mg during or after a meal. In especially severe cases, the dose may be increased to 2 grams per day.

Side effects and contraindications are similar to those of other non-selective NSAIDs.

It is not recommended to take during pregnancy and lactation.

Combined non-steroidal anti-inflammatory drugs

There are drugs containing two or more active substances from the NSAID group, or NSAIDs in combination with vitamins or other drugs. The main ones are listed below.

Dolaren. Contains 50 mg diclofenac sodium and 500 mg paracetamol. In this preparation, the pronounced anti-inflammatory effect of diclofenac is combined with the bright analgesic effect of paracetamol. Take the drug inside 1 tablet 2-3 times a day after meals. The maximum daily dose is 3 tablets.
Neurodiclovitis. Capsules containing 50 mg of diclofenac, vitamin B1 and B6, and 0.25 mg of vitamin B12. Here, the analgesic and anti-inflammatory effect of diclofenac is enhanced by B vitamins, which improve metabolism in the nervous tissue. The recommended dose of the drug is 1-3 capsules per day in 1-3 doses. Take the drug after meals with plenty of fluids.
Olfen-75, produced in the form of a solution for injection, in addition to diclofenac in an amount of 75 mg, also contains 20 mg of lidocaine: due to the presence of the latter in the solution, injections of the drug become less painful for the patient.
Fanigan. Its composition is similar to that of Dolaren: 50 mg diclofenac sodium and 500 mg paracetamol. It is recommended to take 1 tablet 2-3 times a day.
Flamidez. Very interesting, different drug. In addition to 50 mg of diclofenac and 500 mg of paracetamol, it also contains 15 mg of serratiopeptidase, which is a proteolytic enzyme and has a fibrinolytic, anti-inflammatory and anti-edematous effect. Available in the form of tablets and gel for topical use. The tablet is taken orally, after a meal, with a glass of water. As a rule, appoint 1 tablet 1-2 times a day. The maximum daily dose is 3 tablets. The gel is used externally, applying it to the affected area of the skin 3-4 times a day.
Maxigesic. A drug similar in composition and action to Flamidez, described above. The difference lies in the manufacturing company.
Diplo-P-Pharmeks. The composition of these tablets is similar to the composition of Dolaren. The dosages are the same.
Dolar. Same.
Dolex. Same.
Oksalgin-DP. Same.
Cinepar. Same.
Diclocaine. Like Olfen-75, it contains diclofenac sodium and lidocaine, but both active ingredients are in half the dosage. Accordingly, it is weaker in action.
Dolaren gel. Contains diclofenac sodium, menthol, linseed oil and methyl salicylate. All these components to some extent have an anti-inflammatory effect and potentiate the effects of each other. The gel is applied to the affected areas of the skin 3-4 times a day.
Nimid forte. Tablets containing 100 mg of nimesulide and 2 mg of tizanidine. This drug successfully combines the anti-inflammatory and analgesic effects of nimesulide with the muscle relaxant (muscle relaxing) effect of tizanidine. It is used for acute pain caused by spasm of skeletal muscles (popularly - with infringement of the roots). Take the drug inside after eating, drinking plenty of fluids. The recommended dose is 2 tablets per day in 2 divided doses. The maximum duration of treatment is 2 weeks.
Nizalid. Like nimid forte, it contains nimesulide and tizanidine in similar dosages. The recommended doses are the same.
Alit. Soluble tablets containing 100 mg of nimesulide and 20 mg of dicycloverine, which is a muscle relaxant. It is taken orally after a meal with a glass of liquid. It is recommended to take 1 tablet 2 times a day for no longer than 5 days.
Nanogan. The composition of this drug and the recommended dosages are similar to those of the drug Alit described above.
Oksigan. Same.

Cheap analogues of Aertal tablets, as well as cream, ointment and powder

Joint diseases are a pathology that forces patients to use anti-inflammatory painkillers. The article talks about the effective drug Aertal and the features in choosing its inexpensive analogues, taking into account information about the drug and feedback from doctors and patients.

Who is prescribed Aertal and why?

Aertal is a remedy for the treatment of joint diseases containing aceclofenac. Refers to non-steroidal anti-inflammatory drugs for systemic and topical use. Suppresses the synthesis of prostaglandins, providing an anti-inflammatory effect and reducing pain.

It penetrates well into the joint fluid, provides a long-lasting effect. The drug is available in Hungary in the form of tablets and powder for suspension with a single dose of 100 mg of aceclofenac and as a 1.5% cream.

Aertal in the form of oral forms is used to treat pathologies of the musculoskeletal system and some conditions accompanied by pain, including:

rheumatism, including extra-articular changes;
osteoarthritis;
rheumatoid arthritis;
ankylosing spondylitis;
toothache;
primary dysmenorrhea;
lumbodynia.

Aertal is taken 1 tablet or sachet 1-2 times a day after or during meals. The powder is dissolved in warm water and drunk. The maximum daily dose is 200 mg.

Aertal is contraindicated in:

hypersensitivity to aceclofenac, the components of the drug or to acetylsalicylic acid;
after gastrointestinal bleeding or perforation due to NSAIDs;
peptic ulcer of the stomach or duodenum;
bleeding or impaired hemostasis;
severe cardiac, severe renal and hepatic insufficiency;
with angina pectoris and after myocardial infarction or coronary artery bypass grafting.

The medicine is not used during breastfeeding, in the third trimester of pregnancy and in children under 18 years of age.

Side effects of Aertal are most often associated with an undesirable effect on the digestive system.

There were acute erosions and ulcers, perforation of the wall of the digestive tract, bleeding, sometimes severe. Nausea with vomiting, loose stools, flatulence, abdominal pain, exacerbation of gastritis, and other dyspeptic manifestations are noted. There are allergic reactions, neurological disorders, anemia.

In the treatment of aceclofenac may increase the risk of myocardial infarction and stroke. The cream is used topically in adults in the treatment of pain after injuries of the musculoskeletal system, in the complex therapy of lumbago, torticollis and periarthrosis. The product is applied to clean skin up to 3 times a day.

The cream is not used if there were intolerance reactions to its components.

Features of drug interactions require caution in hypertension - aceclofenac reduces the effectiveness of some antihypertensive drugs. It is not used in combination with other NSAIDs, methotrexate, cardiac glycosides, lithium compounds, anticoagulants, fluoroquinolones.

Interactions are more related to oral forms of aceclofenac, with cream treatment, restrictions are minimal.

The cost of Aertal is rubles for 20 tablets, a large package is more profitable - 60 tablets for 800 rubles. 20 packets of 100 mg will cost a cut. The price of 60 grams of cream is 330 rubles. Many analogues are cheaper. Let's consider them.

How to replace Aertal?

Pharmacies sell domestic preparations of aceclofenac in the form of tablets and there is a large assortment of all forms of release of anti-inflammatory drugs with other active substances with similar effectiveness.

Complete analogues of Aertal are represented by three Russian-made generic tablets. They are identical to the Hungarian generic in composition, properties and peculiarities of use (the original remedy is Niplonac).

Their cost is much more affordable:

Aceclofenac (CJSC Berezovsky FZ) up to 100 rubles for 20 tablets;
Alental (CJSC "VERTEX") 250 rubles for 20 tabs;
Aceclofenac (“Synthesis”) - packs of 20 and 60 tablets for 220 and 550 rubles.

Some NSAIDs with other active ingredients can replace Aertal in cases where drugs with aceclofenac are not available.

When choosing a substitute for an anti-inflammatory drug, one must understand that in different clinical situations, not all drugs will have the same effect. The severity of the analgesic and anti-inflammatory effect differs with different duration and nature of the pathological process.

Therefore, the replacement of prescription drugs, which include tablets and Aertal powder, with drugs with a different composition should be carried out by a doctor. On your own or with the help of a pharmacist, you can choose a drug of aceclofenac that is suitable for the price and choose a replacement for the cream.

Tablets and capsules

Aceclofenac can be completely replaced only when using other prescription NSAIDs. Freely sold products - Ibuprofen, Naproxen and Aspirin will not provide the desired effect. Meloxicam, diclofenac, celecoxib and ketoprofen will have a similar effect in chronic joint lesions.

For acute pain, Ketorolac will be the optimal replacement.

Meloxicam is the optimal remedy for patients with joint lesions, it has chondroprotective properties. Available in tablets of 7.5 and 15 milligrams, taken 1 time per day. The drug can be used in remission of stomach ulcers.

Import substitutes - medicines Meloxicam-Teva, Meloxicam Shtada cost a cut for 10 tablets of 15 mg or 20 tablets of 7.5 mg, the same dosage of a Russian drug from different manufacturers costs from 75 to 130 rubles.

Diclofenac is the most famous and very popular because of the cheapness of the drug used for joint diseases. A few years ago it was considered the standard of anti-inflammatory therapy, now its use is limited due to side effects.

It has a pronounced side effect on the stomach, can cause thrombosis and lead to the development of heart attacks and strokes. Reduces the effectiveness of antihypertensive drugs when used together.

It is used in the form of tablets of 50 and 75 mg and capsules of 100 mg. The maximum daily dose is 150 milligrams. Imported drugs Dicloberl and Diklak 75 mg No. 10 - 70 rubles. Russian-made diclofenac costs from 48 rubles. (100 mg 20 pieces)

Ketoprofen - capsules and tablets of 50, 100 and 150 mg. A non-selective drug with a good analgesic effect in chronic inflammation. 25 capsules of foreign Ketonal 50 mg each cost 100 rubles. Domestic Ketoprofen is 1.5-2 times cheaper.

Celecoxib is a selective anti-inflammatory drug, available in capsule form with a dosage of 100 and 200 mg. Does not show gastrotoxicity and can be used for stomach problems.

It affects the processes of excitation in the heart, therefore it is limitedly used in cardiac pathology. From cheap analogues, imported Dilaxa chopped for 10 capsules and domestic Roucoxib-Routek are available at the same price.

Ketorolac is a drug with a predominant analgesic effect, the most effective of those listed in acute conditions - trauma, toothache, after surgery. The maximum effect shows the first 3-5 days after the injury or the appearance of pain.

It is not used for chronic pain (except for oncology). Tablets contain 10 mg of ketorolac, taken up to 4 times a day.

The most famous imported remedy is Romanian Ketanov, the price of 10 tablets is 60 rubles. Domestic Ketorolac costs about 20 rubles.

Creams, ointments and gels

The choice is made among anti-inflammatory drugs based on ketoprofen, nimesulide and diclofenac with a similar analgesic effect:

Fastum gel - contains 2.5% ketoprofen, 30 grams of gel cost 240 rubles, 100g - 550 rubles;
Ketonal - 5% cream with ketoprofen, price 30g - 300 rubles. There is a 2.5% gel, 50g cost 300 rubles;
Bystrumgel - a Russian medicine with the same substance at a concentration of 2.5%, the cost of 30 grams is 190 rubles;
Nise - 1% nimesulide gel, 20 g cost 175 rubles;
Diclac gel containing 5% diclofenac, price 50 g - 270 rubles;
domestic Diclofenac in the form of a 1% gel and ointment, an inexpensive remedy with a price of 30 rubles per 30 grams, a 5% gel costs 2-2.5 times more.

The most effective means with 5% ketoprofen and diclofenac.

Powders in sachets

When choosing a replacement for Aertal in the form of a powder, the funds are compared with other components. The most popular NSAIDs in powders are the Italian drug Nimesil, containing 100 mg of nimesulide. Its cost is 680 rubles for 30 packages.

Nimesulide has many restrictions on use due to hepatotoxicity, in addition to the standard contraindications for NSAIDs, it cannot be used for liver diseases, alcoholism, colds and flu, and if the patient's body temperature rises, the medicine should be discontinued. In a number of countries that continue to use it, diseases of the joints have been excluded from the indications.

In neighboring countries, Dexalgin-sachets (dexketoprofen) and Catafast (potassium diclofenac) are on sale, the effectiveness and safety of which are higher than that of nimesulide.

But even quite young people turn to medical institutions and pharmacies after bruises and injuries.

In order to relieve pain, stop the inflammatory process and relieve swelling, non-steroidal anti-inflammatory drugs are used. It can be both external means, and oral, and injections.

Good remedies are Diclofenac and Aertal, Movalis and other drugs from the category of NSAIDs popular all over the world.

Aertal

The drug is based on the substance Acyclofenac - a derivative of acetic acid. It well relieves inflammation, anesthetizes, relieves fever and swelling. This is a new generation medicine.

It also helps with morning stiffness, is used for toothache, sciatica, rheumatic pains, radiculitis, lumbago.

They are produced in tablets with a dosage of 100 mg of 20 and 60 pieces, powders for internal use, there is also a cream for external use. The active ingredient of Aertal inhibits the synthesis of prostaglandins and prostacyclins responsible for the inflammatory process.

In the form of powder and tablets, caution should be taken in patients with peptic ulcer of the stomach and intestines, damage to their mucous membranes. But unlike most other popular NSAIDs, airtal is easier to tolerate.

Other contraindications include:

kidney and liver diseases
acute rhinitis
diabetes
hives
pregnancy and breastfeeding period

Tablets and powders are taken with plenty of water no more than 200 mg per day, the powder acts faster.

The cream is used externally 2-3 times a day.

Side effects of Aertal:

epigastric pain
kidney and liver failure
cardiac arrhythmias
individual intolerance

Comparison of drugs

Is diclofenac better or worse than Aertal? Diclofenac is the oldest drug, it has more side effects, Aertal irritates the stomach less, has less effect on blood clotting and other indicators.

These drugs are from different price categories. The difference between Aertal and Diclofenac is also in price. The new drug is much more expensive, 10 tablets cost about 700 rubles, while the second is in the price category up to 100 rubles. Aertal cream costs about 300 rubles, and diclofenac ointment is much cheaper. Acyclofenac can be taken regardless of meals, its tolerance by the body is much better.

Aertal is a more modern and improved tool. Aertal is good for patients with diseases of the gastric and intestinal mucosa.

NSAIDs are one of the most purchased and prescribed drugs in the world. Each doctor prescribes the remedy that he considers most effective in this particular case. Treatment is prescribed after a thorough examination and diagnosis.

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IMPORTANT. The information on the site is provided for reference purposes only. Do not self-medicate. At the first sign of disease, consult a doctor.

Cheap analogues and substitutes for the drug aertal in tablets, ointments, powders and ampoules

The drug aertal of Spanish production refers to anti-inflammatory nonsteroidal drugs based on aceclofenac. The drug is an effective analgesic, its use is practiced as an antipyretic drug.

Average prices in pharmacies are 325–850 rubles.

Aertal should not be used during pregnancy, lactation, children under 18 years of age. There are other contraindications.

Analogues of Russian production

The table includes synonyms for aertal from among non-steroidal anti-inflammatory drugs from a domestic manufacturer.

It has identical indications and contraindications, is available in tablets.

On sale there is a gel, rectal suppositories, tablets, injection solution.

A remedy is used for diseases of the joints and the musculoskeletal system, accompanied by pain and inflammation.

The scope includes the treatment of rheumatoid arthritis, arthropathy, arthrosis, bursitis, spondylitis, tendinitis, radiculopathy.

Ukrainian substitutes

Aertal analogues of Ukrainian production have a different composition of the drug, but the same indications for use.

The list contains medicines that will tell you how to replace the drug:

Revmoxicam. The best and cheapest drug for the treatment of rheumatological pathologies and joint diseases. At the heart of the drug is meloxicam. The average price is 110–245 rubles.
Fort Gel. Non-steroidal anti-inflammatory drug with ketoprofen at the heart of the drug. It is used topically to eliminate pain from bruises, injuries, and rheumatic diseases. The average price is 55–70 rubles.
Diclofenac Sodium. An inexpensive Ukrainian close substitute for aertal with the active ingredient diclofenac. Available in the form of ointment, gel, cream, powder for dilution, suppositories, tablets, suspensions.

Anesthetic and anti-inflammatory drug with antipyretic function. The average price is 20–110 rubles.

Belarusian generics

Modern Belarusian generics of aertal should be considered, which can act as an effective replacement for a cheap analgesic and anti-inflammatory drug for rheumatic and other diseases.

It is used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, humeroscapular periarthritis, to relieve pain.

Sold in capsules.

Indications for use: diseases of the joints, rheumatoid arthritis, ankylosing spondylitis.

The drug line includes various forms of release from tablets to powders and suppositories.

Tablets, gel or suspension is used in the treatment of rheumatic and articular diseases, as well as to relieve acute pain.

The cheapest synonym for aertal with the active substance of the same name.

Available in tablets, you can also find a gel, ointment, cream, powder for injection, suspension.

The drug is used for pain relief, fever reduction, as an anti-inflammatory agent.

Can be used in the 2nd and 3rd trimesters of pregnancy, children from 3 months, while breastfeeding.

Other foreign analogues

Below are the best imported drugs from the group of non-steroidal anti-inflammatory drugs.

Asinak. The drug is used to treat inflammatory diseases of the musculoskeletal system. The composition of the drug includes aceclofenac. The country of origin is India. The average price is 315–380 rubles.
Aceclone. A popular analogue of aertal from the category of drugs with aceclofenac is cheaper. Indications are as follows: various types of arthritis, ankylosing spondylitis, gout, osteoarthritis. The drug is produced in India. The average price is 185–450 rubles.
Zerodol. Aceclofenac tablets. Antirheumatic non-steroidal agent, with anti-inflammatory and antipyretic function. The country of origin is India. The average price is 90-150 rubles.
Voltaren. Emulgel based on the potassium salt of diclofenac, which has a pronounced analgesic and anti-inflammatory effect. Swiss medicine with various forms of release: gel, patch, ointment, tablets, injections in ampoules, suppositories, spray. The average price is 210–650 rubles.
Movalis. The drug treats arthrosis, arthritis and other rheumatological diseases of the musculoskeletal system and blood vessels. Tablets, injections and suspension contain meloxicam in the base. The medication is produced in Greece, Germany, Austria. The average price is 205–920 rubles.
Nimesil. One of the best inexpensive imported analogues of airtal with nimesulide in the base. There are many forms of release: cream, gel, tablets, ointment, powder for making a drink, solution for injection, suspension, spray, drops, vaginal and rectal suppositories.

Means of Italian or German production. The average price is 25–690 rubles.

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Movalis or artrosilen which is better

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) for osteochondrosis were discovered in 1829 after the isolation of the first representative of the group from willow bark - salicylic acid. Drugs are prescribed to eliminate inflammation, eliminate pain.

Long-term use (more than a week or two) of most NSAIDs is not recommended due to side effects, however, in patients with degenerative-dystrophic diseases of the spine, there is a need for long-term anti-inflammatory therapy.

The pharmaceutical industry has long been looking for drugs from the NSAID group that have fewer side effects.

The mechanism of action of non-steroidal anti-inflammatory drugs is to suppress the enzyme cyclooxygenase. Without going into details, we will only say that cyclooxygenase blocks inflammatory reactions by preventing the release of allergy mediators from mast cells and basophils.

Note that for the discovery of these substances, John Wayne received the Nobel Prize.

Classification of NSAIDs

In order to explain in detail to readers what non-steroidal anti-inflammatory drugs are and how to use them for osteochondrosis, we suggest considering the classification.

By chemical composition:

Acidic compounds: pyrazolidones, salicylates (aspirin), phenyl and indolacetic acid derivatives (diclofenac, indomethacin, aceclofenac, sulindac), oxycams (lornoxicam, tenoxicam, meloxicam), propionic acid derivatives (ketoprofen, naproxen).
Non-acid substances: sulfonamide (nimesulide), alkanone (nabumetone).

According to the strength of the anti-inflammatory effect in medium doses, these agents can be arranged in the following sequence from largest to smallest: indomethacin, flurbiprofen, piroxicam, diclofenac, ketoprofen, aspirin.

According to the analgesic effect, NSAIDs can be arranged in the following sequence: ketoprofen, indomethacin, piroxicam, naproxen, ibuprofen, aspirin.

“When analyzing the above effectiveness, we note that such a non-steroidal anti-inflammatory drug as aspirin has a weak analgesic and anti-inflammatory effect. Due to its toxic effect, it is practically not used for back pain associated with degenerative processes of the spine.

Any of the above means has a pronounced side effect on the gastrointestinal tract. As a result, the pharmaceutical industry is looking for selective drugs with reduced side effects. As a result of these developments, selective NSAIDs were created. Their mechanism of action is to block type 2 cyclooxygenase.

Their use is allowed for osteochondrosis and other degenerative-dystrophic diseases of the spine.

What drugs to choose and how to use them

In order to use NSAIDs for osteochondrosis and other degenerative-dystrophic changes in the spine, drugs in this group should be carefully selected. When reviewing them, it becomes obvious that some have a more pronounced anti-inflammatory effect, while the other part has an analgesic effect.

“In order to optimally select a drug, you need to know the mechanisms of its effect on the human body and the characteristics of pathological changes in the spinal column in each individual patient.”

In any case, drugs with a pronounced effect and side effects can only be used as prescribed by a doctor.

Among the most popular representatives of the NSAID group used to treat osteochondrosis are nimesulide, meloxicam, ketorolac and diclofenac (aceclofenac). They are prescribed by therapists and neurologists in the treatment of pain syndrome of reflex or compression genesis.

Usually, the beginning of therapy for pain in osteochondrosis and other degenerative diseases of the spine is associated with the appointment of diclofenac, aceclofenac or ketorolac due to the rapid onset of their action and good analgesic effect. It is important to remember that the maximum number of injections of these drugs is 5 days.

A week later, the patient, as a rule, is transferred to tablet preparations with less effect on the gastrointestinal tract and a pronounced anti-inflammatory effect, for example, nimesulide, meloxicam. Highly selective coxibs are still little studied due to their side effects on the cardiovascular system and are prescribed less frequently.

Schemes for the use of the most popular NSAIDs for osteochondrosis with pain are shown in the table below.

Remember that you can not use several painkillers of the same group at the same time with each other. In such a situation, not so much the analgesic effect increases, but the likelihood of side effects and the formation of duodenal ulcers (stomach) with the possibility of bleeding increases.

Whatever drug you choose, it should not be used for a long time! All drugs in this group are prescribed for a period of not more than 14 days, even those sold in pharmacies without a doctor's prescription.

To reduce the negative impact of diclofenac, nimesulide and voltaren on the gastrointestinal tract, doctors may recommend drugs to protect the stomach from damage, for example, omeprazole (Ultop, Omez).

Overview of drugs by efficacy and mechanisms of action

Representatives of the diclofenac group (Voltaren, Naklofen, Rapten Rapid) have a strong analgesic effect and are used for pain in the joints and back. They can not be taken for a long time due to severe side effects. Medicines are contraindicated in aspirin asthma, hematopoietic disorders and pathology of blood coagulation processes.

Comparative studies conducted to evaluate the effectiveness of aceclofenac and diclofenac have shown faster improvement and relief of pain when taking aceclofenac. The frequency of development of side effects was somewhat lower, tolerability was assessed better.

Ketoprofen derivatives ("Artrosilen", "Bystrumkaps", "Ketonal", "Flamaks") have a pronounced analgesic effect. They do not have a negative effect on the intervertebral discs, therefore they are the preferred means for osteochondrosis.

Nimesulide ("Nise", "Nimesil") belongs to the group of low-selective drugs that are used for pain in the back and joints. Ongoing studies (F. Bradbury) of efficacy in comparison with diclofenac and ketoprofen have proven its greater safety and low incidence of gastrointestinal lesions (gastritis, nausea, diarrhea, pain). Moreover, in another study, the risk factor for gastrointestinal damage in nimesulide was as small as in highly selective coxibs.

One should not be afraid of prescribing anti-inflammatory drugs for osteochondrosis with pain syndrome. Despite the negative impact of NSAIDs on the body, no alternatives to them in the treatment of this disease have been found!

Diclofenac in the treatment of pain syndromes. Danilov A.B. Journal "Attending Doctor", No. 5, 2009.
Back pain: differential diagnosis and rational pharmacotherapy. Kolokolov O.V., Salina E.A., Sitkali I.V., Kolokolova A.M., Lukina E.V. Russian medical journal.
Aceclofenac in the treatment of osteoarthritis. Sharapova E.P., Taskina E.A., Raskina T.A., Vinogradova I.B., Menshikova L.V., Alekseeva L.I., Ivanova O.N. Journal "Attending Doctor", No. 8, 2012.

Meloxicam: instructions for use, price, reviews, analogues

Meloxicam is a new generation drug from the group of non-steroidal anti-inflammatory drugs used to treat articular pathologies. Meloxicam relieves inflammation, eliminates pain and fever. This drug can be used to treat inflammation of any kind, including colds and fevers.

But Meloxicam is especially effective for arthritis and arthrosis of a different nature, as well as for ankylosing spondylitis. The tool is available in the following forms:

Depending on the packaging, release form, the cost of the drug varies from 90 to 120 rubles per 15 mg.

Why do we need analog

The effectiveness of drugs from the same group may vary. There is such a thing as bioavailability - this is the amount of the active substance that is absorbed by the patient's body. This indicator is different for each of the drugs with a similar active chemical agent.

The timing is important, through which the maximum concentration of the active substance in the patient's blood is reached. This indicator gives an idea of how quickly the drug works.

The half-life is also taken into account. According to this indicator, it is possible to establish the time of effective action of the drug and calculate the time when it will be possible to take a second drug that is incompatible with the first.

In addition, each of the drugs has its own possible side effects and contraindications - this is also a significant reason why many patients are looking for an analogue.

This parameter depends on the quality of the drug, its composition (excipients). The release form sometimes becomes the reason why patients select an analogue.

Everyone selects a form that would be convenient to take, take with you on the road if necessary and store. Naturally, patients take into account the cost of the drug and its availability in pharmacies.

If we talk about drugs for the treatment of articular pathologies from the group of non-steroidal anti-inflammatory drugs, then a fairly large selection of drugs with a similar effect, but with different indicators listed above, is offered. Therefore, it is usually not difficult to find an analogue.

What can replace Meloxicam

Meloxicam, in case it is not suitable or not available for sale, can be replaced with such drugs:

Amelotex. This analogue is produced and administered mainly in the form of a solution for intramuscular injection. According to the instructions, it is prescribed for degenerative processes in articular tissues, Bechterew's disease, and arthritis. The bioavailability of the drug is 99%. The time to reach the maximum concentration in the blood is 2-3 hours. Meloxicam, in comparison, is absorbed worse and reaches its maximum concentration not so quickly.

An analogue costs an average of 320 rubles per 15 mg of the active substance, it is admitted mainly in ampoules. Amelotex tablets are cheaper - 20 tablets cost from 110 rubles. But tablets are not so popular, since their effectiveness is low and they are very rarely used as an anesthetic and antipyretic.

This analogue can be purchased in the form of a gel for external use in diseases of the musculoskeletal system.

It has the same effect on the body as meloxicam.
This analogue is very similar in composition to meloxicam.
The main difference is that movalis, more precisely, the active substance in its composition, is a patented development of an authoritative European concern.

For this reason, the analogue is very popular and widely known, is in demand among buyers, and has excellent reviews. According to its instructions for use, chemical composition, effects and bioavailability, it is no different from meloxicam.

But its cost is several times higher - 520 rubles for 20 tablets of 7.5 mg. This is explained by the manufacturer's right to a unique form of medicine, which other concerns have to purchase from him.

The high cost does not reduce the popularity of this analogue among patients, as it gives them confidence in the guaranteed quality of the drug.

Artrozan. The main difference of this analogue is the ability to use it for treatment for a long period, if necessary, months and even years. The advantages of the drug are that it has almost no effect on the kidneys and liver, a small dose of the drug is enough per day - just one unit.

The cost of the medication is from 200 rubles for 20 tablets of 15 mg and 350 rubles for a solution of 15 mg in ampoules. Due to its availability, the drug is very popular among patients who are indicated for long-term therapy.

Movasin. It is the most inexpensive analogue. A 15 mg package of the drug costs only 50 rubles. A solution in ampoules of the same concentration costs 60 rubles. In the form of injections, the drug is prescribed only for 2-3 days, then a switch to tablets is recommended. The reason is a high degree of impact on the digestive and circulatory system.

The drug is not prescribed for children under 18 years of age, while movalis can be used from the age of 15.

Matarin. Instructions for use assumes the use of the product mainly for external use, although the drug is also available in the form of tablets. The drug contains 30 mg of meloxicam and 100 mg of capsicum extract. Pepper has a warming effect, you can use the ointment several times a day for a long period.

The price of the medicine is from 170 to 190 rubles per 15 mg. The drug can be used for children over the age of 12 years. The main drawback of the drug is the scarcity in pharmacies.

Which of the analogs is better

According to patient surveys, which drug, the active substance of which is meloxicam, is the best, most often called Movalis. Further, in terms of popularity, the drugs were distributed as follows:

If you do not take into account the cost of the drug, then Movalis is recognized as the most effective, according to customer reviews. If we take into account the price-quality ratio, then Artrozan and Amelotex will be the best.

When buying a drug, different indicators are important for each patient, depending on the goals and the real problem. Someone takes into account only the effectiveness of the tool and its quality, for others its cost is very important. In any case, you can always choose an effective analogue.

If long-term treatment is indicated, then it is advisable to give preference to such drugs as Arthrosis and Mataren. The latter can be used in pediatrics, and this makes it very popular among a certain category of patients.

Movasin is the most affordable drug, highly effective, but has a number of serious contraindications and side effects. It is not prescribed for children under 18 years of age. It cannot be used in the most effective form - an injection solution - for more than three days; it is not advisable to take the drug in tablets for a long period.

Movalis, whose analogues are often not inferior to it in terms of effectiveness, is a popular NSAID. However, not everyone is suitable for its cost. In these cases, it is better to ask the doctor to prescribe a more budgetary analogue. Preference should be given to domestic manufacturers, whose drugs are rarely counterfeited.

As a rule, for pathologies of the musculoskeletal system, Movalis is prescribed by specialists. It belongs to a large group of pharmacological agents - non-steroidal anti-inflammatory drugs. The basis of this drug is such an active substance as meloxicam.

What is meloxicam?

In the instructions for the drug Movalis, you can find information about the pronounced anti-inflammatory, analgesic and antipyretic effects of meloxicam. The specificity of its mechanism of action is reduced to selective inhibition of prostaglandins that provoke the inflammatory process. That is why this medicine is devoid of side effects characteristic of this type of drug.

For example, meloxicam does not provoke the formation of erosions and stomach ulcers with concomitant bleeding, and the percentage of symptoms such as abdominal pain, nausea and vomiting is significantly lower. Meloxicam is almost completely and rapidly absorbed from the gastrointestinal tract due to its high bioavailability.

Such properties of the substance make it possible to prescribe drugs based on meloxicam for a variety of ailments of the musculoskeletal system: arthritis; arthrosis; rheumatism; osteochondrosis; other degenerative-dystrophic pathologies of the spine.

Meloxicam-based preparations are produced in tablet form, in injection ampoules (injections), ointments, gels, and also in the form of rectal suppositories.

Can Movalis be substituted?

Often, when a person gets to a pharmacy with a doctor's prescription, he is forced to refuse to buy the drug due to its high price. When a person needs to take pills, the cost of one package of them will cost him about 500 rubles, but if he is prescribed injections, then a package of ampoules will cost about 600 rubles. In such circumstances, the patient has to adjust the doctor's prescription at his own risk, for example, by reducing the course of therapy, which reduces the effectiveness of the treatment.

Unfortunately, not everyone is aware that now in pharmacies you can find more economical analogues of a drug such as Movalis. These include:

These drugs contain the same substance meloxicam, but they are much cheaper.

What is the difference between Movalis and its analogues?

Movalis is a drug in the development, testing and licensing of which huge sums have been invested. Naturally, all these costs will be included in the final cost of funds. For the production of analogue medicines, there is no need to spend such amounts, as a result of which their retail price will be lower.

If we talk about the base substance meloxicam, then it will be identical in both Movalis and its analogues. But the accompanying substances (adjuvants, other impurities) may well differ. It should also be emphasized that the side effects that may occur if you start drinking Movalis or its analogue preparations will be similar, since they will appear due to the action of the main substance, and not at all additional components.

How to save correctly?

How correct is it to replace Movalis with analog devices? Quite, however, you should know certain rules, which will help you choose a high-quality and budgetary substitute for the drug.

You should choose a trusted, reliable manufacturer.
It is necessary to inform the attending doctor that the original drug is too expensive, then the doctor himself will select a more economical remedy.
You should not make a decision to change the medicine on your own, since even a pharmacist does not have the right to correct doctor's prescriptions.

In addition, when choosing analog drugs, domestic manufacturers should be preferred. What is it connected with? The fact is that today Russian-made drugs are almost never counterfeited, because there is an active opposition to counterfeiting at the state level. In addition, do not forget that the pharmaceutical concerns of the Russian Federation have significantly increased control over efficiency and safety. But the main thing is the relatively low cost of such drugs, which makes it possible for citizens of different income levels to buy domestic medicines.

Why else do people look for analogues? There is also a list of some indicators, thanks to which the most effective drug among its group is revealed. For example, one of these points may be the bioavailability of the drug. This term refers to a specific indicator of the drug substance absorbed in the patient's body. It is worth noting that this indicator can differ significantly for medicines with the same basic substance.

Equally important is another criterion - the time during which the maximum level of a substance in the body is reached. This criterion indicates the speed of action of the drug. It is equally important to take into account the half-life, since, having these data, you can find out the time of action and the minimum period between the use of incompatible drugs. Do not forget the fact that for certain people the form of release of funds is very important. This is due to the individual preferences of the patient, with his concepts of comfort in the use and storage of the drug.

Drug analogues

Both Movalis and its analogues are produced in various forms of release: tablets, injections, suppositories. There are quite a few drugs similar in action to Movalis, but the following can be called the most popular.

Amelotex

This is an analogue drug Movalis, manufactured by Sotex PharmFirma CJSC. On sale you can find tablets, a solution with which intramuscular injections are made, rectal suppositories and a gel for external use. The price range is from 80 rubles for tablets and up to 500 rubles for an injection solution.

The drug has an almost maximum bioavailability of 99%. In addition, he has a fairly quick achievement of the maximum concentration in the blood - 2-3 hours. However, the drug remains in the body for quite a long time. As a rule, injections are used, which are incredibly effective for arthritis, Bechterew's disease and degenerative ailments of the joints.

Artrozan

Another Russian analogue of Movalis, produced by Pharmstandard-Leksredstva OJSC. The cost of tablets in pharmacies ranges from 160 to 400 rubles. This price category makes the drug affordable enough for a wide range of customers, which is important for long-term therapy with the drug. A special distinguishing feature of this remedy is the ability to take the drug for a long time (months and even years). The drug does not have a depressant effect on the liver and kidneys, and the patient also needs a small daily dose (no more than 1 tablet).

Movasin

The most budgetary medicine (from 50 to 110 rubles), produced by the Joint Stock Kurgan Society of Medical Devices "Synthesis". The drug involves a certain scheme of administration. How many days does therapy with this remedy last?

Intramuscularly, Movasin is prescribed for only 2-3 days, and further treatment is possible purely with the help of tablets. This feature of the appointment of the drug is associated with a significant inhibitory effect on the gastrointestinal tract and the human circulatory system. As a rule, such a remedy is prescribed exclusively to people who have reached the age of 18.

Matarin

The drug is a wonderful topical remedy. Although there is a tablet form of release of the drug, in most cases an ointment is preferred, which includes 30 mg of meloxicam and 100 mg of capsicum tincture. You can apply the ointment daily (several times a day), for an extended period. The presence of pepper in the composition of the ointment also has a local warming effect. The cost of the ointment is up to 200 rubles. A significant plus of this remedy is the possibility of its use in relation to children who have reached 12 years of age.

Naturally, the most popular analogue of Movalis is Meloxicam itself. Of all the options, Meloxicam-Teva, which is produced by the Israeli company Teva, is most often preferred. However, based on consumer reviews, Movalis still remains the best remedy for its action.

Please note that all information posted on the site is for reference only and

not intended for self-diagnosis and treatment of diseases!

Copying materials is allowed only with an active link to the source.

Aertal tablets, powder, ointment (cream), indications for use, analogues, prices

Latin name: Airtal

International name: Aceclofenac

Active ingredient: Aceclofenac

Producer: OJSC Gedeon Richter, Hungary;

Pharmacy dispensing condition: By prescription

"Aertal" - a medical drug with an anti-inflammatory effect. As a rule, it is used as an anesthetic for various diseases of the musculoskeletal system.

Medicinal properties

Pharmacodynamics

The active ingredient has an anti-inflammatory, antipyretic, and analgesic effect. Aceclofenac inhibits the production of prostaglandins, and thereby helps relieve pain at the site of the inflammatory process, and also prevents the development of fever. With rheumatism, aceclofenac significantly reduces the strength of pain, relieves stiffness of movements in the morning, relieves swelling of the joints, which improves the general condition of the patient.

Pharmacokinetics

The active substance is quickly absorbed when taking tablets or a suspension prepared on the basis of a powder. The maximum concentration of aceclofenac in the blood reaches after 1 hour 15 minutes. - 3 hours. Penetrating directly into the synovial fluid, its concentration is 57% of the plasma aceclofenac index, with the maximum concentration occurring approximately 2 to 4 hours later than in the plasma itself. The active substance is distributed in a volume of 25 liters.

The active ingredient binds to albumin by 99%. It enters the general circulation without any changes, the main metabolite is 4'-hydroxyaceclofenac.

The half-life is no more than 4 hours. The components of the drug Aertal are excreted by the kidneys, they are usually represented by hydroxy derivatives (2/3 of the applied dose).

Indications for use

You can take Aertal as an anesthetic and to relieve inflammation in the following diseases:

Arthritis of the rheumatoid type
Lumbago
Osteoarthritis
Periarthritis humeroscapular
Ankylosing spondylitis
Diseases that cause pathologies of the musculoskeletal system.

The localization of these types of diseases is different, some of them can be read in more detail in the article: Back pain.

You can also take Aertal as an effective pain reliever for toothache.

Tablets "Aertal"

1 tablet contains:

Price for 20 pieces from 323 rubles to 413 rubles

The main medicinal component: aceclofenac at a dosage of 100 mg;

Additional components included in the drug: glyceryl distearate, croscarmellose sodium, povidone, microcrystalline cellulose.

Each of the tablets is film-coated: round and biconvex (their diameter is approximately 8 mm). On one side of the tablet, you can see an engraved "A". Tablets are available in blisters, each containing 10 pieces. The package can contain up to 9 blisters.

Tablets are stored at t> 25 °C for 3 years from the date of production.

Dosage and administration

Aertal tablets should not be taken crushed. The average daily dose is 2 tablets, each containing 100 mg of aceclofenac. Usually, doctors prescribe taking tablets in the morning and evening (1 tablet in the morning, 1 in the evening).

Powder "Aertal"

1 sachet contains:

Average price - 350 rubles

Active ingredient: aceclofenac, dosage - 100 mg.

Auxiliary components: aspartame, hypromellose, sorbitol, colloidal silicon dioxide, sodium saccharinate, titin dioxide, as well as flavoring agents (milk, caramel and cream).

The powder is intended for the subsequent preparation of a suspension, which must be administered orally. The color of the powder is white or cream (sold in a three-layer packaging bag, a carton box contains 20 pieces).

Patients who have been diagnosed with fructose intolerance cannot take aceclofenac in the form of a suspension, since it contains sorbitol, which provokes indigestion.

The powder is stored at t > 30 °C for 4 years from the date of manufacture.

Dosage and administration

Aertal powder is used mainly once to relieve severe pain. The course of treatment involves the use of 1 sachet in the morning, as well as 1 portion of the suspension in the evening. Preparing the medicine is simple: dilute the contents of the sachet in 60 ml of liquid (water). It is recommended to use the suspension immediately after its preparation.

Ointment "Aertal"

The price of Aertal cream 1.5% 60 g is about 261 rubles

1 g of cream (ointment) contains 100% aceclofenac, which is presented in micronized form - 15 mg.

Additional components: propyl parahydroxybenzoate, emulsion wax, methyl parahydroxybenzoate, liquid paraffin, and water.

Cream (ointment) is recommended for external use. It relieves excessive swelling, inhibits the further development of erythema. Cream or ointment is a local analgesic, has an anti-inflammatory effect.

It is presented in the form of a homogeneous substance of a rich white hue. Produced in aluminum tubes, which contain 60 g of cream, 1 tube is in a cardboard box.

The cream is stored at t > 25 °C, the shelf life is no more than 2 years.

Dosage and administration

Aertal cream is used only for rubbing into the skin. Do not apply cream under bandages that are very squeezing the skin.

It is necessary to rub the cream with light movements in the place of localization of swelling or painful sensations three times during the day. Calculation of the cream required for one application: 2 g per 7 cm 2 of the surface of the skin.

During pregnancy and breastfeeding

During the first two trimesters of pregnancy, the use of Aertal is possible only in some cases when the benefit to the mother outweighs the possible risks to the fetus. Use the drug Aertal during planning or the 1st and 2nd trimesters of pregnancy with caution, the course of treatment should be minimal with a reduced dosage of the drug.

The fact of the allocation of aceclofenoc together with breast milk has not been established. In this case, the drug is prescribed under the strict supervision of a doctor. How many days it will be possible to take the drug, only the attending physician decides.

Contraindications

The description of the drug contains a number of contraindications, it is not prescribed in such cases:

Peptic ulcer, erosion, as well as bleeding localized in the digestive tract
The presence of urticaria
Rhinitis, which is caused by taking nonsteroidal drugs, as well as aspirin
Bronchospasm
Progressive renal failure
Pathologies of hematopoiesis
The period of pregnancy and lactation
Hyperkalemia
Hypersensitivity to active substances that contain the drug Aertal
Age up to 18 years.

The drug is prescribed with caution in diseases of the gastrointestinal tract, liver, kidneys, hypertension, ischemia, diabetes mellitus, peripheral arterial disease, in old age, when smoking, in case of alcohol abuse, with prolonged use of non-steroidal anti-inflammatory drugs.

Aertal cream is not prescribed in violation of the integrity of the skin in the place where the drug is supposed to be applied.

Precautionary measures

With extreme caution, it is worth using the drug for pathologies of the cardiovascular system, kidneys, and also the liver. Reception is not recommended for other diseases, which are accompanied by the occurrence of edema. The use of the drug by this category of patients is fraught with serious consequences, as a result of which renal excretion is disturbed, swelling is observed.

Patients with phenylketonuria should take into account that Aertal powder contains a small amount of phenylalanine (5.61 mg).

If, while taking aceclofenac, the patient experiences dizziness, weakness, impaired functioning of the central nervous system, then it is better to refrain from driving vehicles.

Interaction with other drugs

It should be borne in mind that using this drug reduces the effectiveness of drugs that are used to lower blood pressure, as well as diuretics. The combination of the drug with potassium-sparing diuretics is highly undesirable, as it can provoke the development of hyperglycemia or hyperkalemia.

The manufacturer warns that there is a risk of side effects when taking the drug with glucocorticosteroids or other nonsteroidal drugs. It is possible that Aertal may increase the nephrotoxicity of cyclosporine.

The drug should be taken with caution in combination with diuretics, with a high risk of hypovolemia and in elderly patients.

Side effects

Taking the drug can cause multiple side effects:

Gastrointestinal tract: disruption of the intestines with the presence of colic and flatulence, vomiting or nausea, the occurrence of peptic ulcer and erosion, hepatitis, acute pancreatitis, and stomatitis;

CNS and peripheral NS: impaired sleep quality, excessive excitability, paresthesia, depressive state, dizziness, vertigo, meningitis, impaired visual function and memory impairment, loss of orientation in space, change in sensitivity, as well as taste;

Others: allergic reactions, impaired renal function, hematuria, anemia, leukopenia, hypertension, agranulocytosis, thrombocytopenia, as well as pathologies of the cardiovascular system.

Overdose

An overdose can be detected by the following symptoms: nausea, vomiting, pain in the stomach, weakness, headaches.

As a treatment, it is worth making a gastric lavage, taking activated charcoal. If necessary, the use of antacids, as well as other drugs used in symptomatic therapy, is not excluded.

Analogues

To date, many drugs are produced that are similar in action to Aertal, but the active substance in them is different.

"Movalis"

Boehringer Ingelheim International, Germany

Movalis is produced in the form of tablets, rectal suppositories, gel, injection, powder for solution. It is recommended for the symptomatic treatment of arthritis, ankylosing spondylitis, and arthrosis. Efficacy in the treatment of inflammatory processes has been revealed. The main active ingredient in Movalis is meloxicam.

High efficiency
Ease of use
Relieves cold symptoms

The high price of Movalis
Lots of side effects.

Dr. Reddy's Laboratories Ltd., India

Nise - dosage forms: tablets, suspensions, gel. The drug is a non-steroidal drug that has an anti-inflammatory effect, therefore it is effective in many diseases of the musculoskeletal system, as well as pains of various nature.

Acceptable price
Relieves severe pain quickly
The drug is presented in several dosage forms

Doesn't work right away
Only effective for certain types of pain
There is a large list of contraindications.

"Diclofenac"

Diclofenac is presented in the following dosage forms: tablets, ointment, cream or gel, as well as suppositories. It is prescribed for various pathological processes accompanied by an inflammatory process.

Low cost
Quickly relieves inflammation and relieves pain

Violates the functions of the liver and kidneys and the digestive tract
Low bioavailability (50-60%).

Download instructions for use

Download instructions for tablets "Aertal"

Download instructions for Aertal powder

Download instructions ointment "Aertal"

Artiflex (sachet, cream) and Artiflex Chondro - instructions for use, analogues of Artiflex preparations
Artro asset in tablets, ointments and capsules: instructions for use, analogues, prices
Arava - instructions for use. Arava tablets: their analogues and prices
Brufen - instructions for use, Brufen release forms and Brufen analogues

The doctor said that Movalis must be injected with a chondroprotector, he advised Elbon. It seems like movalis relieves inflammation, but destroys the joint. And Elbona restores. So I didn’t understand - but what’s the point then in general to put movalis?

Elbon comes for a long time, if the pain is severe, Movalis is prescribed. In my opinion, everything is clear as daylight. And then this Elbon needs to be pierced regularly, at least once every six months, so that there are no exacerbations.

Movalis is a good drug, but there are many side effects. The doctor said to put elbon with him, it kind of restores the joint, and the inflammation goes away faster. As a result, I only pierced movalis with her for three days, and everything went away.

I have suffered from arthritis for a long time. already addictive to many drugs, aertal has become a real profit. She removed the exacerbation in a few days, and from other medicines she took only Elbon in injections, no mydocalms and other things that are usually prescribed. That's what fresh painkiller means.

Aina, as for me, if you inject Elbon, then no medicines are needed anymore, she relieves inflammation herself well :) I take painkillers only in cases where it starts to hurt in the interval between her courses. This usually happens after a load.

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