Description overdue on 18/09/2014
- Latin name: Neurodiclovit
- ATC code: M01AB55
- Active substance: Pyridoxine hydrochloride (Pyridoxini hydrochloridum), diclofenac sodium (Diclofenac sodium), Thiamine Hydrochloride (Thiamin hydrochloride), cyanocobalamin (Cyanocobalaminum)
- Manufacturer: G.L. Pharma (Austria)
- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Instructions for use Neyrodiklovita (method and dosage)
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Analogs
- Reviews
- Price, where to buy
Composition
As the medicine contains active substances pyridoxine hydrochloride . diclofenac sodium . thiamine hydrochloride . cyanocobalamin .
In addition, it contains the following additional components: Silicone anti-foaming agent SE2 MC . povidone . Titanium dioxide . trietilatsetat . yellow iron oxide . iron oxide red . methacrylic acid and ethyl acrylate . talc . gelatin .
Product form
The drug is available in capsule form.
Pharmacological action
The drug has anti-inflammatory . pyretic and analgesic action.
Pharmacodynamics and pharmacokinetics
Diclofenac sodium is characterized as anti-inflammatory . antiplatelet . analgesic and pyretic means. It has a dampening effect on the indiscriminate COX-1 and COX-2 It reduces content prostaglandins at the site of inflammation, as well as prevents the metabolism arachidonic acid . At rheumatic diseases of the substance helps to reduce joint swelling, pain, morning stiffness severity. This greatly improves the functional state of the joints.
Pyridoxine hydrochloride normalizes the nervous system. It serves as a coenzyme essential enzymes that are found in neural tissues. In addition, it participates in the biosynthesis of many neurotransmitters .
Thiamine hydrochloride, entering the human body is converted into kokarboksilazu . It coenzyme for many enzymes. It is an important component of metabolic processes in the body. Actively involved in the processes of neural excitation in synapses .
Cyanocobalamin - a means to stabilize the blood formation and maturation of red blood cells, which is involved in many biochemical reactions necessary for normal functioning of the body. It also has beneficial effects on the processes taking place in the nervous system. Coenzyme forms of the substances are necessary for updating and cell growth.
The combination of B vitamins, which is in Neurodiclovit (pyridoxine, thiamine, cyanocobalamin), potentiates analgesic diclofenac properties.
Diclofenac is characterized by rapid and complete absorption when the body. However, this slows down the eating process for 1-4 hours, and reduces the maximum active ingredient concentration of 40%. After application of the capsules inside the maximum concentration of the substance in the body is achieved after 2-3 hours. It is linearly dependent on the magnitude of the dose administered.
The extent of bioavailability - 50%. Strong bond to plasma proteins. Half-life synovial fluid - About 4-5 hours. Maximum concentration synovial fluid is achieved approximately 3 hours later than in plasma.
50% of the active ingredient is cleaved in the liver. Metabolic processes are carried out after hydroxylation and conjugation from glucuronic acid . The splitting Neyrodiklovita involved CYP2C9 P450 enzyme system . 65% of the drug eliminated via the kidneys in the form of metabolites Less than 1% - unchanged. The remainder of the output via the bile, too, in the form metabolites .
Systemic clearance - 350 ml / min. Plasma half-life is 2 hours. Diclofenac can pass into breast milk.
B vitamins that are part of the drug, are water-soluble. Pyridoxine and thiamine absorption occurs in the upper small intestine. This process depends on the dosage. In the body, they are broken down by the liver and excreted mainly via the kidneys. Only about 9% is excreted unchanged. At high doses excretion of pyridoxine and thiamine through the intestines increases.
Cyanocobalamin absorption depends on the presence in the stomach and upper intestinal intrinsic factor. Transportation of the substance is determined Transcobalamin . After the splitting of the liver is excreted mainly in the bile. Through the liver displayed only about 6-30% of cyanocobalamin.
Indications
Neurodiclovit used in the following forms of rheumatic diseases:
- acute gouty arthritis ;
- arthrosis ;
- chronic polyarthritis ;
- neuritis ;
- neuralgia ;
- ankylosing spondylitis ;
- spondylitis ;
- extra-articular rheumatism soft tissue.
Contraindications
The medicine should not be taken in case of hypersensitivity to its components, bleeding from the gastrointestinal tract, asthma from polyposis nasal mucosa, violations hemostasis . pregnancy . breast-feeding , Violations of blood, intracranial bleeding, erosive and ulcerative lesions of the gastrointestinal tract (especially during exacerbations). In addition, it is not recommended to give this to the patient in childhood.
Precautions Neurodiclovit indicated for congestive heart failure, anemia . coronary heart disease, asthma . hepatic or renal failure . diabetes , Inflammatory bowel diseases, induced porphyria , Alcoholism, diverticulitis . hypertension , Systemic connective tissue diseases, Edema syndrome , Old age. You also need to carefully monitor the patient, if the drug is administered after major surgery.
Side effects
The use of capsules may be accompanied by the following side effects:
- gastrointestinal tract and liver : Increase of liver enzymes, abdominal pain . diarrhea . constipation , Bleeding in the stomach, bloated feeling, nausea, flatulence . peptic ulcer (possible complications);
- senses : noise in ears;
- urogenital system : oliguria , Fluid retention, interstitial nephritis . nephrotic syndrome . acute renal failure . proteinuria . papillary necrosis . hematuria . azotemia ;
- nervous system : Appearance dizziness . headache ;
- skin : Rash, itch ;
- the immune system and Forming Organs : agranulocytosis , Aggravation of infectious processes, leukopenia . anemia . eosinophilia . thrombocytopenia . thrombocytopenic purpura .
In addition, rare cases of the gastrointestinal tract and liver disorders appear such as vomiting, melena , The defeat of the esophagus, hepatic necrosis , Dry mucous membranes, hepatorenal syndrome . pancreatitis . colitis . jaundice . thrush . hepatitis . cirrhosis , Change in appetite, holetsistopankreatit .
Rarely the central nervous system are also likely sleep disturbance . depression . aseptic meningitis , Fatigue, nightmares, drowsiness , Irritability, convulsions, disorientation, increased anxiety. And from the skin - alopecia , Increased photosensitivity, eczema . toxic dermatitis . erythema multiforme exudative . hives . Lyell's syndrome , Melkotochechnye hemorrhage.
Very rarely say such adverse reactions as increased blood pressure, blurred vision, taste disturbance, scotoma . diplopia , Hearing loss, swelling of the throat, cough, bronchospasm . pneumonitis . arrythmia . myocardial infarction , Congestive heart failure , Pain in the chest, anaphylactoid reactions . edema lips and tongue, anaphylactic shock . allergic vasculitis .
Instructions for use Neyrodiklovita (method and dosage)
For those who are appointed Neurodiclovit, instructions for use recommends swallow capsules whole during meals, while drinking the liquid in sufficient quantity. Dosages may vary depending on the severity of disease. The average dose is designed to accommodate 1-3 capsules a day, or about 100 mg of diclofenac.
Instructions for use Neyrodiklovita says that adult patients are usually prescribed for the start of the course receive 2-3 capsules per day. However, the maximum dosage should not exceed three capsules. Maintenance dose - 1 capsule 1-2 times a day.
Patients in the elderly, the tool should be used with caution.
Children under the age of 14 years may appoint Neurodiclovit, but its maximum dosage should not exceed 1 capsule 2 times a day.
Duration of the course is determined by a specialist.
Overdose
Before the drug in high doses may experience the following symptoms: vomiting, headache , Dizziness, dizziness . breathlessness . Patients in children may occur myoclonic seizures . abdominal pain , Disorders of the liver and kidney, nausea, bleeding.
As the treatment prescribed gastric lavage, forced diuresis Reception activated carbon. Symptomatic therapy. Hemodialysis little effective.
Cooperation
The purpose of this medication may cause increased:
- the level of lithium in combination with lithium;
- severity of adverse reactions with the use of other NSAIDs;
- likelihood of bleeding in the gastrointestinal tract in combination with glucocorticoids ;
- the effectiveness of potassium-sparing diuretics and drugs that inhibit platelet aggregation ;
- concentration and toxicity Methotrexate .
Moreover, the efficiency decreases Neyrodiklovita interacting with loop diuretics and antihypertensive agents . The concentration of its active ingredient (diclofenac) is also reduced when combined with acetylsalicylic acid . Suction cyanocobalamin decreased when taken with Colchicine . Neomycin . PAS and antidiabetic type drugs Biguanidine .
Do not combine with Neurodiclovit Levodopa As it may blunt the severity of it protivoparkinsonicheskogo action. In addition, it may reduce the the antihypertensive effect of diuretics or antihypertensive drugs . So the combination used with caution. This definitely needs to be controlled arterial pressure . You also need to eat plenty of fluids, and at the beginning and after the completion of necessary control of the kidneys as may occur nephrotoxicity .
In combination with reuptake inhibitors Serotonin It increases the risk of bleeding from the gastrointestinal tract.
Dosages of antidiabetic drugs, while the use Neyrodiklovita should be carefully monitored.
Combination with Colestipol or Kolestiramin reduces the Absorption diclofenac approximately 30-60%. So that reception of data between the means necessary to make an interval of several hours. In addition, diclofenac concentrations could reduce some drugs stimulating enzymes ( Rifampicin . Phenytoin . Carbamazepine . St. John's Wort ).
It should also be borne in mind that thiamine inactivated 5-fluorouracil , a antacids In turn, reduces its Absorption . Loop diuretics can inhibit tubular reabsorption thiamine, and prolonged course of treatment to reduce its concentration.
Terms of sale
Neurodiclovit sold in pharmacies by prescription only.
Storage conditions
Keep the medication you need in a dry place inaccessible to small children and reliably protected against the penetration of sunlight. Optimum temperature - not more than 25 ° C.
Shelf life
Keep the drug should be no longer than 3 years.
Analogs Neyrodiklovita
Naklofen Duo
Olfen 100
Olfen-75
Nayzilat
Fanigan
Aertal
Indomethacin
Ortofen
Voltaren
Dikloberl
Ketanov
Pharmacies can be found the following analogues Neyrodiklovita:
- Blokium B12;
- Bol-Ran;
- Diklokain;
- Diclofenac;
- Diclofenac with Paracetamol;
- Doleks;
- Maksigezik;
- Olfen-75;
- Fanigan;
- Flamidez;
- Tsinepar.
What does the pill offered as analogues of the funds to help in every case, it is better to refine your doctor.
Reviews Neurodiclovit
Neurodiclovit reviews of doctors received mostly positive. The main thing is to make this tool strictly in accordance with the appointment of a specialist. Efficacy noticeable at the beginning of the course. Reviews Neurodiclovit say that his action becomes obvious from the first days of use, and the adverse reactions reported infrequently.
Price Neyrodiklovita where to buy
Price Neyrodiklovita, on average, is about 220 rubles for packaging, containing 30 capsules. In Ukraine, the cost of funds - about 70 hryvnia. It is worth noting that the price Neyrodiklovita lower than many of its peers.
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