Voligel

Indications

• Rheumatology: For inflammatory and degenerative rheumatic conditions such as polyarthritis, ankylosing spondylitis, osteoarthritis, and acute gout.
• Surgery and Traumatology: Used for managing pain and inflammation from sprains, bruises, dislocations, fractures, and soft tissue injuries.
• Obstetrics and Gynecology: Effective for primary dysmenorrhea, episiotomy, adnexitis, endometritis, parametritis, salpingitis, and mastitis.
• Otorhinolaryngology: Administered pre-operatively to prevent pain, inflammation, and swelling.
• Dentistry: Alleviates post-operative and post-traumatic pain, inflammation, and swelling.
• Other Uses: For pain prevention and treatment of inflammation in urogenital surgeries and renal and biliary colic.

Pharmacology

Cinarex contains Diclofenac Sodium, a potent NSAID with anti-rheumatic, anti-inflammatory, analgesic, and antipyretic properties. It inhibits prostaglandin synthesis, reducing inflammation, pain, and fever. Diclofenac is well-absorbed from the gastrointestinal tract, reaching peak plasma levels in about 2 hours. It is extensively bound to plasma proteins and metabolized in the liver.

Dosage & Administration

• Diclofenac FC Tablets: 75-150 mg daily, divided into 2-3 doses after meals.
• Diclofenac SR Tablets: 1 tablet daily, with an option to increase to 150 mg by adding conventional tablets. For children, 1-3 mg/kg body weight daily.
• Diclofenac Dispersible Tablets: 2-3 tablets daily, maximum 150 mg. Dissolve in water before ingestion. Not recommended for children except juvenile rheumatoid arthritis.
• Diclofenac TR Capsules: 1 capsule daily, preferably after meals.
• Diclofenac Suppositories: 50 mg, 2-3 times daily. Maximum daily dose is 150 mg.
• Diclofenac Injection: 1 ampoule daily, increasing to 2 ampoules for severe cases.
• Diclofenac Gel: Apply 2-4 g to the affected area 3-4 times daily. Rub in lightly. Can be used alongside other Diclofenac forms.

Interactions

• Lithium and Digoxin: May increase plasma levels.
• Anticoagulants: Risk of bleeding; no significant effect on anticoagulant activity.
• Cyclosporin: Risk of nephrotoxicity when used together.
• Methotrexate: Potential for serious toxicity if used within 24 hours of NSAIDs.
• Quinolone Antimicrobials: Risk of convulsions; caution advised.
• Other NSAIDs and Steroids: Increased risk of side effects; may lower plasma levels of each.

Contraindications

• Contraindicated for individuals allergic to Diclofenac or any component of the formulation.
• Avoid use in patients with peptic ulcers or asthma attacks triggered by NSAIDs.

Side Effects

• Common: Mild epigastric pain, nausea, diarrhea, dizziness, headache, peripheral edema, and skin reactions such as rash and eczema.
• Diclofenac Gel: May cause local irritation, redness, and rash.

Pregnancy & Lactation

• Pregnancy: Use only if necessary and with caution. Not recommended during the first trimester. Minimal Diclofenac detected in breast milk; generally considered safe for breastfeeding.

Precautions & Warnings

• Peptic Ulcers: Monitor for gastrointestinal bleeding.
• Application: Avoid contact with eyes and mucous membranes. Wash hands thoroughly after application.

Therapeutic Class

• NSAIDs: Drugs for Osteoarthritis, Rheumatoid Arthritis, and Non-steroidal Anti-inflammatory Drugs (NSAIDs).

Storage Conditions

Store in a cool, dry place below 30°C, protected from light. Keep out of reach of children.