Indications

Rheumatology: Effective for inflammatory and degenerative rheumatism, including chronic polyarthritis, ankylosing spondylitis, osteoarthritis, and acute gout. Also addresses peri-articular rheumatic disorders.
Surgery and Traumatology: Provides relief for sprains, bruises, dislocations, fractures, soft tissue injuries, and post-surgical recovery.
Obstetrics and Gynecology: Treats primary dysmenorrhea, episiotomy recovery, adnexitis, endometritis, parametritis, salpingitis, and mastitis.
Otorhinolaryngology: Used pre-operatively to manage pain, inflammation, and swelling.
Dentistry: Reduces post-operative and post-traumatic pain, inflammation, and swelling.
Other Uses: Manages pain and inflammation in urogenital tract surgeries and renal or biliary colic.

Pharmacology

Voligel Max contains Diclofenac Sodium, a powerful NSAID known for its anti-rheumatic, anti-inflammatory, analgesic, and antipyretic effects. It works by inhibiting prostaglandin synthesis, which reduces inflammation, pain, and fever. Diclofenac is rapidly absorbed, reaching peak plasma levels within 2 hours and is highly protein-bound. It undergoes first-pass metabolism in the liver.

Dosage & Administration

Diclofenac FC Tablet: Adults: 75-150 mg daily in 2-3 doses after food. Reduce dose for long-term use.
Diclofenac SR Tablet: Adults: 1 tablet daily with liquid at mealtimes; may increase to 150 mg. Children: 1-3 mg/kg body weight daily.
Diclofenac Dispersible Tablet: Adults: 2-3 tablets daily, up to 150 mg. Children: Not generally recommended except for juvenile rheumatoid arthritis (1-3 mg/kg body weight). Dissolve in water before swallowing.
Diclofenac TR Capsule: 1 capsule daily, preferably after meals.
Diclofenac Suppository: Adults: 50 mg, 2-3 times daily, up to 150 mg.
Diclofenac Injection: 1 ampoule daily, may increase to 2 in severe cases.
Diclofenac Gel: Apply 2-4 g to affected areas 3-4 times daily. Rub in lightly; can be used alongside other Diclofenac forms.

Interaction

Lithium & Digoxin: May increase plasma levels.
Anticoagulants: Possible increased bleeding risk; monitor closely.
Antidiabetic Agents: No significant interaction reported.
Cyclosporin: Caution advised due to risk of nephrotoxicity.
Methotrexate: Avoid concurrent use due to toxicity risk.
Quinolone Antimicrobials: Potential for convulsions; use with caution.
Other NSAIDs & Steroids: May increase side effects.

Contraindications

Hypersensitivity to Diclofenac or any ingredients.
Not suitable for individuals with a history of peptic ulcer, cutaneous epithelioma, or asthma exacerbated by NSAIDs.

Side Effects

Mild, transient side effects such as epigastric pain, nausea, diarrhea, dizziness, or headache. Possible skin reactions include rash, eczema, and irritation from the gel.

Pregnancy & Lactation

Use during pregnancy only if absolutely necessary; avoid during the first trimester. Diclofenac Sodium Gel is not recommended during pregnancy. Minimal Diclofenac may be present in breast milk, with no expected adverse effects on infants.

Precautions & Warnings

Monitor for peptic ulceration or gastrointestinal bleeding. Avoid contact with eyes or mucous membranes; wash hands after application. Not to be ingested.