Buying Voltaren Online

Dosing and Administration

The tablets should be swallowed whole with some liquid, preferably before meals.The dose should be adjusted individually. Side effects can be minimized by using the lowest effective dose for the minimum period necessary to control symptoms (see. Precautions).

For adults, the recommended initial daily dose is 100-150 mg. In mild cases, as when long-term therapy is generally sufficient destination 75- 100 mg. The total daily dose for adults is usually divided into 2-3 doses. If necessary to facilitate nocturnal pain and morning stiffness, in addition to receiving the drug prescribed Voltaren day in the form of rectal suppository before bedtime. The daily dose should not exceed 150 mg.

In primary dysmenorrhoea the daily dose picked individually and as a whole it is 50-150 mg. The initial dose may be 50-100 mg, but if necessary, it can be within several menstrual cycles increase, but not more than 200 mg / day. Use of the drug should be started as soon as possible after the first symptoms of pain; the duration of treatment, depending on the symptoms, up to several days.

Children drug can be recommended from 0.5 to 2 mg / kg of body weight per day depending on the severity of symptoms; this dose is distributed into 2-3 doses. In the treatment of juvenile rheumatoid arthritis daily dose may be increased to a maximum daily dose - 3 mg / kg. Do not exceed the maximum daily dose - 150 mg.Elderly patients (65 years and older). For this group of patients starting dose correction is not required.

Patients with congestive heart failure (NYHA-I) or significant cardiovascular risk factors. In patients with congestive heart failure (NYHA-I) or significant risk factors for cardiovascular effects of diclofenac may be used only after careful evaluation and with prodolzhitedyyusti-herayii. more ..... 4 weeks - only at doses <100 mg per day (see PRECAUTIONS.).

Patients with impaired renal function. Voltaren is contraindicated in patients with renal impairment (See Contraindications.). As special studies in patients with impaired renal function have not been conducted, specific recommendations for dose adjustment can not be given. We recommend caution when using Voltaren in patients with mild and moderate renal impairment (see. Precautions).Patients with impaired liver function.

Voltaren is contraindicated in patients with hepatic impairment (See Contraindications.). As special studies in patients with hepatic impairment have not been conducted, specific recommendations for dose adjustment can not be given. We recommend caution when using Voltaren in patients with mild to moderate hepatic impairment (see. Precautions).

Overdose

The typical clinical picture, characteristic of an overdose of diclofenac does not exist. Overdose may be accompanied by symptoms such as vomiting, gastrointestinal haemorrhage, diarrhea, dizziness, tinnitus or convulsions. In the case of pronounced poisoning may develop acute renal failure and liver damage.

Treatment. NSAIDs acute poisoning treatment consists of applying a supportive and symptomatic therapy. Supportive and symptomatic treatment is indicated for complications such as hypotension, renal failure, convulsions, disorders of the gastrointestinal tract, and respiratory depression. It is unlikely that forced diuresis, hemodialysis or hemoperfusion would be useful for the removal of NSAIDs, as active ingredients of these drugs largely bound to plasma proteins and lend themselves to intensive metabolism.

Possible administration of activated charcoal with a potentially toxic overdose, and gastric decontamination conduct (vomiting, gastric lavage) for potentially life-threatening overdose.

Precautionary measures

Upon receipt of all the NSAIDs are possible gastrointestinal bleeding, ulceration and perforation which can be fatal, and marked during the treatment period on the background of the warning signs, or in their absence, or in patients with severe gastro-intestinal diseases in history. In general, these phenomena are most dangerous to the elderly. In some cases, when patients receiving Voltaren, are developing these complications, it is necessary to cancel the drug. While receiving the drug Voltaren necessary medical monitoring of patients who have gastrointestinal disease or ulcerative lesions of the stomach or intestines to the history of ulcerative colitis or Crohn's disease.

The risk of gastrointestinal bleeding increases with increasing doses of NSAIDs, as well as in patients with an ulcer history, especially if the disease was complicated by hemorrhage or perforation or occurred in the elderly. To reduce the risk of toxic effects on the gastrointestinal tract in patients with ulcer history, in particular, complicated by bleeding and perforation, as well as in elderly patients, treatment should be started with the lowest effective dose and stick to it in the future.

In the above patients and patients requiring concomitant use of drugs containing low doses of aspirin or other drugs that may increase the risk of adverse reactions in the gastrointestinal tract, should consider the desirability of combined therapy in combination with protective agents (e.g., inhibitors of proton pump or misoprostol).Patients who receive concomitant treatment with systemic corticosteroids, anticoagulants, antiplatelet agents or selective serotonin reuptake inhibitors, it is advisable to be careful.

Clinical trials and epidemiological data strongly suggest the presence of an increased risk of arterial thrombotic events (such as myocardial infarction or stroke) which can be associated with the use of diclofenac, particularly when used in high doses (150 mg daily) and long-term use.

Patients with significant risk factors for cardiovascular events (eg hypertension, hyperlipidemia, diabetes mellitus, smoking) should only prescribe diclofenac after tshatePio ^ w ^ ^ rMShd ёniya- this possibility.

Because of the possible increased risk of cardiovascular events with long-term use or high doses of the drug should be administered to patients in the diclofenac and the lowest effective dose take it the shortest time necessary to reduce the severity of symptoms. You should periodically reassess the need for the relief of symptoms and response to treatment.

In patients with congestive heart failure (NYHA-I) or significant risk factors for cardiovascular events (. Eg, hypertension, hyperlipidemia, diabetes mellitus, smoking), diclofenac may be used only after careful evaluation and with the duration of therapy for more than 4 weeks - only at doses <100 mg per day.

Patients should be alert to signs and symptoms of severe arteriotromboticheskih effects (eg, chest pain, shortness of breath, weakness, slurred speech), which may arise suddenly. Patients should be instructed on the need for an immediate visit to a doctor in such cases.