When choosing anti-inflammatory drugs for therapy for various pathologies of the musculoskeletal system, the question may arise of choosing between the drugs Movalis or Diclofenac: which helps better and is preferable to use. To find out the answers to these questions, it is necessary to study the pharmacological characteristics of medications and review the results of clinical studies to compare these medications.
Treatment of pathologies of the musculoskeletal system
Anti-inflammatory drugs are basic in the treatment of a large number of diseases of the musculoskeletal system, including degenerative pathologies. Non-steroidal drugs, which include Movalis and Diclofenac, have a pronounced therapeutic effect, but also have side effects . The main undesirable effect when using these drugs is a negative effect on the organs of the digestive system. Therefore, non-steroidal anti-inflammatory drugs are not prescribed for more than 10 days.
Compound similarities
If we consider the composition of these drugs, we can see that they are similar only in the presence of sodium hydroxide and water for injection as excipients.
Movalis:
The active substance is meloxicam.
Excipients:
- water for injections;
- sodium hydroxide;
- sodium chloride;
- glycofurol;
- poloxamer 188;
- meglumine;
- glycine.
If we consider the composition of these drugs, we can see that they are similar only in the presence of water for injection as excipients.
Diclofenac:
The active substance is diclofenac sodium.
Excipients:
- water for injections;
- sodium hydroxide;
- sodium metabisulfite;
- propylene glycol;
- mannitol;
- benzyl alcohol.
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Therapeutic effect of Diclofenac and Movalis
Diclofenac and Movalis are commonly prescribed medications that have a similar spectrum of actions, including anti-inflammatory, analgesic and antipyretic. But still, the effects of these drugs are different.
Diclofenac is a non-selective cyclooxygenase inhibitor, which is responsible for the greater number of possible negative reactions. Movalis is a selective inhibitor of cyclooxygenase type 2, and therefore there is no negative effect on the gastrointestinal tract when used. This is the main, but not the only difference in the action of drugs . The pharmacological characteristics of each drug will help to identify the similarities and differences between the effects of Diclofenac and Movalis.
Pharmacological characteristics of the drug Diclofenac
Diclofenac has the following effects:
- anti-inflammatory;
- antipyretic;
- antiaggregation;
- analgesic;
- antirheumatic.
All these actions are possible due to inhibition of the enzyme cyclooxygenase. Because of this, the biochemical reactions of the arachidonic cascade become impossible, which causes a disruption in the synthesis of prostaglandins, leukotrienes, thromboxane and prostacyclin. The release of enzymes from lysosomes is blocked, and the aggregation of blood platelets is suppressed.
When the medication is used internally, complete resorption occurs; food intake can provoke a decrease in the rate of absorption, but does not have a depressing effect on its usefulness. Achieving the maximum concentration of a bioactive substance in plasma may differ depending on the dosage form:
- when taken orally in a short-acting tablet form, Cmax is achieved after 1-2 hours;
- when taken orally in a tablet form of prolonged action - after 5 hours;
- for intramuscular administration - after 10-20 minutes;
- for rectal administration - after half an hour.
Diclofenac binds to plasma proteins almost completely (99%). The bioactive substance enters the synovial fluid and tissues, where the increase in concentration will be somewhat slower. When applied topically, Diclofenac reaches the site of pathology through the skin.
About a third of the drug is excreted in the feces in a metabolized form, the remaining two-thirds undergo biotransformation in liver cells and are excreted in the urine.
Diclofenac has a more pronounced anti-inflammatory effect than acetylsalicylic acid, ibuprofen, butadione, and indomethacin.
Diclofenac helps relieve pain in the joints at rest and during movement, eliminates stiffness in the joints in the morning, their swelling, and the effect of the drug is aimed at improving the functionality of the joints. For post-traumatic and postoperative inflammation, the drug relieves pain and reduces swelling of the affected area. In the case of course use of Diclofenac for polyarthritis, the concentration of the active substance in articular and periarticular tissues is higher than in plasma.
The medicine is prescribed for the treatment of various diseases:
- inflammatory joint pathologies (gout, rheumatoid arthritis, rheumatoid arthritis, ankylosing spondylitis);
- degenerative-dystrophic pathologies (osteochondrosis, osteoarthritis);
- neuralgia, myalgia, sciatica, lumbago;
- pathological conditions of periarticular tissues (bursitis, tendovaginitis, rheumatic lesions of muscle tissue);
- post-traumatic and postoperative pain syndromes;
- adnexitis;
- migraine attacks;
- hepatic and renal colic;
- infectious and inflammatory pathologies of the respiratory system.
In forms for topical use, Diclofenac is prescribed for the correction of injuries to muscle tissue, tendons, ligaments and joints, and local forms of rheumatism. In the form of eye drops, the drug is used for the treatment of non-infectious conjunctivitis and for some operations on the organs of vision.
Contraindications to the use of Diclofenac:
- stomach ulcer;
- disorders of hematopoietic processes;
- exacerbation of intestinal inflammation;
- “aspirin” asthma;
- child's age up to 6 years;
- the period of bearing a child (especially the last trimester).
The prescription of this medication is limited for diagnosed disorders of the functionality of the kidneys and liver, heart failure, porphyria, lactation and during professional activities with a high concentration of attention.
Adverse reactions to Diclofenac:
- digestive disorders (vomiting, nausea, constipation, diarrhea, flatulence);
- NSAID gastropathy (erythema, erosion, ulcers in the antrum of the stomach);
- erosions, ulcers in the intestines;
- bleeding;
- pancreatitis;
- liver dysfunction (drug-induced hepatitis);
- impaired renal function (nephritis, rarely - failure);
- headaches and dizziness, irritability, excessive fatigue;
- local manifestations of allergies: exanthema, erythema, erosion, ulcers;
- systemic anaphylaxis;
- disorders of the hematopoietic organs (anemia, leukopenia, thrombocytopenia);
- increased blood pressure;
- convulsive conditions;
- in the case of intramuscular injection - the formation of abscesses, necrotic changes in adipose tissue;
- in the case of rectal administration - mucous-bloody discharge from the rectum, painful defecation.
To minimize the risk of side effects, when using Diclofenac, you should regularly donate blood for a general analysis to determine the formula and for a biochemical analysis to assess the functional state of the liver and a stool test for occult blood.
Characteristics of Diclofenac
Diclofenac has anti-inflammatory, analgesic and antipyretic properties. The active ingredient is diclofenac sodium. Release forms: tablets for oral administration, solution for injection, ointment and gel for external use, suppositories for rectal administration, eye drops.
The mechanism of action of the drug is not aimed at preventing the development of the disease, but at relieving pain and inflammation. Tablets and suppositories are prescribed for cancer, pathologies of the musculoskeletal system, inflammation of the pelvic organs, and inflammatory diseases of the ENT organs.
Injections are recommended for algodismenorrhea, lumbago, neuralgia, spinal osteochondrosis, arthritis, rheumatic lesions of soft tissues and other diseases of the musculoskeletal system. Injections are prescribed for a short time if tablets do not help.
Gel and ointment help with injuries, muscle pain, arthritis and other diseases of the musculoskeletal system.
Diclofenac has many contraindications: bronchial asthma associated with aspirin intolerance, bleeding and ulcerative lesions of the gastrointestinal tract, intestinal inflammation, heart, kidney and liver failure, intolerance to the components of the drug. The drug is not used in the third trimester of pregnancy and during breastfeeding, and in the first and second trimesters strictly according to indications and in a limited dosage. Tablets should not be used in the treatment of children under 6 years of age, and suppositories under 14 years of age.
Diclofenac also has relative contraindications: old age, ulcerative colitis, pathologies of the peripheral circulatory system and much more. Such an extensive list shows that the medicine cannot be used without consulting a doctor.
Taking the drug often causes side effects from various organs, so if unpleasant symptoms appear during the treatment period, you should definitely inform your doctor about them.
Diclofenac has anti-inflammatory, analgesic and antipyretic properties.
Pharmacological characteristics of the drug Movalis
Spectrum of pharmacological effects of Movalis:
- anti-inflammatory;
- antipyretic;
- analgesic.
Structurally, Movalis is a derivative of enolic acid. The mechanism of action of the drug is based on the selective inhibition of type 2 cyclooxygenase. Due to the selectivity of the effect on various forms of the enzyme, the severity of undesirable reactions from the digestive system is reduced.
When administered intramuscularly, absorption of the active substance occurs completely. The maximum concentration of meloxicam in plasma is one hour after entering the body.
The bioavailability of the drug when taken orally in tablet form reaches 89%. Maximum concentration in plasma when taken orally occurs after 5-6 hours. The intake of food does not impair the absorption of the drug.
When using rectal suppositories, the maximum concentration of the bioactive substance in plasma occurs after 5 hours. Therefore, suppositories are bioequivalent to the tablet form of the drug. Movalis is able to enter the synovial fluid, the local concentration is about 50% of the content in plasma.
The drug is excreted from the body in feces and urine in a metabolized form; less than 5% is excreted in unchanged form.
Movalis is prescribed in the following cases:
- for rheumatoid arthritis;
- with ankylosing spondylitis;
- for osteoarthritis and other degenerative pathologies.
Contraindications for use:
- hypersensitivity to the bioactive substance and auxiliary components of the drug;
- a history of bronchial asthma, skin manifestations of hypersensitivity or angioedema while taking non-steroidal anti-inflammatory drugs;
- stomach ulcer;
- ulcerative colitis;
- impaired liver function;
- impaired kidney function;
- pathologies of the blood coagulation system;
- heart failure;
- periods of childbearing and breastfeeding;
- injection solution is not prescribed to children under 18 years of age;
- Rectal suppositories and tablet forms are not prescribed to children under 12 years of age.
List of adverse reactions:
- disruption of hematopoietic processes (manifest in the form of anemia, leukopenia, thrombocytopenia);
- anaphylactic reactions;
- headaches and dizziness, sleep disturbances, mood swings;
- esophagitis, gastritis, colitis, stomach and duodenal ulcers;
- impaired liver function, hepatitis;
- dermatitis, photosensitivity, erythema, rashes, itching;
- bronchial “aspirin” asthma;
- renal failure, nephritis;
- impaired vision function, conjunctivitis.
In the case of a course of Movalis, to minimize side effects, the functional state of the hematopoietic system, liver, and organs of the digestive system should be monitored.
Characteristics of Movalis
The drug has anti-inflammatory, analgesic and antipyretic effects. The active ingredient is meloxicam. Its action is aimed at inhibiting the production of prostaglandins - substances that are mediators of inflammation. Release forms of Movalis are tablets and suspension for internal use, suppositories for rectal use, solution for intramuscular injection.
For rheumatological pain and problems with joints, doctors prescribe drugs from the NSAID group, for example, Movalis or Diclofenac.
The medication is prescribed for rheumatoid arthritis, ankylosing spondylitis and osteoarthritis, including degenerative changes in joints and arthrosis.
The drug has many contraindications:
- bronchial asthma and polyposis, combined with intolerance to drugs containing acetylsalicylic acid or drugs from the NSAID group;
- exacerbation of gastrointestinal ulcers, ulcerative colitis;
- gastrointestinal or cerebrovascular bleeding in the active stage or recently suffered;
- kidney and liver diseases;
- uncontrolled heart failure;
- postoperative pain syndrome associated with coronary artery bypass grafting;
- intolerance to galactose, fructose and the components that make up Movalis.
The medicine is contraindicated for use during pregnancy and lactation, and for children and adolescents under 18 years of age.
In addition to absolute contraindications, there are also relative ones. In the following cases, the drug can be used in treatment, but with caution:
- pathology of the gastrointestinal tract in the anamnesis;
- cardiac ischemia;
- diseases of the arteries of the peripheral circulatory system;
- diabetes;
- smoking and alcohol addiction;
- elderly age.
Before using the medicine, you should consult your doctor.
Movalis also has a large number of possible side effects. The respiratory system, digestive system, nervous, urinary, hematopoietic, immune and cardiovascular systems may react negatively to taking the medication. Mental disorders, expressed in mood swings and disorientation, are rarely observed. From the senses, unpleasant symptoms may appear in the form of tinnitus and visual impairment.
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Movalis is contraindicated for use during pregnancy and lactation, and for children and adolescents under 18 years of age.
Results of clinical studies of the effectiveness of Movalis and Diclofenac
To identify the preferred drug, studies were carried out on the effectiveness of Diclofenac and Movalis and compared therapeutic results and side effects. In 2001, N. A. Shostak and D. A. Shemetov published the results of a study of the effect of drugs on patients with osteochondrosis of the lumbosacral spine , complicated by severe pain .
The effectiveness of Diclofenac was studied in the treatment of 24 patients, Movalis - 30. The study revealed that Movalis and Diclofenac have a similar rate of achieving an analgesic effect and comparable overall effectiveness . However, the advantage of Movalis is its greater safety with regard to the likelihood of side effects from the digestive system.
Movalis is just as effective, but safer than Diclofenac, a non-steroidal anti-inflammatory drug, and therefore it can be recommended as a good drug for the treatment of patients with pathologies of the musculoskeletal system.
Comparison of drug costs
The question of the price of medicines in a number of situations is decisive in the issue of choosing a drug. The approximate price for different forms of Diclofenac and Movalis is shown in the table.
| The drug and its form | approximate price |
| Diclofenac | |
| Pills | 20 pieces - 40-70 rubles |
| Solution for intramuscular injection | 30-70 rubles |
| Suppositories | 60-250 rubles |
| Ointments and gels | 30-150 rubles |
| Movalis | |
| Pills | 20 pieces - 650-800 rubles, 10 pieces - 500-600 rubles |
| Solution for intramuscular injection | 5 ampoules - 900 rubles, 3 ampoules - 650 rubles |
| Suppositories | 300-350 rubles |
Of course, the cost of various forms of Diclofenac is several times less than the cost of similar forms of Movalis, which is why it is purchased by patients more often. However, if the doctor prescribed Movalis, it means that in a specific clinical situation it is more appropriate to use this drug.
When answering the question: Movalis or Diclofenac - which is better, reviews should not be decisive in making a specific decision. Only a specialist who is treating the patient can choose the right medication. Self-prescription of a particular medication can aggravate the condition due to the development of side effects from many organ systems, so you should be especially careful and follow all medical recommendations.
Patient reviews
Mikhail, 41 years old, Syzran: “I started injecting Diclofenac as prescribed by a doctor for inflammation of the knee joint. The pain was severe, but on the third day of treatment it began to subside. There were no side effects."
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Oksana, 31 years old, Bryansk: “Movalis injections were prescribed for lower back pain, which regularly appears due to displacement of the vertebrae. A total of 3 injections were prescribed. After the first one it became much easier.”