Voltaren - a brand name known non-steroidal anti inflammatory drug (NSAID) diclofenac, which produces the Swiss pharmaceutical company Novartis Pharma. This non-narcotic analgesic of origin for systemic and topical use having an analgesic, antiinflammatory, and (to some extent) antipyretic action.

Mechanism of action Voltaren

Voltaren (international non-proprietary name - diclofenac) - this is the first generation of NSAIDs, effective medicament to reduce inflammation and pain. He produced tablets of various dosages for oral administration, in a solution for injection in vials, rectal suppositories in a emulgelya for outdoor use. Unfortunately, like all first-generation NSAIDs, Voltaren Voltaren - relieve inflammation and pain   It has a lot of side effects.

The mechanism of action is based on voltaren that it inhibits the enzyme cyclooxygenase (COX), which is involved in the formation of prostaglandins - biologically active substances involved in the formation of the inflammatory process. Suppression of prostaglandin results in a reduction of inflammation and pain. Part of the preparation possesses antipyretic properties.

But not all prostaglandins cause inflammation. Some of them protects the gastric mucosa from the various effects. Voltaren inhibits the synthesis of prostaglandins, and that as a result in long-term systemic use Voltaren leads to the destruction of the mucous membrane and the appearance of erosive and ulcerative lesions of the stomach wall.

Indications and contraindications for use

Voltaren is used in the following diseases and conditions:

• inflammatory and metabolic diseases of joints and spine, which are accompanied by pain;
• autoimmune diseases of the joints and spine - rheumatism, rheumatoid arthritis, ankylosing spondylitis; when extra-articular soft tissue rheumatic affections;
• in all diseases of the spine, which are accompanied by pain;
• with attacks of gout;
• in renal and hepatic colic;
• for pain arising from injuries and operations, especially if they are accompanied by inflammation;
• painful menstruation, pain caused by inflammatory processes of female genital mutilation;
• pain in the ear, marked inflammation in the throat and nose, accompanied by swelling and pain;
• headache, including migraine.

The use of Voltaren contraindicated:

• gastric ulcer and duodenal ulcer;
• allergies (including exhibiting bronchospasm) any other NSAIDs, including aspirin;
• in inflammatory processes in the rectum (rectal suppositories);
• at the age of 18 years (for injection);
• if you are hypersensitive to the components of the drug;
• while breast-feeding.

In pregnancy, diclofenac is not indicated in I (warning fetal anomalies) and III (may cause suppression of the contractile ability of the uterus) trimesters. In the II trimester drug is given for emergencies only obstetrician or prenatal therapist.

Voltaren Be wary appoint patients with impaired liver and kidney function, in any gastrointestinal disease, diseases of the cardiovascular system, elderly patients, patients with asthma and patients who have a tendency to bleed.

Side effects and overdose

When using Voltaren orally or by injection, the following side effects:

• from the gastrointestinal tract - abdominal pain, nausea, vomiting, diarrhea or constipation, bloating, loss of appetite; sometimes - ulcerative processes in the stomach and intestines, which are accompanied by bleeding; inflammation in the oral cavity, in the tongue, esophagus;
• of the liver - liver, hepatitis Hepatitis - the scourge of our time ;
• Nervous system - headache, dizziness, sleep disturbances, skin sensitivity, memory, orientation in the surrounding area, irritability, convulsive readiness, bad mood, anxiety, fear, trembling of the limbs, sometimes - psychosis;
• From the senses - visual impairment, hearing and taste;
• on the part of the circulatory system - palpitations, heart pain Pain in the heart - always consult a doctor , Increased blood pressure, heart failure;
• from the blood - decrease in peripheral blood platelet counts (bleeding tendency), leukocytes, including granular (immunosuppression), red blood cells (anemia);
• by the kidneys and urinary tract - edema, acute renal failure, blood and urine protein The protein in the urine - a sign of danger, which should not be underestimated Inflammatory processes in the kidney;
• Allergic reaction - skin rash (including urticaria), severe allergic reactions such as necrosis of the mucous membranes, increased sensitivity to light, bronchospasm, anaphylactic shock, and so on;
• the application of rectal suppositories may be a local reaction - exacerbation of hemorrhoids; intramuscular injection - sealing, pain, abscesses, necrosis at the injection site.

Voltaren overdose manifests increased all of its side effects. It is recommended to call an ambulance.

Galina Romanenko

Although pain relievers can not cure back pain, they relieve the pain and make it possible to deal with its causes, such as physical therapy, and the ability to work. There are many categories and types of drugs for pain. Choose them according to the strength of symptoms, duration, location and possible side effects.

Anti-inflammatory agents

The first means to which people usually resort is sold without a prescription non-hormonal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. They are considered the easiest analgesics, and usually they try first. Acetaminophen, although not related to the NSAIDs are also widely analgesic for pain in the back.

There are NSAIDs that are sold by prescription, such as celecoxib, diclofenac Diclofenac - relieve inflammation and pain , Nabumetone and meloxicam.

Although it is soft enough money, they can have side effects - especially if you take high doses for a long time. This may be a problem with the digestive tract, ulcers and kidney damage, and acetaminophen can adversely affect the liver.

You can also use anti-inflammatory agent in the form of a topical cream, putting it on the sore spot. Although potentially have the same side effects, the risk is generally lower because the drug does not interact with the whole organism.

Other topical agents may contain components such as capsaicin, camphor, menthol, and eucalyptus oil

Muscle relaxants

If the painkillers do not help, your doctor may suggest that you relaxants - means to relax the muscles.

These may be substances such as cyclobenzaprine, tizanidine, baclofen, carisoprodol, and so on. These tools help fight muscle spasms that cause back pain.

Muscle relaxants can be particularly useful in traumatic pain. For example, carisoprodol considerably reduces the pain and improves the functioning of the three days of treatment.

Most of these funds have side effects, the most common - drowsiness. If you have not received these funds, you should not drive a car and perform other tasks related to the high concentration.

Opioids

For some patients, NSAIDs and muscle relaxants are not sufficiently effective. People with chronic back pain, especially after surgery, sometimes prescribe opioids. These compounds act on nerve cells in the brain to relieve pain. There weaker drugs such as Vicodin (acetaminophen and hydrocodone) and Tylenol with codeine, but is more powerful, such as morphine.

Common side effects include drowsiness, constipation, the risk of addiction, allergies.

There weaker stage between NSAIDs and narcotics. Tramadol also affects the opioid receptors in the brain, but it is weaker than morphine or hydrocodone therefore not considered addictive substance.

But sometimes, in the most severe cases, drugs are needed. However, to avoid prolonged use, because, in addition to the side effects they cause and increased pain.

Corticosteroids

As anti-inflammatory agents, corticosteroids reduce inflammation and pain. They can take a pill or by injection.

Steroids - the strongest anti-inflammatory drugs. A short course of steroids prescribed if NSAIDs and muscle relaxants do not help. This can help overcome inflammation, until it has become chronic.

Often prescribed high-dose methylprednisolone, followed by several smaller doses for five or six days.

Corticosteroids may also be administered in spinal ganglia or in the joints to prevent the development of arthritis. This is the most targeted use of medicines, which reduces the likelihood of side effects.

Side effects of steroids include excessive bone loss, weight gain, and the problems with blood sugar Blood sugar - a very important indicator .

Adjuvant therapy

Why back pain prescribe antidepressants or medication for seizures? Because they can be effective for treating a particular kind of pain caused by nerve problems.

Some antidepressants such as duloxetine and means of epilepsy, such as pregabalin or gabapentin, can be useful for nervous symptoms. Other antidepressants, such as amitriptyline or nortriptyline, may prescribe for chronic back pain. If back pain is due to nerve entrapment (in such cases, the pain is often passed up, as well as numbness), one of these tools can be effective.

These drugs are similar side effects. The most common ones are: headache, nausea, constipation, diarrhea, insomnia, sexual side effects, fatigue.

Be sure to call your doctor if you have any serious side effects, such as allergic reaction (itching, rash, swelling), changes in heart rate, convulsions, hallucinations, aggression, mood swings Mood swings in women - bad character or a disease? , Suicidal thoughts Suicide in terms of the psychiatrist - can it be prevented? .

Regardless of what medicines you are taking pain in the back, they should not be your only way to ease the pain. It is also important to apply physical therapy, especially pain have not become chronic. Be sure to consult with your doctor.