Chronic pain develops over a long period of healing. Its treatment requires complex therapy, in which multidirectional medications are used, among which, in addition to the typical narcotic and non-narcotic analgesics in this case, adjuvant therapy drugs are used.
Among them are steroid hormonal anti-inflammatory drugs and ointments. However, hormones are not always prescribed by specialists for the treatment of chronic pain syndrome. Steroid anti-inflammatory drugs have a fairly extensive list of side effects and contraindications.
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Definition and qualification
Hormones are biologically active substances of protein nature, complex in their chemical structure, which are synthesized in the human body and have specific properties.
There are several classifications of human hormones. They are distinguished by their chemical structure, place of synthesis, functions, etc. Based on their chemical structure, hormones are divided into catecholamines, thyroid hormones, peptide hormones and steroid hormones. What steroid hormones are and in what preparations they are found will be discussed further.
So, steroid hormones are characterized by the fact that their precursor is cholesterol.
Reference . Cholesterol is a complex, fat-soluble organic substance. It is found in all cell membranes of the human body. The body synthesizes most of it in the liver independently from various organic acids supplied with food. Some cholesterol enters the body from outside.
It is from cholesterol that all steroid hormones are synthesized. These include estrogens, androgens, mineralocorticoids and glucocorticoids. Of all classes of steroid hormones, glucocorticosteroids have a pronounced anti-inflammatory effect. These are biologically active substances that are synthesized in the adrenal cortex and have a number of important functions. They are part of all hormonal anti-inflammatory drugs.
Classification
The clinical and pharmacological group of steroids includes drugs with main components that have biological activity. Cortisone and Hydrocortisone are glucocorticosteroids of natural origin. The rest of the drugs are their synthetic analogues, derivatives of hydrocortisone, obtained as a result of fluoridation or other chemical reactions. Artificial steroids are characterized by higher therapeutic efficacy, lower frequency of use, and less pronounced adverse reactions. In medical practice, a classification of hormonal drugs is accepted depending on the time of their therapeutic effect:
- The half-life of short-acting steroids (cortisone, hydrocortisone) is from 8 to 12 hours. They are usually included in external agents that are rarely used in the treatment of joint pathologies. Intended mainly for the treatment of inflammatory skin lesions. Hormone replacement therapy is carried out using tablets and injections for a deficiency of natural hormones in the body;
- The half-life of intermediate-acting steroids (methylprednisolone, prednisolone, triamcinolone) is from 18 to 36 hours. They are most often used in orthopedics, rheumatology, and traumatology. They are several times more clinically effective than short-acting agents, but have less effect on water and electrolyte balance. Significantly less likely to provoke adverse systemic reactions;
- The elimination period for long-acting steroids (betamethasone, dexamethasone) ranges from 36 to 54 hours. The drugs are not intended for long-term treatment due to severe side effects and toxic effects on the body.
Glucocorticosteroids are also classified depending on the route of administration. Tablets and injections are used to treat joint pathologies. The latter are injected intramuscularly, intravenously, into the joint cavity, sometimes directly into the inflamed tendon. Hormonal products are produced in the form of lyophilisates for the preparation of solutions and suspensions. The following steroid drugs are most often used in the treatment of degenerative-dystrophic and inflammatory joint pathologies:
- Dexamethasone;
- Depo-Medrol;
- Triamcinolone (Kenalog);
- Hydrocortisone;
- Betamethasone (Diprospan, Celeston, Flosteron);
- Prednisolone.
These hormonal agents are characterized by pronounced anti-inflammatory, antiallergic and immunosuppressive activity. They also affect metabolism: lipids, proteins, carbohydrates.
Differences between NSAIDs and NSAIDs
Let's look at what non-steroidal and steroidal anti-inflammatory drugs are and what is their difference.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of drugs that are synthesized from various organic acids (salicylic, acetic, propionic) and do not contain hormonal components.
Steroidal anti-inflammatory drugs (SAIDs) are medications whose main active ingredients are glucocorticosteroids.
Mechanism of action
In response to various damages, inflammation develops in the human body. This process is characterized by increased temperature, hyperemia (local redness of the inflamed area), pain and swelling. Symptoms of inflammation occur under the influence of so-called inflammatory mediators.
Reference . Inflammatory mediators are biologically active substances that are synthesized either by the cells of damaged tissues or by white blood cells and cause clinical symptoms of inflammation.
These include prostaglandins, leukotrienes, biologically active substances, lysosomal enzymes.
The difference between steroidal anti-inflammatory drugs and non-steroidal ones is that they block the inflammation process at different levels and in different ways .
NSAIDs block the enzyme cyclooxygenase, which helps stop the synthesis of inflammatory mediators.
Reference . Cyclooxygenase (COX) is an enzyme that is a large protein molecule, its main task is to catalyze the reaction of the synthesis of inflammatory mediators from arachidonic acid.
Steroid hormones have a different mechanism of action. They have many effects and block the inflammation process from different sides. Glucocorticosteroids reduce the level of cyclooxygenase, reduce the motor and synthetic activity of monocytes, macrophages, lymphocytes and other cells that are present at the site of inflammation.
Reference . Monocytes, macrophages and lymphocytes are types of white blood cells (leukocytes). They differ from each other in shape, size and functions. What these cells have in common is that they are all responsible for the formation of human cellular immunity and prevent the penetration and spread of foreign substances in the body.
Due to the action of glucocorticoids in tissue cells, the production of the phospholipase enzyme, which is responsible for the synthesis of biologically active substances that contribute to the development of inflammatory reactions, is reduced.
Corticosteroids during pregnancy and lactation
Although there are many side effects, taking corticosteroids, especially prednisone, is relatively safe during pregnancy. However, your doctor will decide to prescribe these medications based on your condition.
If you are taking corticosteroids and are planning to become pregnant, be sure to discuss this with your doctor! If you become pregnant while taking these medications, do not suddenly stop taking them - it may not be safe!
Corticosteroids can pass into breast milk, so breastfed babies may experience side effects from these medications. Discuss alternative treatments with your doctor or switch your baby to formula feeding.
Withdrawal symptoms
Reducing your dose of corticosteroids or stopping them can be difficult. If you have been taking these medications for a long time, sudden withdrawal can be dangerous. Your body should produce corticosteroids in response to stress, but if the drugs are abruptly discontinued, the adrenal glands will not be able to quickly readjust and increase the synthesis of their own hormone. That is why doctors gradually reduce the dose, eventually stopping the medicine completely.
If you have been taking steroids for weeks or months, you may experience unpleasant withdrawal symptoms as you taper your dose. These may include muscle, bone and joint pain, nausea, weight loss, headache, and even fever. Fortunately, these symptoms are usually mild and go away quickly.
Konstantin Mokanov
The use of glucocorticoids, even short-term, can “program” for decades to come the work of many organs and systems in the unborn child (control of blood
, metabolic processes, behavior formation). Synthetic hormone mimics signal
for the fetus on the mother's side and thereby forces the fetus to force the use of reserves.
This negative effect of glucocorticoids is enhanced by the fact that modern long-acting drugs (Metypred, Dexamethasone) are not deactivated by placental enzymes and have a long-lasting effect on the fetus.
Glucocorticoids, by suppressing the immune system, help reduce a pregnant woman's resistance to bacterial and viral infections, which can also negatively affect the fetus.
Glucocorticoid drugs can be prescribed to a pregnant woman only if the result of their use significantly outweighs the risk of possible negative consequences for the fetus.
Previously, there was a practice of prescribing glucocorticoids to maintain pregnancy. But no convincing data on the effectiveness of this technique have been obtained, so it is not currently used.
In obstetric practice, Metypred, Prednisolone and Dexamethasone are most often used. They penetrate the placenta in different ways: Prednisolone is destroyed by enzymes in the placenta to a greater extent, and Dexamethasone and Metipred - by only 50%.
Therefore, if hormonal drugs are used to treat a pregnant woman, it is preferable to prescribe Prednisolone, and if to treat the fetus, it is preferable to prescribe Dexamethasone or Metypred. In this regard, Prednisolone causes adverse reactions in the fetus less often.
Glucocorticoids penetrate into breast milk in small doses poorly and do not pose a danger to the baby.
Drugs in higher doses and a long course of treatment of a nursing mother with hormones can cause growth retardation in the child and suppression of the function of the endocrine glands (pituitary gland, hypothalamus, adrenal glands).
Indications for use
Glucocorticoids have not only an anti-inflammatory effect, but also a number of other beneficial properties. They have antiallergic, immunosuppressive, antishock and antitoxic effects on the human body. In this regard, glucocorticoids can be used to relieve various pathological conditions.
The main indications for the use of glucocorticosteroids are acute life-threatening conditions (shock, toxic lesions, acute allergic reactions), acute inflammatory diseases (diseases of the blood system, infectious mononucleosis, etc.), chronic inflammatory diseases (rheumatic diseases, collagenosis, autoimmune diseases, etc. ), conditions after organ and tissue transplantation, adrenal insufficiency.
The anti-shock effect of hormones is associated with their ability to increase blood pressure, constrict blood vessels, activate liver enzymes, and stabilize the condition of cell membranes. All this helps to establish internal balance in the body and remove it from a state of shock.
In acute inflammatory diseases, glucocorticoids reduce the activity of the inflammatory response by reducing the amount of inflammatory mediators. By stopping the synthesis of cyclooxygenase, the amount of prostaglandins and leukotrienes decreases, swelling, pain and redness at the site of inflammation decreases.
Reducing the production of phospholipase by cells also reduces the amount of inflammatory mediators. In addition, glucocorticosteroids help reduce the cellular response of specific cells, such as lymphocytes, monocytes, macrophages, etc.
In chronic inflammation, these hormones stabilize the cell membranes of leukocytes, this causes a decrease in their reactivity, that is, cells react with less activity to the irritating agent. This reduces chronic inflammation and stabilizes the condition of a patient with autoimmune diseases.
By stopping the synthesis of inflammatory mediators, steroid drugs have an analgesic effect, but pain syndrome as such is not considered an indication for the use of such drugs.
Use in organ and tissue transplantation is also justified by reducing the reactivity of leukocytes. The new transplanted tissue or organ is perceived by the body as a foreign agent that must be destroyed. Therefore, as with any ingestion of a “foreign” substance, the mechanisms of inflammation and elimination are activated. Glucocorticoids help reduce inflammation and rejection processes.
Note : Glucocorticosteroids are also prescribed as replacement therapy when, due to some reason, the body lacks these hormones, for example, with congenital underdevelopment of the adrenal glands. In this case, the missing doses are added from outside.
special instructions
The dosage regimen depends on the nature of the pathology, the patient's response to the steroid drug used, age and weight. But even with effective therapy without serious manifestations, the withdrawal syndrome characteristic of hormonal drugs should be taken into account. It consists of an exacerbation of the degenerative or inflammatory process after abrupt cessation of treatment. The following pathological conditions may also occur:
- increased body temperature;
- pain in muscles and joints;
- weakness, fatigue, drowsiness.
Sometimes (usually under stress) an Addisonian crisis occurs - vomiting, collapse, convulsions. To prevent the development of withdrawal syndrome, at the last stage of treatment, dosages are gradually reduced, as is the frequency of their administration. The main principle of treating joint diseases with glucocorticosteroids is to ensure maximum therapeutic effects using minimal doses. It is unacceptable to use any hormonal drugs without a doctor's prescription.
Contraindications
Due to the peculiarities of their effect on the body, glucocorticoids are contraindicated in pregnancy, osteoporosis, gastric and duodenal ulcers, in conditions with acquired immunodeficiency, for example, after recent operations, in some acute infectious diseases (syphilis, active forms of tuberculosis, acute endocarditis) .
Since such drugs have a pronounced effect on carbohydrate metabolism, these drugs are contraindicated in diabetes mellitus. Individual intolerance to this group of drugs is also a contraindication.
Early menopause Nope, never heard of it
Soothing herbs for the prevention of early menopause
The female body reacts sensitively to constant stress, under the influence of which the production of prolactin, the hormone responsible for lactation and suppresses ovulation, increases. If the situation is not corrected, this may lead to fading of ovarian function, and this should not happen ahead of time. Calming herbal infusions will help you cope with nervous tension and improve your health. Valerian, lemon balm, and motherwort have an excellent effect on the nervous system and make a woman more resilient. Such medicinal herbs can also be added to tea.
Clover drink
Often the first symptoms of menopause are fatigue, irregular periods, pain in the lower abdomen, and lack of sexual desire. They warn about reduced levels of estrogen - sex hormones. Clover will help normalize their level. A tea is prepared from a spoon of its leaves and a glass of boiling water, which is drunk three times a day.
Milk thistle seed meal
If a woman often takes medications, her body is filled with toxins that negatively affect the liver and ovaries, suppressing the functions of the latter. You can remove toxins using meal - a powder obtained by squeezing the oil from milk thistle seeds. It is taken a teaspoon once a day, washed down with slightly warmed water. It is best to take this medicine in the morning before meals. The course of treatment is a month.
Decoction of boron uterus
A universal remedy for early menopause and many gynecological problems is the boron uterus. A decoction is prepared from it by adding a spoonful of the raw material to a glass of boiling water and boiling the mixture in a water bath for a quarter of an hour. After cooling for 4 hours, take the product by spoon 4-5 times a day.
It also makes sense to take phytoestrogens, but I will talk about them in the next article.
Nicotine doesn't just kill horses.
Scientists conducted studies to determine the connection between the occurrence of premature menopause and smoking. So, women who smoked experienced menopause a year or two earlier. Year after year, the number of women who smoke is only growing, which means the number of women experiencing hormonal disorders ahead of time is growing.
If, nevertheless, early menopause occurs, then medication is required. It is best to use folk remedies that have a gentle effect on the body, for example, phytoestrogens, are characterized by the absence of toxic substances and restore a woman’s health and youth.
With warmth and care, Dilyara Lebedeva.
Side effects
The side effects of drugs containing glucocorticoids are directly related to their mechanism of action.
For example, the immunosuppressive effect, which is used as the main effect in the treatment of chronic inflammatory diseases, can also act as a side effect. When using glucocorticoids as replacement therapy, you need to be prepared for a sharp decrease in immune status. This will lead to an exacerbation of chronic infections, disturbances in the normal microflora, and the appearance of fungal diseases of the skin and mucous membranes.
Glucocorticoids have a significant effect on the metabolism of carbohydrates, fats and proteins in the body. They increase blood sugar levels and promote the redistribution of fat and protein. From the extremities, the fat layer goes to the abdomen, face and neck. Due to increased destruction of building protein, muscle mass decreases, the muscles of the limbs become thin and flabby. Due to an increase in sugar levels, a condition such as steroid diabetes mellitus may develop.
These hormones also affect electrolyte metabolism. With systemic use, complications such as steroid osteoporosis, decreased calcium and potassium levels may occur. Steroids help reduce the absorption of calcium ions in the gastrointestinal tract and increase its excretion by the kidneys.
The most commonly used drugs for the treatment of joints and their characteristics
For frequent use, combinations with prednisone, dexamethasone, and triamcinolone are popular. Thanks to them, the active substance of the drugs enters the vascular bed faster.
Dexamethasone
An artificially derived, widespread and affordable drug. Available in ampoules, tablets, eye drops, ointments. Any form can be prescribed for various joint diseases that are characterized by pain:
- periarteritis
- epicondylitis
- styloiditis
- bursitis
- pressure neuropathy
- osteochondrosis
- arthritis
- osteoarthritis
The specificity of the drug is that it eliminates the work of the pituitary gland without the activity of mineralocorticosteroids. After taking one gram, it stays in the blood for about two days, and the effect of 2 grams is equivalent to the effect of 7 grams of prednisone.
Dexamethasone injection
During therapy for a particular disease, it is necessary to monitor concomitant diagnoses: blood pressure, sugar levels and blood counts, and monitor the condition of the musculoskeletal system (x-ray of the hand for density). To avoid side effects, a diet high in protein and potassium and antacids (to reduce irritation of the gastrointestinal tract and duodenum) are recommended. The body's response is higher in patients with hypothyroidism and liver cirrhosis. In patients with progressive angina or heart attack, necrosis extends much further than expected and slows down scar formation, therefore it is practically not used for concomitant cardiac pathology.
Interesting fact . During treatment, the immune response decreases, so vaccination is not recommended.
An interesting reaction occurs on the nervous system - increased emotional instability. Therefore, psychosis must be noted in the anamnesis, and the patient needs supervision.
Patients may hide their emotions, but this is important for adjusting treatment, so it is important not to miss this moment.
For adrenal insufficiency, nonsteroidal anti-inflammatory drugs are used in conjunction with mineralocorticoids.
Cortisone
Not so easy to put into dosage form. Available in the form of tablets and dry matter with a special solvent.
Note. It is important to dissolve the substance with exactly the solvent that comes with the drug. Otherwise, the concentration in the bloodstream and the expected effect are reduced.
Medicines are prescribed for systemic connective tissue diseases:
- polymyalgia rheumatica
- giant cell arteritis
- systemic dermatomyasis
- lupus erythematosus
- together with mineralocorticoids for chronic adrenal insufficiency.
Criteria for polymyalgia rheumatica
If the patient is already taking anticoagulants, antiplatelet agents, cardiac glycosides, estrogens, anabolics, their effect will increase after taking cortisone. And the effect of hypoglycemic, antihypertensive and diuretics will decrease.
When prescribing cortisol, it is possible to use alternating therapy. This is a treatment regimen in which drugs are administered every other day, but in amounts equal to two days. This helps to avoid adverse reactions and maintain the effect of the drug.
It is also necessary to monitor the pressure and condition of the corneal vessels. With a sharp increase in pressure or withdrawal, a micro-rupture of the vessel and hemorrhage into the retina is possible.
Giant cell arteritis
Absolutely contraindicated in renal failure. In case of cirrhosis, the therapeutic effect may be enhanced.
Adverse reactions to cortisone are common, so it is prescribed rarely and with great caution. If adverse reactions occur, a smooth withdrawal regimen begins immediately, preferably replacing it with other drugs. If the patient’s health is satisfactory, but there is an opportunity to switch to safer means, a transition is made.
Hydrocortisone
A synthetic steroid, widely used in tablet form, topically (skin, mucous membranes), intravenously and in the joint space.
Preparations from some pharmacological companies
Used for:
- rheumatoid arthritis,
- synovitis (including deforming osteoarthritis),
- all types of bursitis,
- gouty arthritis, nonspecific tenosynovitis,
- carpal tunnel syndrome,
- arthritis after injury.
It is recommended to administer intravenously, intra-articularly or into the periarticular space. When the drug is injected directly into the cartilage tissue, it is possible to avoid adverse reactions, and the result is permanent for 3-6 months.
Intra-articular administration of the drug
Despite the convenience and long-lasting results, intra-articular administration of the drug is contraindicated if:
- had joint arthroplasty,
- an operation was performed to perform an intestinal anastomosis.
The combined use of the drug with barbiturates, antiepileptics, and antihistamines leads to a decrease in the effect of hydrocortisone. And hydrocortisone itself, in turn, increases clearance, increases blood sugar levels in diabetics, and distorts the work of anticoagulants. When joints are treated with antifungal drugs, heart failure and dilatation of the heart chambers increase.
Aldosterone
Aldosterone is a hormone of the adrenal cortex. Its task is to regulate mineral metabolism, it increases the absorption of sodium ions and removes potassium ions. There are many studies now asking the question: “Is increased aldosterone associated with joint inflammation in rheumatoid arthritis?” Indeed, studies confirm that in patients with elevated aldosterone levels, inflammatory cells were found in the synovium. As well as an increase in villi, lymphoid follicles, fibrin.
If the examination revealed elevated aldosterone, without clinical signs of arthritis, it is worth conducting additional examinations.
Schematic representation of how aldosterone works
Sinalar
A topical drug that reduces inflammation, pain, itching, and swelling. Compared to hydrocortisone, the effectiveness is 40 times higher. For the treatment of joints, it is used as an additional component in the initial stages of treatment to relieve pain, and after discharge from the hospital. Preferably in short courses. For large swelling, it is preferable to choose cream or liniment. Just for inflammation of the joints, you can use ointment. It is allowed to apply the cream under the bandage for 3-4 days. Without a bandage, apply up to 4 times a day.
It also showed good results for lupus, psoriasis, and allergic skin reactions. These diseases often occur as concomitants in the treatment of joints.
Dosage form of sinalar
Betamethasone
Found in all dosage forms. Solutions for intravenous administration are prescribed for systemic lupus erythematosus and rheumatoid arthritis to relieve inflammation and reduce pain. For intra-articular administration it is prescribed for arthritis of various etiologies, arthrosis, spondylitis, Reiter's disease. At the same time, for these diseases it can be prescribed in tablet form.
Skin manifestations of systemic lupus erythematosus
This remedy has a positive effect on the condition of the joints. But additional research has been conducted on its effect on the development of cancer and suppression of fertility. The results were mixed. Therefore, betamethasone rarely appears on prescription sheets.
Concomitant use of estrogens or COCs causes severe adverse reactions. Combination use with other medications produces the same reactions as with other steroids.
Appearance of a bottle of betamethasone produced in the Russian Federation
Note! A popular treatment regimen is a combination of NSAIDs and NSAIDs. It allows you to bring pain relief to the patient as quickly as possible and act on cartilage tissue. After feeling better, one drug is discontinued, and treatment continues in the most comfortable and safe conditions.
Medrol
Tablets for oral administration. The dose is selected individually, starting from 4 milligrams per day. It should be minimal but effective to reduce inflammation and relieve pain. Symptoms of overdose have not been described; in practice, cases of toxicity have not been encountered. If absolutely no improvement is observed with increasing dosage, it is necessary to change the drug.
This tool allows for alternative therapy for diseases of the musculoskeletal system, joints and systemic connective tissue diseases. And it is prescribed as maintenance therapy after discharge to reduce pain.
Interesting fact! Medrol is prescribed to children for growth retardation.
Since there is an effect on the nervous system, insomnia, euphoria, depression, and rapid changes in emotional background are possible. Therefore, during times of stress, the dosage is increased.
If the dose taken causes suppression of the immune response, individual infections may occur hidden. In this regard, prophylactic antibacterial agents are prescribed for long-term treatment. And if you have herpes, postpone treatment.
Medrol, manufactured by Phzer
Momat
Corticosteroid for topical use. Practically not absorbed into the bloodstream. A small amount of cream is applied to the inflamed joint, and after 30 minutes, you can feel pain relief. Great for home use after consultation with a doctor.
Applying cream to the inflamed joint to relieve pain
Blocks inflammatory mediators and the accumulation of neutrophils - providing an anti-exudative and anti-inflammatory effect. Blocks the late stage of the allergic reaction, which also reduces inflammation.
It is not recommended to apply to a large area or under a bandage. It is recommended to avoid contact with mucous membranes. If an infection occurs, you must consult your doctor again to prescribe antimicrobial therapy.
It is not recommended to recommend the cream to a neighbor or prescribe it for yourself without consulting a doctor. After application, the initial appearance of inflammation will change, which will complicate diagnosis. After regular use and improvement in well-being, you should stop applying gradually. If discontinued abruptly, symptoms may return (pain in the joint area, swelling, redness).
Appearance of the Momat bottle
Urbanzon
The drug is available in tablets and injections. Prescribed for systemic connective tissue diseases, acute and chronic inflammatory diseases of the joints, the first sign of which is pain.
If tablets are prescribed for joint diseases, they are usually taken in the morning after meals. The dosage is selected by the attending physician. It differs from others in that it primarily affects interleukins.
Urbazon is not effective for septic shock, but is effective for other types of shock. Shows the best result when used together during anti-tuberculosis therapy.
During treatment with Urbazone, there is a decrease in calcium absorption due to the weakening effect of vitamin D. Therefore, ergocalciferol and parathyroid hormone are prescribed in parallel.
Try to avoid simultaneous administration with diuretics to avoid the development of hypokalemia, increased blood pressure and the development of pulmonary edema.
Simultaneous administration with other glucocorticosteroids leads to the appearance of acne, hirsutism and cataracts.
Popular steroid drugs
Here are the most commonly prescribed medications in this group.
Steroidal anti-inflammatory drugs
Steroidal anti-inflammatory drugs include glucocorticoids. For systemic use in inflammatory diseases, drugs containing prednisolone, dexamethasone, and triamcinolone are more often used.
This is due to the fact that these substances are absorbed better than others in the gastrointestinal tract, enter the bloodstream faster and have a systemic effect. It is important to understand that the better the drug is absorbed and the more pronounced systemic effect it has, the stronger the side effects will be.
In the retail chain of pharmacies, the indicated active ingredients are present in such drugs as “Medopred”, “Decortin”, “Dexafar”, “Dexamed”, “Maxidex”, “Oftan”, “Kenalog”, “Ftorokort”, etc. All these drugs belong to the prescription class and are dispensed only as prescribed by a doctor.
Anti-inflammatory ointments for joint pain based on diclofenac
Note! Effective ointments for joints based on diclofenac are both preparations containing one component and combined ones. Anti-inflammatory ointments for joints and ligaments with diclofenac, containing one component, are:
Anti-inflammatory ointments for joints and ligaments with diclofenac, containing one component, are:
- Diclofenac;
- Diclofenac-Acri;
- Diclofenacol;
- Diclak gel;
- Diclovit;
- Dicloran;
- Dicloran plus;
- Diclonate P gel;
- Diclobene;
- Ortofen ointment;
- Voltaren Emulgel;
- Naklofen;
- Olfen;
- Fanigan;
- Dikloberl 75.
Effective ointments for joint pain that have a combined composition are:
When using the listed drugs:
- pain subsides at the site of application of the ointment;
- swelling decreases;
- the number and amplitude of movements of the affected joints increase.
They are used to relieve pain from:
- inflammation of muscles, ligaments, cartilage;
- degenerative joint diseases;
- rheumatic muscle lesions;
- post-traumatic pain;
- neuralgic phenomena in the muscles.
- urticaria - the appearance of rashes, blisters;
- bronchospasm - a sudden contraction of the muscles of the bronchial wall, limiting the supply of oxygen;
- angioedema or Quincke's edema - an increase in the size of the face, its parts, and limbs.
- Hypersensitivity to diclofenac.
- Skin damage.
- State of pregnancy.
- Lactation.
- Under six years of age.
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