Diclofenac is an effective non-hormonal anti-inflammatory drug that is actively used in neurology, rheumatology and traumatology.
Has a large selection of dosage forms. We will discuss further what Diclofenac gel and ointment are used for.
Composition and features
Diclofenac is available in several dosage forms. Apply ointment or gel externally.
The substance is diclofenac sodium, its concentration in the ointment is 10 or 20 mg per 1 g, in the gel - 10 or 50 mg per 1 g. Accordingly, the gel can be 1 or 5 percent, and the ointment 1 or 2 percent.
The auxiliary components in the gel are alcohol, propylene glycol, lavender oil, purified water and hyaetellose. The ointment additionally contains propylene glycol, dimethyl sulfoxide and macrogol.
The gel is a homogeneous transparent substance with a slight yellow tint or no color, there is a specific odor, the base is water.
The basic component of the ointment is fat; it has a thicker consistency. Therefore, it is better to use a gel for joints and deep layers of the epidermis. It spreads more easily and dries faster, does not leave stains on clothes and creates a protective film on the skin.
If the skin at the site of application is irritated and prone to peeling, then it is better to use ointment, as it additionally softens and moisturizes the skin at the site of application.
pharmachologic effect
Diclofenac is a representative of the group of non-steroidal anti-inflammatory drugs.
Reduces the production of arachidonic acid and disrupts the synthesis of prostaglandins, therefore it has a triple effect:
- relieves inflammation;
- relieves pain;
- reduces high temperature.
When used externally, it reduces pain in joints both at rest and during movement, relieves swelling and stiffness in the morning, and allows you to increase physical activity.
Diclofenac solution for injection: does it need to be diluted?
According to the instructions, Diclofenac solution for injection is a completely finished drug that does not need to be diluted before injection into the muscle. For severe pain, the doctor may recommend adding 1 ml of 2% Lidocaine to 3 ml of the drug.
If intravenous injections are prescribed, then dilution is strictly necessary. For one ampoule of the drug, take 100-500 ml of saline solution or 5% glucose. Add 1 ml of 4.2% sodium bicarbonate to the dropper to neutralize the acidity of the solution.
How long does it take for Diclofenac to be removed from the body in injections?
After administering 75 mg of Diclofenac in injections, it is eliminated from the body in 4-6 hours from the blood, and it can remain in the joint cavity for up to 8-10 hours.
How long does it take for it to start working?
Diclofenac infection acts quickly, you can expect pain relief to begin within 8-10 minutes, and maximum pain relief occurs by 20 minutes. The injection allows you to relieve moderate and intense pain already in the first day, but for the anti-inflammatory effect of the drug to manifest itself, it takes at least 3 days.
Mechanism of action of Diclofenac
How long does it last?
One injection of the medication lasts for at least 6 hours, but for many patients, administering an ampoule for a day is enough.
Indications for use
Diclofenac ointment and gel are prescribed for the following pathologies of bones and muscles:
- inflammatory and degenerative diseases of articular joints (osteochondrosis, radiculitis, arthrosis, arthritis, including ankylosing spondylitis);
- bruises as a result of injuries;
- rheumatic fever and inflammatory swelling of soft tissues (tenosynovitis, bursitis);
- sprains of tendons, muscles and ligaments, accompanied by an inflammatory response;
- myalgia and arthralgia provoked by heavy physical exertion.
The remedy is intended to eliminate negative symptoms, but does not affect the progression of the disease.
Why is Diclofenac injection dangerous?
The danger of Diclofenac injections is manifested in the risk of complications:
- local - suppuration, abscess of the buttock, destruction (necrosis) of tissue;
- allergic reactions - from rash to bronchospasm, suffocation, rapid development of swelling of the face and respiratory tract;
- irritation of the mucous membrane of the stomach and intestines, development of inflammation, ulcerative defect, bleeding;
- deterioration of the kidneys and liver;
- swelling and increased blood pressure;
- changes in blood clotting - a tendency to bleeding, but there is also a possibility of thrombosis with the development of a heart attack or stroke.
Diclofenac should not be injected in the 3rd trimester of pregnancy, as the risk of bleeding, weakness of labor, and heart defects in the child increases.
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How to use Diclofenac ointment
According to the instructions for use of Diclofenac ointment, the product in a volume of 2-4 g is distributed over the skin at the site of pain, using a slight rubbing motion. It is allowed to use the ointment 2-3 times a day, but the maximum dose should not exceed 8 g.
Children 6-12 years old are allowed to use the ointment no more than twice a day. When determining it, take into account the fact of simultaneous use of diclofenac drugs in other dosage forms (for example, tablets or suppositories).
Duration of therapy is up to 14 days.
How to inject Diclofenac correctly, dosage
Diclofenac can be injected into a muscle (usually the gluteal muscle) or into a vein. The dosage for an adult at one time is 75 mg (3 ml), the drug is administered to children only from 12 years of age at the same dose. The maximum amount of medication per day is 150 mg, so you can inject only 2 ampoules, but with an interval between injections of several hours (at least 6). To enhance the effect of Diclofenac for pain due to osteochondrosis, it is combined with vitamins or agents that reduce muscle tension.
For neck pain
Diclofenac for neck pain is usually administered intramuscularly 3 ml (75 mg) once a day. This helps increase the range of motion in the cervical spine. If one injection is not enough, then after 8-12 hours you can add the drug in one of the following options:
- one more injection;
- 50 mg tablet orally;
- suppository 50 mg orally;
- rubbing with 5% Diclofenac gel.
Injections of the medication are carried out for 2-3 days. If the pain does not subside, then to continue treatment, the patient’s injections are canceled and tablets or suppositories are prescribed in a daily dose of no more than 150 mg. They can also be combined with the application of gel and ointment.
For pain in the lower back, back
Pain in the lower back and back is relieved with 1 injection of Diclofenac, but in case of severe pain, the dosage can be doubled. In this case, the second injection is carried out after 6-8 hours and always in the other gluteal muscle.
For elderly patients, it is best to use the minimum dose of 75 mg, that is, one ampoule is administered per day. To facilitate movements, apply a gel or ointment topically 2-3 times a day. After 2-3 days of injections, it is recommended to switch to external forms of the drug or combine them with tablets and suppositories.
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For osteochondrosis
The use of Diclofenac injections is indicated only for moderate and severe pain due to osteochondrosis. One or maximum two ampoules are used per 24 hours and no more than 3 days. As soon as the acute attack is over and movement is possible, the injections are canceled.
If there are diseases of the kidneys, liver, stomach or intestines (even without an exacerbation), 1 injection of the drug and external agents are prescribed. The Diclofenac medicinal patch has good effectiveness. It can be applied from the very first day of injections.
In gynecology
Diclofenac injections in gynecology are prescribed for intense pain due to menstruation (algodismenorrhea), inflammation of the ovaries (oophoritis), and uterine appendages (adnexitis). A severe attack of pain can be relieved by administering an injection and a suppository (into the rectum) of 50 or 100 mg. This scheme is used for no more than 1 day. In the future, in case of female diseases, they most often switch to suppositories.
If the drug is prescribed after surgery (for example, removal of fibroids), then intravenous injections are acceptable. In this case, 75 mg (one ampoule) is dissolved in 100-500 ml of saline and administered very slowly (over 0.5-2 hours), if necessary, a second dropper is placed after 6 hours.
What to inject with in combination
Diclofenac can be injected in combination with drugs that reduce muscle tone - Mydocalm, Tolperisone. They are indicated for muscle tension and stiffness of movement due to acute pain, pinched nerve due to osteochondrosis. Administer 1 ampoule of one of the drugs at intervals of 6-8 hours after Diclofenac.
For joint diseases of a rheumatic nature, rheumatoid arthritis, hormones are prescribed to enhance the anti-inflammatory effect. For injection, take 3 ml of Diclofenac and 1 ml of Dexamethasone. This mixture is administered only under the supervision of a doctor; in orthopedics it is also used for therapeutic blockades (intra-articular or paravertebral injections).
Mydocalm Dexamethasone Alflutop
When the articular surface is destroyed in patients with arthrosis, chondroprotectors are used - Alflutop, Rumalon. They are administered in courses of 1-2 ml per day for 15-30 days.
If Diclofenac is prescribed to relieve an attack of renal or hepatic colic, then it is advisable to add injections of antispasmodics - No-shpa, Papaverine 2-4 ml.
Tramal Nalbufin No-shpa
Severe postoperative, post-traumatic pain may require the administration of centrally acting painkillers (Tramal, Nalbuphine) 1 ml intramuscularly. They are used only in stationary conditions, as their properties are similar to narcotic ones.
How to use Diclofenac gel
Instructions for use of Diclofenac gel contain detailed information on doses and methods of use of the medicine.
The gel is used only externally in adults and children over 12 years of age according to indications. Apply to the site of inflammation with light rubbing movements 2 or 3 times a day. For one application, 2 g of the drug is enough, which corresponds to a strip of 4 cm.
The maximum permissible dose per day is no more than 6 g. Duration of therapy is no more than two weeks, longer periods are possible in agreement with the attending physician. Be sure to wash your hands after using Diclofenac.
Diclofenac injections: how to do and where
Diclofenac injections are given intramuscularly (in the buttock) and into a vein (dropper). The main rule for self-administration is maintaining sterility. It is also necessary to immerse the needle deeply and select the correct injection site.
How to inject intramuscularly into the buttock
When injecting Diclofenac into the buttock, you must first find the upper outer quadrant. To do this, the first time it is best to draw two stripes on the skin with iodine - the first divides the buttock in half vertically, and the second horizontally. The injection site should be the part closest to the lower back and side surface. The injection area should not be hard or painful.
Sequence of use of Diclofenac ampoule solution:
- Open the ampoule.
- Draw up all the contents into a 5 ml syringe.
- Release excess air.
- Wipe the injection site with an alcohol swab.
- With a confident and quick movement, pierce the skin so that the syringe is at an angle of 90 degrees and the needle enters 3/4 of the soft tissue.
- Release the solution from the syringe very slowly.
- Remove the needle and cover the injection area with an alcohol swab.
Is it possible to keep up?
Diclofenac can be injected into the leg, but this method can be more painful, since the skin of the thigh contains more nerve fibers and blood vessels. To inject the drug you need:
- Sit on a chair with your leg bent at a 90-degree angle and firmly on the floor.
- Choose a place on the outer lateral surface of the thigh approximately in the middle.
- Wipe the injection area with alcohol.
- Quickly pierce the skin and insert the needle 2 cm.
- Slowly release the solution into the muscle.
- Remove the needle and apply pressure to the injection site with an alcohol swab.
At the next injection, be sure to change sides - the injection is given in the other thigh.
Shoulder injection
Diclofenac is not recommended for injection into the shoulder because:
- compaction and suppuration often occur in this area;
- the accumulation of the drug slowly resolves;
- the injection is very painful.
In exceptional cases, the injection is carried out by a specialist, since it is impossible to perform it correctly on your own. The injection site is chosen at the border of the upper and middle third along the outer surface.
How to inject yourself, dosage
If you have to inject Diclofenac yourself, it is important to adhere to the basic rules of injection:
- dosage for 1 time – 3 ml (75 mg), in case of severe pain, a second injection is allowed after 6-8 hours;
- deep intramuscularly;
- in compliance with sterility - wash your hands with soap, put on sterile gloves, do not touch anything with the needle after drawing the solution;
- If pain and/or hardening occurs, an iodine mesh is applied.
Self-administering Diclofenac is dangerous, as even injections administered by trained nurses can lead to thickening, long-term pain and numbness in the leg.
How to inject - slowly or quickly
Diclofenac is always administered as slowly as possible. This helps it gradually spread through the soft tissues and more quickly absorb the injected substance. For intramuscular injections, to slowly deliver the drug, gently press the piston.
How to open an ampoule
To open an ampoule of Diclofenac with a dot, you need to take it in your left hand (with the dot facing you), and in your right hand - a sterile napkin or cotton pad moistened with alcohol. Cover the tip of the ampoule with an alcohol wipe on top and break it off with a movement away from you. If there is a ring painted on the ampoule, then open it in the same way, but it does not matter which side it is facing.
Opening an ampoule of Diclofenac with a notch
It is extremely rare to find ampoules without a dot and a ring; to open them you need a special file. It is usually included in the package, but if you don’t have it, a stationery knife or metal nail file will do. One of these devices needs to apply a notch using progressive, sawing movements. Then the ampoule is taken with this line towards you and the tip is broken off, as in cases of marking.
What happens if you administer it intravenously?
Diclofenac is also suitable for intravenous administration, but it must be dissolved in 100 ml of saline solution. The drip is placed for at least half an hour. The concentrated drug can cause inflammation of the venous wall.
Watch this video for instructions on how to use Diclofenac injection solution:
Can the product be used by pregnant women and children?
Pregnancy, especially the third trimester, is a contraindication to the use of Diclofenac. If treatment with the drug is necessary in the first half of pregnancy, the doctor is obliged to evaluate all the negative consequences for the fetus and the expected benefits for the woman.
The ability of the drug to pass into breast milk has not been studied, so treatment is not advisable during breastfeeding. If there are serious reasons to use a gel or ointment during lactation, do not apply the substance to large areas of the skin and do not treat it for a long time.
In pediatric practice, it is used in the treatment of children only from 12 years of age.
Contraindications and side effects
According to the instructions for Diclofenac ointment, treatment with the drug is contraindicated for:
- high sensitivity to the constituent substances, aspirin or other non-steroidal anti-inflammatory drugs;
- complete or incomplete combination of bronchial asthma with recurrent polyposis of the nose and paranasal sinuses, angioedema or urticaria;
- late pregnancy and lactation;
- treatment of children under 6 years of age;
- open wound surfaces on the skin at the site of application.
Contraindications also apply to the use of the gel, which is prohibited in the treatment of children under 12 years of age.
The drug is prescribed with caution in the early stages of pregnancy, for erosions and ulcers of the stomach and intestines, for chronic dysfunction of the heart and bronchial asthma, severe dysfunction of the liver and kidneys, with a tendency to bleeding, in the treatment of elderly patients.
When applied topically, undesirable reactions may occur:
- rash, burning and redness at the application site;
- urticaria and angioedema with hypersensitivity to the components of the drug;
- with prolonged use, in rare cases, the development of bronchial asthma is possible.
How many days can you take Diclofenac injections?
Diclofenac can be injected for 2-3 days; if you need to continue treatment, then instead of injections, tablets, suppositories, and external forms are prescribed.
How often, how many times a day
Ampoules with a solution of the drug are administered once a day; in case of severe pain, another injection is allowed. It is imperative that time pass between injections; it is allowed to inject a second time no earlier than after 6 hours. The best option is two-time administration with an interval of 12 hours.
Injections of the drug are usually used for intense pain or an attack of acute pain. It is best to inject it for 2 days in a row, and then switch to suppositories or tablets, but it is also possible to carry out 2-3 injections every other day.
How many injections can you give per course?
During the course of treatment, you can give no more than three injections of Diclofenac. If the pain persists, then internal dosage forms (tablets, capsules) and rectal suppositories (into the rectum) are subsequently used. They differ from injections only in the speed of pain relief, so there is no point in using injections after acute pain has been eliminated.
How many times a year can you
Diclofenac can be used 3-4 times a year. This applies to those patients who have no restrictions on the use of the drug (diseases of the stomach, intestines, liver, kidneys, blood vessels, allergic reactions). There should be no adverse reactions after the course.
It is very important to understand that the drug does not have any therapeutic effect; it has an analgesic effect only at the time of injections or taking tablets, or administering suppositories. If a chronic disease is not treated, then all the symptoms will return, and with a long course or frequent use, the condition of the digestive organs worsens, and there is a risk of complications.
