Features of the composition and pharmacological action of Dexalgin
The components of one tablet are presented:
- dexketoprofen trometamol;
- corn starch;
- glycerol palmitostearate;
- microcrystalline cellulose;
- titanium dioxide;
- propylene glycol;
- sodium carboxymethyl starch;
- hypromellose;
- Macragol 600.
The injection solution contains a similar active ingredient, additional components are sodium chloride and hydroxide, ethanol, and purified water.
The medicine is included in the subgroup of NSAIDs; half an hour after use, a decrease in pain and temperature is noted. The drug has an anti-inflammatory effect. The maximum concentration of Dexalgin when taken orally occurs after 40 minutes, the half-life by the kidneys does not exceed 2 hours. With MK injections it is achieved after 10 minutes.
Contraindications
Dexalgin is contraindicated if you are allergic to dexketoprofen or other non-steroidal anti-inflammatory drugs, as well as to any of the components.
Contraindicated in the presence of gastric or duodenal ulcers, primarily in the presence of anamnestic gastrointestinal bleeding, in case of other bleeding in the active stage (including suspected hemorrhagic stroke or subdural/epidural hematoma), in the case of ongoing anticoagulant therapy, in the presence of hemorrhagic diathesis and other disorders of the blood coagulation system.
Dexalgin is not used for Crohn's disease or ulcerative colitis. In case of existing severe dysfunction of the liver (score 10-15 points on the generally accepted Child-Pugh scale) and kidneys (creatinine clearance less than 50 ml per minute).
It is not used if the patient has aspirin-dependent bronchial asthma (including a history), severe heart failure, or for the treatment of pain during coronary artery bypass grafting.
Dexalgin is not used in pediatric practice.
Dexalgin is contraindicated in pregnant and lactating women. Due to the fact that Dexalgin contains ethanol, the drug is not used for neuraxial administration (intrathecal, epidural, intrathecal).
Use with caution if you have a history of allergic conditions; in cases of hematopoietic disorders; with systemic lupus erythematosus, mixed connective tissue diseases; if other medications are taken simultaneously, if there is a predisposition to hypovolemia; coronary heart disease is present; should be used with caution in people over 65 years of age.
Contraindications and indications for Dexalgin therapy
The instructions recommend using tablets to relieve pain caused by:
- surgical interventions - in the postoperative period;
- radiculitis, algodismenorrhea;
- menstruation, dental diseases;
- neuralgia, sciatica;
- arthrosis, rheumatoid arthritis;
- osteochondrosis, spondyloarthritis;
- proliferation of metastases in bone tissue.
The solution in injections is prescribed when it is impossible to take Dexalgin orally - after injuries, operations, and with renal colic.
The drug is contraindicated in patients:
- with individual intolerance to the component composition;
- pathologies of the gastrointestinal tract, heart, liver and kidneys;
- bronchial asthma;
- undergoing anticoagulant therapy.
Dexalgin is not prescribed to minors, during pregnancy and breastfeeding.
Special instructions for the use of Dexalgin injection
Dexalgin Injection cannot be administered neuraxially, epidurally, or into the intrathecal space due to its ethanol content. The drug should be prescribed with caution to patients with a history of allergies. Persons with symptoms of gastrointestinal disorders or a history of gastrointestinal diseases require medical supervision, especially in case of gastrointestinal bleeding. In those isolated cases when gastrointestinal bleeding develops in patients taking dexketoprofen, the drug is immediately discontinued. NSAIDs can inhibit platelet aggregation and increase bleeding time. The simultaneous use of dexketoprofen and low molecular weight heparin drugs in prophylactic doses in the postoperative period was studied during clinical trials. No effect on coagulation parameters was detected. Despite this, careful monitoring of patients who simultaneously take Dexalgin Inject and other drugs that affect blood clotting is necessary. Like other NSAIDs, Dexalgin Inject can cause an increase in the level of creatinine and nitrogen in the blood plasma, have a negative effect on the urinary system, leading to the development of glomerulonephritis, interstitial nephritis, papillary necrosis, nephrotic syndrome and acute renal failure. As with the use of other NSAIDs, there may be a slight transient increase in the parameters of some liver tests, a significant increase in the activity of glutamino-oxaloacetic and glutaminopyruvic transaminases in the blood serum. Dexalgin Injection should be prescribed with caution to patients with hematopoietic disorders, patients with systemic lupus erythematosus or other connective tissue diseases. Like other NSAIDs, Dexalgin Inject can mask the symptoms of infectious diseases. Isolated cases of exacerbation of infectious processes localized in soft tissues have been reported when using NSAIDs. Therefore, medical supervision is required for patients with signs of bacterial infection or worsening of their condition during treatment with dexketoprofen. Caution should be exercised when prescribing the drug to patients with impaired liver, kidney, heart function or with conditions that may cause fluid retention in the body. In these patients, the use of NSAIDs can lead to worsening of the condition and fluid retention in the body. Caution should also be exercised when prescribing dexketoprofen to patients using diuretics or predisposed to hypovolemia, since they have an increased risk of developing nephrotoxicity. Caution is necessary when prescribing the drug to elderly people, as they are more likely to experience adverse reactions, such as gastrointestinal bleeding or intestinal perforation. The risk of developing these reactions depends on the dose of the drug; they can occur at any stage of treatment, often in a more severe form without warning symptoms and without a history of such disorders. Elderly patients are more likely to have impaired renal, liver or cardiovascular function, so their condition must be regularly monitored. Due to possible dizziness and drowsiness, dexketoprofen may impair the ability to drive vehicles and operate machinery. The effectiveness and safety of dexketoprofen in children has not been studied, so it should not be prescribed to children.
Adverse reactions
During therapeutic procedures, non-standard effects may occur, manifested by:
- vomiting with nausea, high blood pressure;
- tachycardia, nettle fever, chills;
- redness, skin rashes, dermatitis;
- anemic and fainting states, cephalalgia;
- sleep disturbances, digestive disorders, bleeding.
Dexalgin tablets can cause discomfort in the epigastric area and heartburn. The injection solution causes pain and local temperature increase in the injection area, hematomas and inflammation.
The medicine must not be mixed with alcoholic beverages. Violation of the rules can provoke severe intoxication with clinical symptoms of poisoning.
Side effects of the drug Dexalgin injection
Possible side effects from the use of the drug, grouped by organ system and frequency of occurrence (common - 1-10%, infrequent - 0.1-1%, rare - 0.01-0.1%, very rare - ≤0.01% ), are given in the table:
Organ systems | Frequent | Infrequent | Rare | Very rare |
| Blood system disorders | – | Anemia | – | Neutropenia, thrombocytopenia |
| Metabolic disease | – | – | Hyperglycemia, hypoglycemia, hypertriglyceridemia | – |
| Nervous system disorders | – | Headache, dizziness, insomnia, drowsiness | Paresthesia | – |
| Visual impairment | – | Blurred vision | – | – |
| Hearing impairment and labyrinthine disorders | – | – | Noise in ears | – |
| Heart disorders | – | – | Extrasystole, tachycardia | – |
| Vascular disorders | – | Hypotension, feeling of heat and redness of skin areas | Hypertension, peripheral edema, superficial thrombophlebitis | – |
| Respiratory system disorders | – | – | Bradypnea | Bronchospasm, dyspnea |
| Gastrointestinal disorders | Nausea, vomiting | Abdominal pain, dyspepsia, diarrhea, constipation, hematemesis, dry mouth | Gastric ulcer, bleeding, perforation, anorexia | Pancreatic damage |
| Hepatobiliary system disorders | – | – | Increased liver enzyme activity, jaundice | Liver damage |
| Skin disorders | – | Dermatitis, itching, rash, sweating | Urticaria, acne | Severe skin reactions (Stevens-Johnson syndrome, Lyell's syndrome), angioedema, other skin reactions, photosensitivity |
| Musculoskeletal and connective tissue disorders | – | – | Muscle spasms, joint movement disorders | – |
| Renal and urinary tract disorders | – | – | Polyuria, pain in the kidney area | Kidney damage (nephritis, nephrotic syndrome) |
| Disorders of the reproductive system and mammary glands | – | – | In women - menstrual irregularities; in men - prostate dysfunction | – |
| General disorders and reactions at the injection site | Pain at the injection site | Inflammatory reaction, bruising/hemorrhage at the injection site, soreness, fever, fatigue, chills | Back pain, loss of consciousness, tremors | Anaphylaxis, facial swelling |
| Laboratory indicators | – | – | Ketonuria, proteinuria | – |
The following side effects are also possible, as they are described for other NSAIDs, and may be associated with inhibition of prostaglandin synthesis: aseptic meningitis, occurring mainly in patients with systemic lupus erythematosus or connective tissue diseases; hematological disorders (thrombocytopenic purpura, aplastic anemia and rarely - agranulocytosis and bone marrow hypoplasia).
The nuances of taking Dexalgin
The instructions draw attention to the following rules for using tablets:
- the dosage is calculated by the doctor individually;
- a single dose is 0.5-2 tablets (25 mg each), procedures are performed 2-6 times a day;
- the maximum daily volume of medication cannot exceed 3 tablets;
- The duration of therapy is 5 days.
The injection solution is prescribed according to a specific scheme:
- intramuscular administration - 2 ml slowly, every 8-12 hours, 50 mg, daily dosage does not exceed 0.15 g, treatment lasts for 2 days;
- intravenous – carried out according to the dosages of intramuscular treatment, the medication is administered for about 15 seconds;
- drip – 2 ml of the drug is diluted in 100 ml of physiological solution, the dropper is placed for 15-30 minutes.
Accidentally taking an excess amount of medication provokes sleep disturbances, problems with orientation in space, cephalgia, and nausea. In case of intoxication, symptomatic therapy is used.
Features of interaction
The abstract draws attention to the following nuances of joint therapy with Dexalgin:
- an increased risk of bleeding occurs when using anticoagulants, NSAIDs, Heparin, Ticlopidine, Citalopram, Fluoxetine, Sertraline;
- danger of toxic effects on the body - when treated with lithium preparations, Methotrexate, sulfonamides;
- prohibition on combination with cardiac glycosides, thrombolytics, quinolones without supervision by the attending physician;
- The development of acute renal failure can be provoked by diuretics and ACE inhibitors.
The injection solution must not be mixed in the same syringe with individual medications, the list includes: Pethidine, Hydroxyzine, Dopamine, Promethesine, Pentazocine.
Analogs
If side effects or signs of intolerance to Dexalgin appear, the drug must be replaced with a suitable remedy. The list of analogues is presented:
- Depiofen, Brufen, Bofen;
- Vimovo, Brustan, Dexifen;
- Zo-tek, Ibuprex, Ibuprom;
- Ibunorm, Ibufen, Ibuprofen;
- Ibutard, Imet, Ketonal, Ivalgin;
- Irfen, Naproff, Majezik-sanovel;
- Novigan, Nurofen, Nurosan, Faspik, Promax.
The cost of the original and replacements may vary significantly.
Terms of sale and storage
Dexalgin is sold in pharmacies only with a doctor's prescription. The drug is stored in dark rooms at temperatures up to 25 degrees. The medicine is suitable:
- tablets - for 2 years, after expiration of the period they are disposed of together with household waste;
- solution in ampoules - up to 5 years; after preparation, the medicine retains its properties for no more than one day (provided the temperature is from 3 to 9 degrees and in a dark place).
Dexalgin in ampoules costs from 265 rubles, the price of tablets depends on the number of units in the package and starts from 279 rubles.
Indications
Dexalgin is able to relieve pain of various origins. For example, with toothache, renal colic, in cases of post-traumatic, postoperative pain, as well as with sciatica, neuralgia, radiculitis, pain with metastases in the bones, in the case of algodismenorrhea.
As an anti-inflammatory agent, dexalgin is used to eliminate symptoms in both acute and chronic inflammatory diseases, as well as in cases of inflammatory-degenerative and metabolic disorders of the musculoskeletal system. For example, in the case of rheumatoid arthritis, spondyloarthritis, as well as arthrosis and osteochondrosis.
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