When joints hurt or injuries begin to bother you, your doctor may prescribe Ancoxia. This is an antirheumatic, non-steroidal anti-inflammatory drug that is used to treat patients with diseases of the musculoskeletal system accompanied by pain. Arcoxia is available in the form of tablets with dosages of the active substance etoricoxib 30 mg, 60 mg, 90 mg and 120 mg.
Arcoxia with different types of dosage
Contraindications
According to clinical studies, the following contraindications have been identified:
- tendency to gastrointestinal bleeding;
- individual intolerance to the components of the drug;
- bliposis of the nose or sinuses in the acute stage and frequent relapses;
- intolerance to NSAIDs;
- pregnancy and breastfeeding;
- children dronchial asthma;
- 16 years old;
- the period after surgery associated with coronary artery bypass grafting;
- peripheral arterial disease;
- blood pressure over 140/90 Hg;
- cerebrovascular diseases, including those accompanied by bleeding;
- lactase deficiency, malabsorption syndrome.
- ulcers, erosion and perforation of the gastrointestinal tract, intestinal inflammation;
- kidney disease in progress, chronic renal failure;
- severe liver failure;
- hyperkalemia;
- blood diseases caused by bleeding disorders (hemophilia);
- liver diseases;
Doses and method of administration of the drug Arcoxia
The dosage of Arcoxia is prescribed by the doctor himself.
Arcoxia is prescribed only by the attending physician. He can correctly calculate the dosage and risks for the patient. Take the medicine one tablet once a day, regardless of meals. The course of treatment should not exceed 8 days.
- for osteoarthritis: 1 tablet 30 or 60 mg per day, depending on the severity of symptoms;
- for rheumatoid arthritis and ankylosing spondylitis: 1 tablet 90 mg per day;
- for acute gouty arthritis: one 120 mg tablet per day. The duration of therapy is no more than 8 days;
- for acute pain (including after dental surgery): 1 tablet 90 or 120 mg, depending on the severity of the pain syndrome;
- for chronic pain: 1 tablet 60 mg.
Diaflex Rompharm capsules 50 mg, 30 pcs.
Manufacturer
K.O.Rompharm Company S.R.L., Romania
Compound
1 capsule contains diacerein 50 mg.
pharmachologic effect
Pharmgroup:
NSAIDs.
Pharmaceutical action:
Diaflex Rompharm is a drug used for inflammatory and inflammatory-dystrophic diseases of the musculoskeletal system. Diacerein is an anthraquinoline derivative, a diacetylated derivative of rhein. Metabolized to an active metabolite, rhein, it inhibits the activity of interleukin-1, which plays an important role in the development of inflammation and cartilage degradation in osteoarthritis.
Inhibits the action of other cytokines (including interleukin-6, tumor necrosis factor-alpha). The action develops after 2-4 weeks. Diacerein has analgesic and anti-inflammatory activity when taken orally.
Pharmacokinetics: Rapidly absorbed from the gastrointestinal tract, bioavailability increases by 25% when taken simultaneously with food. Time to reach Cmax - 144 minutes. With a single dose of 50 mg, Cmax is 3.15 mg/l; with repeated doses, due to the cumulation of the drug, Cmax increases. Completely deacetylated to rhein. The connection of rhein with proteins (albumin) is almost 100%. Rein penetrates the placental and blood-brain barriers.
T1/2 - 255 min. Excreted by the kidneys unchanged - 20%, in the form of glucuronide - 60%, in the form of sulfate - 20%.
Indications
Primary and secondary osteoarthritis.
Contraindications
— age up to 18 years; - lactose intolerance, lactase deficiency, glucose-galactose malabsorption; - hypersensitivity to diacerein and other components of Diaflex Rompharm (including anthraquinone laxatives). With caution: severe liver or kidney failure, intestinal obstruction, inflammatory bowel disease.
Side effects
From the digestive system: diarrhea, nausea, vomiting, abdominal pain, hepatitis.
Allergic reactions: urticaria, fever, bronchospasm, angioedema, anaphylactic shock.
Other: malaise, intense coloration of urine (depending on pH) from yellow to brown (has no clinical significance).
Interaction
Antacids reduce the absorption of the drug. When taken simultaneously with drugs that affect the intestinal microflora (including antibiotics), with substances that change the quality of intestinal contents and the rate of emptying (fiber), the frequency of side effects from the intestines increases.
Drugs containing aluminum hydroxide and/or magnesium hydroxide reduce the bioavailability of diacerein.
Concomitant use with laxatives is not recommended.
How to take, course of administration and dosage
Diaflex is taken orally, after meals, it must be swallowed whole, without chewing, with water, 50 mg 2 times a day (morning and evening).
Continuously for a long time or in courses (at least 4 months).
Diacerein may cause accelerated intestinal transit during the first 2 weeks, so it is recommended to start treatment with one capsule per day in the evening with food for 4 weeks.
Then the dose is increased to 100 mg/day.
Overdose
Symptoms: diarrhea, weakness.
Treatment: symptomatic. In case of severe diarrhea, monitoring of plasma electrolyte composition is necessary.
Special instructions
The duration of treatment can be long. Before the therapeutic effect occurs, diacerein can be taken simultaneously with analgesic drugs (including NSAIDs). Periodic monitoring of blood counts, liver function tests, and urine is necessary. If renal function deteriorates, the dose of the drug must be reduced.
In patients with chronic renal failure, with CC less than 30 ml/min, the dose of diacerein should be reduced to 50 mg/day and then titrated according to tolerability and clinical effectiveness.
Colored urine may make it difficult to interpret urine test results (such as glucose tests).
Release form
Capsules.
Storage conditions
The drug should be stored in a place protected from light, out of reach of children, at a temperature not exceeding 25°C.
Best before date
3 years
Active substance
Diacerein
Conditions for dispensing from pharmacies
On prescription
Dosage form
capsules
Purpose
For adults as prescribed by a doctor
Indications
Osteoarthritis
Barcode and weight
Barcode: 5944728001510 Weight: 0.022 kg
Side effects when taking Arcoxia
Vomiting and nausea are side effects when taking Arcoxia.
Like any drug, Arcoxia has a number of side effects when taken. :
- epigastric pain, dyspepsia (heartburn, belching, diarrhea, nausea, vomiting), flatulence, increased peristalsis, constipation, dry mucous membrane, oral cavity, gastritis, ulcer of the gastric or duodenal mucosa, irritable bowel syndrome, esophagitis, gastrointestinal ulcers (with bleeding or perforation) and the oral mucosa;
- taste disturbance, headache, dizziness, weakness, drowsiness, sleep disturbances, sensory disturbances, incl. paresthesia/hyperesthesia, anxiety, depression, hallucinations, confusion;
- blurred vision, conjunctivitis;
- noise in ears;
- renal failure (rare), reversible renal dysfunction (increased concentration of creatinine in the blood, protein in the urine), edema, fluid retention;
- anaphylactic/anaphylactoid reactions, including a marked decrease in blood pressure and shock, palpitations, increased blood pressure, hot flashes, cerebrovascular accident, atrial fibrillation, congestive heart failure, hypertensive crisis;
- cough, shortness of breath, nosebleeds, bronchospasm;
- swelling of the face, itching, rash, urticaria;
- Stevens-Johnson syndrome, Lyell's syndrome;
- infections of the upper respiratory tract, urinary tract;
- muscle cramps, arthralgia, myalgia;
- changes in appetite, weight gain;
- leukopenia, thrombocytopenia;
- flu-like syndrome, chest pain.
Diaflex 50 mg No. 30 caps.
Instructions for medical use of the drug Diaflex Trade name Diaflex International nonproprietary name Diacerein Dosage form Capsules, 50.0 mg Composition One capsule contains the active substance - diacerein 50.0 mg, excipients: magnesium stearate, lactose monohydrate, composition of the capsule shell: titanium dioxide (E 171), yellow iron oxide (E 172), gelatin. Description Hard gelatin capsules are glossy, yellow body and cap. The contents of the capsules are a homogeneous yellow powder. Pharmacotherapeutic group Other non-steroidal anti-inflammatory drugs. ATC code M01AX21 Pharmacological properties Pharmacokinetics When taken orally, diacerein undergoes complete deacetylation into its active metabolite rhein before entering the systemic circulation. The apparent bioavailability of rhein is 35-60%. A stable concentration is achieved by the third dose and the half-life averages 7-8 hours. Taking diacerein with food delays systemic absorption, but increases the amount of absorbed substance by 25%. After oral administration, the maximum concentration in blood plasma is reached after 2.2 hours and is 3.2 mg/l. The volume of distribution after oral administration of a single dose of diacerein 50 mg is 13.2 l. Rein binds well to blood plasma proteins - up to 99%. Rhine is converted in the liver to glucuronide (60%) or sulfate (20%). Up to 20% of unchanged rhein and the main part of the metabolites are excreted by the kidneys. After administration of a single dose of diacerein 50 mg, the half-life was 4.3 hours, the apparent total plasma clearance was 1.6 L/hour, and the renal clearance was 0.13 L/hour. Pharmacodynamics Diaflex activates cartilage restoration by stimulating the production of TGF-b, which activates chondrocytes and stimulates the production of type II collagen, proteoglycan and hyaluronan. Rhine, an active metabolite of diacerein, reduces the production of metalloproteinase-1, -3, -9 and -13 and has a chondroprotective effect. It has anti-inflammatory activity in models of acute inflammation. Diaflex does not inhibit prostaglandin synthesis. Diaflex restores changes in bone metabolism while maintaining bone mineral density by improving the formation/absorption balance. Indications for use: primary and secondary osteoarthritis. Method of administration and dosage Adults; orally, after meals, it is necessary to swallow whole, without chewing, with water, 1 capsule (50 mg) 2 times a day (morning and evening). Diaflex during the first 2 weeks may cause accelerated transit in the intestines, so it is recommended to start treatment with one capsule per day in the evening after meals for 4 weeks. Then the dose is increased to 100 mg/day. Elderly people, patients with impaired renal or liver function No dose adjustment is required. Patients with acute renal failure (creatinine clearance less than 30 ml/mi): The daily dose is reduced by half. The course of treatment is 6 months. Side effects Very often - diarrhea Often - soft stools, abdominal pain Rarely - itching, eczema, rash - pigmentation of the rectal mucosa - dark yellow color of urine Contraindications - hypersensitivity to diacerein, or any component of the drug - colopathy (ulcerative rectacolitis, disease Crohn's) - occlusive or subocclusive syndrome - abdominal pain syndromes of unknown etiology - severe liver dysfunction - children under 18 years of age - pregnancy and lactation. Drug interactions Special attention should be paid to the association of diacerein with certain medications taken for diseases of the gastrointestinal tract (salts, aluminum oxides and hydroxides, calcium and magnesium). Some potentiation of diuretics is possible. Special instructions Diaflex acts slowly, the analgesic effect appears after 30 - 45 days, and during this period it may be necessary to simultaneously prescribe analgesics and anti-inflammatory drugs. Patients with pre-existing enterocolitis or severe renal impairment should use this drug with extreme caution under strict medical supervision. The medicine may cause your urine to turn a deep yellow color. The drug contains lactose; patients with hereditary galactose intolerance, lactose deficiency (Lapp) or poor glucose-galactose absorption syndrome should not take this drug. Features: influence of the drug on the ability to drive vehicles and potentially dangerous mechanisms. Does not affect. Overdose Symptoms: Expect increased side effects, mainly diarrhea and its consequences. Treatment: symptomatic. A specific antidote is not known. Due to the high degree of binding to blood proteins, the effectiveness of hemodialysis should not be expected. Release form and packaging 10 capsules in blister packs made of polyvinyl chloride film and aluminum foil. 3 contour strip packs together with instructions for use in the state and Russian languages are placed in a cardboard pack. Storage conditions Store in a dry place, protected from light, at a temperature not exceeding 25° C. Keep out of the reach of children! Shelf life: 3 years Do not use after the expiration date indicated on the package. Conditions for dispensing from pharmacies By prescription Manufacturer Rompharm Company S.R.L., Romania st. Eroilor 1A, Otopeni. tel. +40 21 208 9743, +40 21 208 97 42, fax: +40 21 266 49 38 Address of the organization receiving complaints from consumers regarding product quality in the Republic of Kazakhstan Representative office of Rompharm Company in the Republic of Kazakhstan, Almaty, st. Tole bi, 305, office 19, telephone/fax 8/7272/232952,
Interaction with other drugs and alcohol
The use of Arcoxia does not replace the need to use other groups of medications, including antibiotics. But it's worth remembering the following:
- Before combining Arcoxia and other drugs, you should consult your doctor;
- Arcoxia enhances the effectiveness of anticoagulants and antiplatelet agents, lowering prothrombin time;
- reduces the effect of diuretics and antihypertensive drugs;
- if acetylsalicylic acid is used, then as a prevention of cardiovascular complications. But you should not get carried away, as gastric bleeding may be provoked;
- the compatibility of cyclosporines with Arcoxia enhances its nephrotoxic effect.
Analogs
Analogues of the drug Arcoxia
Arcoxia has structural and non-structural analogues. Structural substitutes have the same active ingredient. Such drugs include:
- Etoricoxib (30, 60, 90, 120 mg);
- Costarox (30, 60, 90, 1240 mg);
- Bixitor (60, 90, 120 mg);
- Etorium (60, 90, 120 mg).
Arcoxia or Movalis
Movalis is a drug whose active ingredient is meloxicam. Arcoxia and Movalis have similar indications, but the release forms are different. Arcoxia is available in the form of tablets, and Movalis in the form of tablets, injection solution, suspension, and rectal suppositories. Movalis is less dangerous for patients with pathologies of the digestive tract and cardiovascular system.
Arcoxia or Nimesil
The active substance Nimesil is nimesulide. It, like Arcoxia, blocks the activity of COX 2, which makes it possible to achieve an analgesic effect and be used for the treatment of inflammatory and degenerative diseases of the musculoskeletal system. But Nimesil has an additional area of application: it is prescribed for the treatment of infectious and inflammatory processes of the respiratory system. Reduces temperature, relieves pain and inflammation.
Release form Nimesil - effervescent tablets (100 mg), medicinal granules (100 mg per packet), which are diluted in a glass of warm water.
Arcoxia or Aertal
The active ingredient in Aertal is aceclofenac. Release form: tablets, cream for external use and powder, from which a suspension is first prepared before use. Airtal has high bioavailability. Unlike Arcoxia, it is less irritating to the mucous membrane of the digestive tract, which makes it possible to use it in patients with concomitant diseases of the stomach and intestines. Airtal is also more often used in patients with cardiovascular pathologies, especially in old age.
Arcoxia or Dexalgin
The active substance in Dexalgin is dexketoprofen. It is sold in tablets, ampoules (the solution is administered intramuscularly), and granules (preparing a suspension for oral administration). Otherwise, this is a NSAID with similar indications, action and contraindications.
Arcoxia or Diclofenac
Diclofenac is an NSAID that is the drug of choice in the treatment of pathologies of the musculoskeletal system. The frequent use of the drug is explained by its low cost and at the same time good analgesic effect. But long-term use of the drug has a negative effect on the gastric mucosa. Arcoxia, compared to Diclofenac, is a more effective and safe medicine.
Arcoxia or Costarox
Kostarox is a medicine with the same active ingredient. Kostarox, unlike Arcoxia, is available in dosages of 60, 90, 120 mg.
Non-structural analogues mean drugs that contain a different active substance, but have a similar therapeutic effect. Non-structural substitutes are considered:
- Movalis;
- Nimesil;
- Aertal;
- Dexalgin;
- Diclofenac;
- Celebrex.
Arcoxia or Celebrex
Celebrex also belongs to the group of NSAIDs. The medicine contains celecoxib. Sold on the market in the form of capsules (100, 200 mg, as well as a set of capsules 200 mg and 400 mg) Celebrex is indicated for the following diseases:
- osteoarthritis;
- rheumatoid arthritis;
- primary dysmenorrhea;
- ankylosing spondylitis;
- pathologies of bone and muscle structures, accompanied by pain.
Celebrex is less likely to cause ulcers and bleeding in the digestive tract than Arcoxia. But both drugs are more likely to provoke high blood pressure and other cardiovascular complications than Meloxicam.
Arcoxia is a relatively new non-steroidal anti-inflammatory drug. It was developed to reduce gastrointestinal complications. Its effectiveness is slightly lower than that of Movalis and Airtal, which have high bioavailability and minimal side effects on the vascular and digestive systems. But Arcoxia also deserves attention, since it is practically no inferior in safety for patients with concomitant pathology of the stomach.
Instructions for use DIAFLEX
If concomitant use of antibiotics is necessary, which may disrupt the intestinal microflora, temporary cessation of therapy should be considered.
The risk/benefit ratio of treatment should be assessed in patients with a history of enterocolitis (especially in patients with irritable bowel syndrome).
Concomitant dietary intake increases the bioavailability of diacerein (about 24%), while significant dietary deficiency reduces bioavailability.
Taking diacerein often results in diarrhea, which can cause dehydration and hypokalemia. If diarrhea develops, the patient should stop taking the drug and contact their doctor immediately to discuss alternative treatment. Caution should be exercised if the patient is concomitantly receiving diuretics as Dehydration and hypokalemia may develop. Particular caution should be observed in case of hypokalemia in patients receiving cardiac glycosides (digitoxin, digoxin).
The simultaneous use of laxative drugs should be avoided.
Caution should be given to patients with renal impairment.
The drug contains lactose, so patients with rare hereditary diseases such as galactose intolerance, lapp lactase deficiency or glucose-galactose malabsorption syndrome should not take Diaflex.
During post-registration monitoring, cases of increased activity of liver enzymes in the blood serum and symptomatic acute liver damage were identified. Before starting treatment, the patient should be asked about concomitant, current and history of liver diseases, and an examination should be carried out to identify violations of the functional state of the liver. Liver diseases are a contraindication to the use of diacerein. It is necessary to monitor laboratory and clinical manifestations of liver damage, and observe precautions when used simultaneously with other drugs with the risk of developing hepatotoxic reactions. Treatment with diacerein should be discontinued if an increase in liver enzyme activity is detected or the development of symptoms of liver damage is suspected. The patient should be informed of the signs and symptoms of hepatotoxicity and advised to consult a physician immediately if symptoms of liver damage are suspected.
Patients should be advised to limit alcohol consumption while using diacerein.
Use in pediatrics
The safety and effectiveness of the drug in pediatric practice have not been established. The use of the drug in children and adolescents is not recommended due to lack of data.
Impact on the ability to drive vehicles and operate machinery
Data on the effect of the drug on the ability to drive vehicles and operate machinery are not provided.
