April 5, 2020
When considering what ointments are used for dermatitis, it is worth saying right away that they are divided into two large groups: hormonal and non-hormonal. They differ not only in composition, but also in the degree of effectiveness and safety.
An ointment is considered the best for dermatitis on the skin of a particular patient if it meets a number of requirements:
- effectively relieves burning and itching;
- relieves acute and chronic inflammatory processes;
- moisturizes the skin;
- reduces the severity of pain;
- prevents the penetration of viruses, fungi and bacteria into the foci of inflammation (this is evidenced by the absence of secondary attached infections).
Pharmacodynamics and pharmacokinetics
The active substance is diclofenac . The drug has antipyretic, analgesic and anti-inflammatory effects. The main component of the drug is a derivative of phenylacetic acid. The main mechanism of action is aimed at non-selective inhibition of cyclooxygenases-1,2, a decrease in the concentration of prostaglandins in the inflammatory focus, and disruption of the metabolic process of arachidonic acid . The drug has additional antiplatelet activity.
Composition and dosage forms
Ortofen contains one active substance - diclofenac, which has a pronounced analgesic, anti-inflammatory and moderate antipyretic effect. The drug has several forms of release for systemic and local use:
- tablets: white, flat-cylindrical, with a dosage of 25 mg, auxiliary components: povidone, starch, magnesium stearate and others;
- gel: a clear, slightly viscous liquid containing 5% diclofenac, packaged in 100 ml bottles, containing water, ethyl alcohol, propylene glycol and other binders;
- Ortofen ointment: 20% preparation in the form of a homogeneous viscous mass, available in tubes of 30 and 50 ml;
- water-based injection solution: liquid in 3 ml ampoules containing 25 mg. diclofenac in 1 ml.
Indications for use of Ortofen
What do tablets and ointment help with? Let's consider the indications for the use of this medication.
The drug is prescribed for the treatment of diseases of the musculoskeletal system of degenerative and inflammatory origin: Personage-Turner disease amyotrophy ), ankylosing spondylitis (ankylosing spondylitis), chronic juvenile arthritis, rheumatism, arthritis in Reiter's disease , psoriatic arthritis, rheumatoid arthritis, osteoarthritis.
The drug is effective for relieving pain after surgery, trauma, cancer, neuralgia, sciatica , bursitis, myalgia, radiculitis, arthralgia, toothache, migraine, headache, tendinitis , ossalgia, lumbago.
The medication is used for adnexitis, inflammatory diseases of the pelvic organs, algodismenorrhea , otitis, pharyngitis, tonsillitis and other diseases of the ENT organs.
The drug is prescribed for the relief of febrile syndrome, which accompanies the course of many infectious and “cold” diseases.
pharmachologic effect
The active ingredient of Ortofen ointment is diclofenac sodium , a derivative of phenylacetic acid. Its use in the treatment of pathologies of the musculoskeletal system allows for constant monitoring of various pathogenetic mechanisms. The combination of anti-inflammatory and analgesic effects determines the high therapeutic effectiveness of the external agent. The results of numerous experiments have revealed the undoubted superiority of diclofenac in relieving inflammation compared to Indomethacin, Naproxen, Phenylbutazone, due to its complex effect. During treatment, the synthesis of bioactive compounds decreases or completely stops. These include:
- thromboxane A2;
- leukotrienes;
- prostaglandins PGE2, PGF2b;
- prostacyclins.
The mechanism of action of NSAIDs is to suppress the activity of cyclooxygenase and reduce the production of prostaglandins, which mediate the development of inflammation.
Contraindications
Ortofen is not used for “aspirin” asthma , with intolerance to diclofenac, with various disorders of the blood coagulation system, with hematopoiesis disorders, with the “aspirin” triad (recurrent polyposis of the nose, paranasal sinuses combined with bronchial asthma and intolerance to acetylsalicylic acid , pyrazolone-type medications), during pregnancy, erosive and ulcerative lesions in the digestive tract, hemophilia , breastfeeding, anemia, leukopenia, tendency to bleeding, prolongation of the bleeding period, children under 6 years of age.
For swelling, alcoholism, renal and liver failure, arterial hypertension, erosive and ulcerative lesions of the digestive system, for decompensated forms of chronic heart failure, for anemia, bronchial asthma, diabetes mellitus , in the postoperative period, for acute inducible hepatic porphyrias and elderly patients Ortofen prescribed with caution.
Side effects
Gastrointestinal tract: peptic ulcers, flatulence, constipation, dyspeptic disorders, diarrhea syndrome, cramps, abdominal pain, increased liver enzymes, gastrointestinal bleeding, perforation , dry mouth, aphthous stomatitis , esophageal damage, blood in the stool, melena , jaundice, hepatorenal syndrome , hepatitis, liver cirrhosis, hepatonecrosis, colitis, pancreatitis, perversion of taste perception.
Nervous system: anxiety, headache, weakness throughout the body, diplopia, depression, drowsiness, sleep disturbances, convulsions, aseptic meningitis .
Sense organs: scotoma , possible irreversible decrease in auditory perception, blurred visual perception, taste disturbances.
Skin: itching, rash, eczema , urticaria , alopecia, Lyell's syndrome, Stevens-Johnson syndrome , toxic dermatitis, photosensitivity.
Genitourinary system: proteinuria , nephrotic syndrome , fluid retention in the body, azotemia, papillary necrosis, acute renal failure, interstitial nephritis , oliguria. Hematopoietic organs: the development of anemia, eosinophilia, leukopenia, thrombocytopenic purpura, and agranulocytosis is rarely observed.
Respiratory system: laryngeal edema, cough, development of bronchospasm. Cardiovascular system: congestive heart failure, increased blood pressure.
Allergic responses: swelling of the tongue and lips, anaphylactic shock, anaphylactoid reactions.
Instructions for use of Ortofen (Method and dosage)
Ortofen tablets, instructions for use
The tablets are not chewed, taken orally after meals.
The dosage for adults is 25-50 mg 2-3 times a day. The amount of the drug is gradually reduced when the required therapeutic result is achieved, after which they switch to a maintenance dose of 50 mg/day.
When treating rheumatoid juvenile arthritis, the daily amount of the drug can be increased to 3 mg/kg.
Ortofen injections, instructions for use
A single intramuscular injection of the drug is acceptable to relieve exacerbations of chronic diseases, and subsequently switch to taking oral forms. The medicine is injected intramuscularly at a dose of 75 mg.
Ortofen ointment, instructions for use
Apply about 3 g of ointment to the sore spot in a thin layer. A maximum of 8 g of the product should be applied externally per day.
Pharmacokinetics
Local application ensures partial gradual absorption of the active substance, amounting to about 6%. The advantages of the drug include the creation of a higher concentration of diclofenac sodium in the synovial fluid than in the systemic circulation. 99% of the active ingredient binds to serum proteins albumin. The half-life is 3-6 hours . The maximum therapeutic concentration is detected in the inflammatory focus after approximately 2-3 hours.
Diclofenac is metabolized by hepatocytes by glucuronidation of unchanged molecules or by single or multiple hydroxylation and methoxylation. As a result of biochemical reactions, phenolic metabolites are formed, most of which are transformed into glucuronide conjugates. Two of them are characterized by biological activity similar to non-transformed diclofenac. Studies have revealed that active metabolites remain in the human body longer.
More than 60% of the active ingredient of Ortofen ointment is evacuated by the urinary system in the form of glucoronic conjugates of metabolites or unchanged NSAIDs. 40% of the active ingredient is excreted along with bile acids during bowel movements.
Overdose
Manifested by myoclonic convulsions , epigastric pain, disturbances in the liver and kidneys, bleeding, clouding of consciousness, hyperventilation of the pulmonary system, headaches and dizziness.
Gastric lavage, emergency administration of enterosorbents , and syndromic therapy are required. Forced diuresis and hemodialysis have not proven their effectiveness and are not used.
How does Ortofen work?
The mechanism of action of all forms of the drug is determined by the non-steroidal anti-inflammatory active component they contain. The injection solution and tablets have a systemic effect, relieve symptoms of fever and acute pain. Diclofenac indiscriminately inhibits the activity of pain and inflammatory prostaglandins, has an antiplatelet property - it increases blood flow. After administration intramuscularly or orally, the medicine is distributed in all fluids and tissues of the body. The liver and kidneys take part in the transformation and filtration of drug metabolites.
Topical preparations: Ortofen ointment and gel have moderate analgesic properties and are used to reduce pain in muscles and joints. Part of the drug is absorbed orally through the skin. With prolonged use, the active substance may accumulate in the blood and affect the tissues of internal organs.
Interaction
Ortofen is able to increase the level of cyclosporine , digoxin, lithium preparations, methotrexate in the blood. The drug reduces the severity of the effect of diuretics, increases the likelihood of bleeding when taking alteplase, urokinase, streptokinase, antiplatelet and anticoagulant drugs. There is a decrease in the effectiveness of sleeping pills and antihypertensive drugs.
The medication increases the nephrotoxicity of cyclosporine, enhances the toxic effect of methotrexate, and increases the severity of side effects of glucocorticosteroids and other NSAID medications. It is not recommended to prescribe simultaneously with paracetamol.
The drug reduces the effectiveness of hypoglycemic agents . Valproic acid , cefotetan, cefamandole, plicamycin, cefoperazone increase the likelihood of developing hypoprothrombinemia .
St. John's wort, corticotropin, ethanol and colchicine significantly increase the risk of gastrointestinal bleeding .
Medicines that, by their mechanism of action, cause blocking of tubular secretion, can increase the level of the main substance in the blood, which increases the toxicity and effectiveness of the drug Ortofen.
Hormonal ointments
When there is no positive dynamics from the use of non-hormonal ointments, specialists resort to hormonal drugs. Their main components are glucocorticosteroids - hormones that are produced by the adrenal glands in the human body. The mechanism of action of such drugs is based on the effect on the metabolism of proteins and carbohydrates. Hormonal ointments restore the level of cortisone, with a deficiency of which the body becomes unable to cope with inflammatory processes.
Depending on the degree of impact on the skin, hormonal ointments are divided into several categories:
- weak,
- average,
- strong,
- very strong.
The latter are used only for the most severe forms of dermatitis, so they are never prescribed first. Examples of hormonal ointments:
- Hydrocortisone,
- Celestoderm,
- Akriderm,
- Advantan,
- Elokom,
- Dermovate,
- Fucicort.
The main disadvantages of hormonal ointments in the treatment of dermatitis:
- Addiction. The main disadvantage is that over time the ointment ceases to be effective for treating a particular patient. The same active components of hormonal ointments are addictive.
- Side effects. Due to their hormonal nature, such ointments have many unpleasant side effects. They appear when used incorrectly or for too long. In severe cases, skin atrophy and even adrenal insufficiency may develop.
- Presence of withdrawal syndrome. As in the case of non-hormonal ointments, when using hormonal ointments, you cannot interrupt the course and skip application. The withdrawal syndrome manifests itself especially strongly when abruptly stopping a hormonal drug. This means that symptoms of dermatitis may suddenly return. For this reason, hormonal drugs are discontinued gradually, reducing the dose and number of applications.
Hormonal products can claim to be the best ointments for dermatitis, but only in terms of effectiveness. Yes, they help cope with the symptoms of the disease faster than non-hormonal ones. But at the same time, they can have a short-term effect, require very strict adherence to the treatment regimen, have side effects and a large list of contraindications, which includes:
- venereal diseases;
- tuberculosis;
- pregnancy and lactation;
- herpes;
- bacterial or fungal skin lesions.
special instructions
Ortofen can be taken half an hour before meals to achieve a faster therapeutic effect. In other cases, the drug is recommended to be taken before, during, or after meals. Tablet dosage forms are not chewed and washed down with the required amount of liquid.
an important role in maintaining renal blood flow , which requires the doctor to have a special attitude towards patients with pathologies of the renal and cardiac systems, as well as persons taking diuretics with a reduced volume of circulating blood. Long-term therapy requires periodic monitoring of liver function and the state of peripheral blood ; it is recommended to conduct regular stool tests for occult blood.
Ortofen affects the course of certain motor and mental reactions, therefore it is recommended to refrain from driving vehicles and performing complex work during the period of treatment with diclofenac.
Analogs
In medical practice, structural analogues of Ortofen ointment are used, that is, those that contain an identical active ingredient - the sodium salt of diclofenac. In the treatment of pathologies of the musculoskeletal system, regular application of the following drugs to the area of inflammation has proven successful:
- Voltarena;
- Dolobene;
- Diklaka;
- Diklovita;
- Diclofenac in the form of a gel or ointment.
Structural analogues are characterized by the same indications and contraindications as Ortofen ointment. The doctor may prescribe external preparations that have a similar therapeutic effect, but contain another non-steroidal drug - Ketoprofen, Nimesulide, Piroxicam, Meloxicam, Ibuprofen.
It is strictly forbidden to independently replace Ortofen ointment without prior consultation with a neurologist or rheumatologist. Anesthetic ointments vary significantly in doses and duration of the therapeutic course.
Ortofen's analogs
Level 4 ATC code matches:
Voltaren
Rapten
Zerodol
Dickloberl Retard
Dikloberl N 75
Dicloberl
Ketanov
Dolak
Panoxen
Ketorolac
Naklofen Duo
Naklofen
Olfen-100
Olfen-75
Neurodiclovit
Nizilat
Fanigan
Aertal
Methindol retard
Analogs are the following drugs: Almiral , Argett , Bioran , Voltaren , Diklak , Dicloberl , Diclovit , Dicloran , Diclorapid , Dicloreum , Diclofenac , Diclofenac Sodium , Naklofen , Nergez , Olfen , Feloran , Evinopon .
Reviews about Ortofen
The tablets quickly and effectively help relieve pain and inflammation and reduce fever. The drug is effective for otitis, bursitis, inflammation of the joints, and is a good pain reliever for arthritis.
The downside is that it has a bad effect on the stomach, which can lead to ulcers. The medicine also has a large number of contraindications.
Reviews of Ortofen ointment also testify in favor of this remedy. The medicine instantly relieves pain and relieves inflammation in problem areas.
Ortofen price, where to buy
The price of Ortofen in tablets is approximately 40 rubles.
The price of Ortofen injections starts from 40 rubles per pack of 10 ampoules of 3 ml.
The price of Ortofen ointment is 30-60 rubles per 30 g.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Ortofen gel for external use.
approx. 5% 50g Vertex AO RUB 224 order - Ortofen ointment 2% 50gVertex AO
129 RUR order
- Ortofen ointment 2% 30gVertex AO
108 RUR order
- Ortofen gel for external use. approx. 5% 30gVertex JSC
RUB 141 order
- Ortofen gel d/nar. approx. 5% 100g Vertex JSC
RUB 286 order
Pharmacy Dialogue
- Ortofen ointment (tube 2% 30g)Vertex
85 rub. order
- Ortofen ointment (tube 2% 50g)Vertex
115 rub. order
- Ortofen gel (tube 5% 30g)Vertex
126 rub. order
- Ortofen (table enteric dissolved.p.pl.vol. 25 mg No. 20) TCPP JSC
26 RUR order
- Ortofen (tablet p/o 25 mg No. 20) TCPP
30 rub. order
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Pharmacy24
- Ortofen 0.025 g No. 30 tablets PAT "Vitamin" Ukraine
8 UAH order
PaniPharmacy
- Ortofen forte tablets Ortofen forte tablets. 50mg No. 30 Ukraine, Health LLC
12 UAH order
- Ortofen tablets Ortofen tablets. p/o 0.025g No. 30 Ukraine, Vitamins PJSC
11 UAH order
- Ortofen tablets Ortofen tablets. p/o 0.025g No. 30 Ukraine, Tekhnolog ChAO
9 UAH order
- Ortofen forte tablets Ortofen forte tablets. 50 mg No. 10 Ukraine, Health LLC
4 UAH order
- Ortofen tablets Ortofen tablets. p/o 0.025g No. 30 Ukraine, Health LLC
11 UAH order
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