Ortophen
Ortophen (Ortophenum, Diclofenac, Voltaren).
It exerts anti-inflammatory, analgesic and antipyrietic effects. By the potency of anti-inflammatory and analgesic effects it overtops acetylsalicylic acid, Butadion and Ibuprofen.
Pharmacokinetics. Taken orally, it gets absorbed quickly and completely. Bioavailability – 50%. It easily penetrates into tissues and synovial fluid, t1|2 - 2 hours in plasma and 3-6 h. in synovial fluid. It undergoes biotransformation mainly in liver, excretion by kidneys.
Indications: rheumatoid arthritis, acute rheumatism, ankylosing spondylitis (Bechterew's disease), arthrosis, spondylarthrosis. By its potency in case of rheumatism and Bechterew’s disease it is as effective as Prednisolone and Indometacin.
It is also used for neuralgia, myalgia, diseases of extra-articular tissues (tendovaginitis, bursitis), for traumatic and postoperative pains accompanied by inflammation, gout.
It is applied topically when there’s a trauma of tendons, ligaments, muscles and joints; in case of localized forms of rheumatism of soft tissues.
Contraindications: gastric and duodenal ulcers, inflammatory diseases of intestine in the acute phase, BA, pregnancy.
With caution: for the patients suffering from other GI diseases, involvements of liver and kidneys.
If the drug is taken for a long period of time, the blood picture and hepatic functions should be monitored with the help of occult blood feces analysis.
Prescription: parenterally (i/m, i/v), rectally and topically.
Orally it is prescribed in the form of tablets – 0,025-0,05 g (25-50 mg) 2-3 times a day (sometimes up to 4-6 times a day). When the therapeutic effect is achieved, one gives 0,025 g (25 mg) 3 times a day. The course of treatment usually takes about 5-6 weeks. Tablets should be swallowed without chewing, during or before meal.
I/m or i/v - 0,075 g (1 ampoule) 1-2 times a day. The effect is obtained faster and more expressed. I’m injections are usually performed during 2-5 days (up to 2 weeks) and then one substitutes them with tablets.
Rectal suppositories (0,05-0,1 g)are prescribed for adults before sleep.
Ointment is carefully rubbed into the stkin – 2-4 g 2-4 times a day.
The drug is usually well-tolerated and rarely causes any side effects. Although, sometimes it might cause (especially at the beginning of the treatment) pains in epigastric region, belching, vomiting, diarrhea as well as headaches and slightly dizziness. These effects are usually gone on their own.
In special cases skin allergic reactions are possible as well as hepatitis, interstitial nephritis, edema, bronchospasmodic reactions, disturbances of blood formation, AP rise.
Injected i/m, one sometimes observes the formation of infiltrates, abscess.
Used for a long period of time, it may cause an ulcerogenic action.
Interaction. It shouldn’t be prescribed together with acetylsalicylic acid because its concentration in blood gets lower. Ortophen increases the concentration of lithium, digoxin, indirect anticoagulants, peroral hypoglycemic drugs, antibacterial drugs of quinolones group in blood. It also increases the toxicity of glucocorticosteroids (GI hemorrhages), weaken the effect of diuretics.
Dosage forms: 0,025g tablets dissolved in intestines; rectal suppositories - 0,05 g; 2,5% solution in 3ml (75mg) ampoules; 2% ointment in 30 g tubes.
