Pharmacy No. 84. Delivery of medicines to your home and office.

Delivery on Sundays and holidays does not work!

Medicines

my basket

Apteka84.kz is an online pharmacy that offers its customers medicines, medicinal and decorative cosmetics, dietary supplements, vitamins, baby food, intimate products for adults, medical equipment and thousands of other medical and cosmetic products at low prices. All data presented on the Apteka84.kz website is for informational purposes only and is not a substitute for professional medical care. Apteka84.kz strongly recommends that you carefully read the instructions for use contained in each package of medicines and other products. If you currently have any symptoms of the disease, you should seek help from a doctor. You should always tell your doctor or pharmacist about all the medicines you take. If you feel you need further help, please consult your local pharmacist or contact our GP online or by telephone.

Diacerein-SZ

Registration number

LP-007210

Compound

per capsule

active ingredient: diacerein - 50 mg

excipients: lactose monohydrate (lactopress) (milk sugar) – 103.0 mg, microcrystalline cellulose 102 – 100.0 mg, croscarmellose sodium (primellose) – 12.0 mg; povidone K-30 (medium molecular weight polyvinylpyrrolidone) – 12.0 mg; magnesium stearate – 3.0 mg.

Hard, opaque gelatin capsules No. 1
Case: titanium dioxide E 171 – 1.0000%,
iron dye yellow oxide E 172 – 0.1920%
gelatin – up to 100%
Cap: iron dye black oxide E 172 – 0.5300%,
iron dye red oxide E 172 – 0.9300%,
titanium dioxide E 171 – 0.3333%,
iron dye yellow oxide E 172 – 0.2000%,
gelatin – up to 100%

Description

Hard, opaque gelatin capsules No. 1: yellow body with brown cap. The contents of the capsules are yellow powder.

ATX code

M01AX21

Pharmacological properties

Pharmacodynamics

Diacerein is an anthraquinoline derivative, a diacetylated derivative of rhein.

Metabolized to the active metabolite rhein, inhibits the activity of interleukin-1, which plays an important role in the development of inflammation and dehydration of cartilage in osteoarthritis.

Diacerein inhibits the action of other cytokines, including interleukin-6, tumor necrosis factor-α. Diacerein also slows down the formation of metalloproteinases (collagenase, elastase), which are involved in the process of damage to cartilage tissue. With long-term use, diacerein stimulates the synthesis of proteoglycans and does not affect the synthesis of prostaglandins. Diacerein has anti-inflammatory activity when taken orally.

Pharmacokinetics

After oral administration, diacerein is rapidly absorbed from the gastrointestinal tract and is completely deacetylated to rhein. Simultaneous administration of the drug with food increases bioavailability by 25%.

The maximum concentration (Cmax) of rhein in plasma is reached after 144 minutes. The plasma half-life is 255 minutes.

The connection of rhein with albumin is almost 100%. With a single dose of 50 mg, Cmax reaches 3.15 mg/l. With repeated administration of the drug, Cmax increases due to the accumulation of the drug. Rhine is excreted by the kidneys unchanged (20%) and in the form of glucuronide (60%) and sulfate (20%). Rhine penetrates the placental and blood-brain barriers.

Indications for use

Symptomatic treatment of osteoarthritis of the hip and knee joints in the absence of the need to achieve a quick effect.

Contraindications

Hypersensitivity to the active substance and other components of the drug. Hypersensitivity to anthraquines (eg laxatives).

Lactose deficiency, lactose intolerance, glucose-galactose malabsorption.

Inflammatory bowel diseases (ulcerative colitis, Crohn's disease). Intestinal obstruction or pseudo-obstruction.

Abdominal pain syndrome of unknown etiology.

Current liver disease and/or history of liver disease.

Severe renal failure (creatinine clearance less than 30 ml/min) and a history of kidney disease.

Children's age (up to 18 years).

Pregnancy and breastfeeding period.

CAREFULLY

Moderate renal failure (creatinine clearance 30-60 ml/min) and chronic renal failure, irritable bowel syndrome, patients 65 years of age and older.

USE DURING PREGNANCY AND BREASTFEEDING

Due to the lack of clinical data, the use of diacerein during pregnancy is contraindicated. Diacerein-SZ, like other drugs in this group, can be found in breast milk. In this regard, the drug Diacerein-SZ is contraindicated during breastfeeding.

Directions for use and doses

For oral administration.

The prescription of the drug Diacerein-SZ should be performed by a specialist with experience in the treatment of osteoarthritis (osteoarthrosis). Standard intake: 1 capsule 2 times a day (morning and evening, after meals). Since some patients may develop loose stools or diarrhea, it is recommended to start taking Diacerein-SZ 50 mg once a day with an evening meal for the first 2-4 weeks. Then it is possible to use 50 mg 2 times a day with food: the first time with a morning meal, the second time with an evening meal. Capsules should be swallowed whole without opening them and washed down with a glass of water.

Elderly age

Because elderly patients are more vulnerable to complications associated with acute diarrhea, it is not recommended to prescribe Diacerein-SZ to patients over the age of 65 years with a history of diarrhea.

No dosage changes are required when treating older patients with Diacerein-SZ.

However, caution should be exercised. If diarrhea occurs, you should stop treatment and consult your doctor.

The effect of treatment should be expected after 2-4 weeks. The drug Diacerein-SZ is taken continuously for a long time or in courses lasting at least 4 months.

Kidney failure

In patients with moderate renal failure (creatinine clearance 30-60 ml/min), the dose of the drug should be halved to 50 mg (1 capsule) per day.

Side effect

In accordance with the WHO classification, undesirable effects are classified according to their frequency of development as follows: very often (≥ 1/10), often (from ≥ 1/100 to <1/10), infrequently (from ≥ 1/1000 to <1 /100), rare (from ≥ 1/10000 to <1/1000), very rare (from < 1/10000), frequency unknown - it was not possible to determine the frequency of occurrence based on available data).

Immune system disorders

Infrequently:

allergic reactions

Gastrointestinal disorders

Often:

diarrhea, abdominal pain;

Often:

frequent bowel movements, flatulence.

As a rule, with continued treatment these phenomena weaken. Cases of severe diarrhea with dehydration and water-electrolyte imbalance have been identified.

Unlike NSAIDs, diacerein does not cause gastrointestinal ulcers.

Disorders of the liver and biliary tract

Infrequently:

increased activity of liver enzymes.

Skin and subcutaneous tissue disorders

Rarely:

itching, rash, eczema (itchy, red rash).

Frequency unknown:

intense coloration of urine from yellow to brown (depending on pH), which does not require dose reduction (cancellation) of the drug.

Post-registration observations

During post-marketing monitoring, cases of acute liver damage were identified, including increased activity of liver enzymes in the blood serum when taking diacerein. Most of them were observed during the first months of treatment. It is necessary to monitor laboratory and clinical manifestations of liver damage in patients (see section “Special Instructions”).

If any of the adverse reactions indicated in the instructions worsen, or you notice other adverse reactions not listed in the instructions, tell your doctor.

Overdose

In case of overdose, diarrhea and weakness are possible. In case of overdose or accidental use of medication by children, consult a doctor. Treatment is symptomatic.

Interaction with other drugs

The drug Diacerein-SZ is not recommended to be taken together with substances that affect the quality of intestinal contents and the rate of bowel movement (for example, a large amount of fiber). Antacids reduce the absorption of the drug. When taken concomitantly with antibiotics or chemotherapy drugs that affect the intestinal microflora, the frequency of adverse events from the intestine may increase. Diacerein may cause diarrhea and hypokalemia. Caution should be exercised when used simultaneously with diuretics (loop and thiazide) and/or cardiac glycosides (digoxin, digitoxin) due to an increased risk of developing arrhythmias)

special instructions

The duration of treatment, depending on the result achieved, can be long. In the period preceding the development of the therapeutic effect, the drug Diacerein-SZ can be taken simultaneously with analgesics and non-steroidal anti-inflammatory drugs. Periodic monitoring of blood levels, liver enzymes, and urine is necessary. If kidney function worsens, the doctor should reduce the dose of the drug.

The use of diacerein is not recommended for rapidly progressing osteoarthritis of the hip and knee joints due to the slow development of the clinical effect of the drug.

Diarrhea

Taking diacerein often leads to the development of diarrhea (see section "Side effects"), which can cause dehydration and hypokalemia.

If diarrhea develops, stop taking the drug and contact your doctor immediately to discuss alternative treatment.

Caution should be exercised if the patient is concomitantly receiving diuretics, as dehydration and hypokalemia may occur. Particular caution should be exercised in case of hypokalemia in patients receiving cardiac glycosides (digitoxin, digoxin) (see section “Interaction with other drugs”).

The simultaneous use of laxative drugs should be avoided.

Hepatotoxicity

During post-registration monitoring, cases of increased activity of liver enzymes in the blood serum and symptomatic acute liver damage were identified (see section “Side Effects”).

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 (see section “Contraindications”).

It is necessary to monitor laboratory and clinical manifestations of liver damage, and observe precautions when used simultaneously with other drugs with a characteristic risk of developing hepatotoxic reactions. Patients should be advised to limit alcohol consumption while using diacerein.

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.

Impact on the ability to drive vehicles and operate machinery

The effect of diacerein on concentration, speed of psychomotor reactions when driving vehicles, operating machinery, and engaging in other potentially hazardous activities has not been studied.

Release form

Capsules 50 mg.

10 or 14 capsules in contour cell packaging made of polyvinyl chloride film and printed varnished aluminum foil or aluminum foil with thermovarnish coating or imported aluminum foil.

30 capsules each in BP polymer jars made of low-pressure polyethylene with tension caps made of high-density polyethylene with a sealing element and control of the first opening, or in polymer bottles made of low-density polyethylene with tension caps made of high-density polyethylene with a sealing element and control of the first opening.

Labels made of label or writing paper, either self-adhesive or imported, are glued onto jars and bottles.

Each jar, bottle, 2, 3 contour cell packages of 10 capsules or 2 contour cell packages of 14 capsules, together with instructions for use, are placed in a cardboard pack made of cardboard for consumer packaging or imported.

Best before date

2 years. Do not use after the expiration date indicated on the package

Storage conditions

In a place protected from light, at a temperature not exceeding 25 ° C.

Keep out of the reach of children.

Vacation conditions

Available with prescription

Diacerein in the treatment of osteoarthritis of the knee joints: results of a comparative study