Sewerage and drainpipes portal / Pipes / Dexalgin injections from what. Dexalgin: instructions for use

Dexalgin injections from what. Dexalgin: instructions for use

05.12.2020

Anti-inflammatory drug Dexalgin inject, has an analgesic, anti-inflammatory and antipyretic effect, is used to relieve pain of various origins. The analgesic effect occurs 30 minutes after parenteral administration. The duration of the analgesic effect after administration at a dose of 50 mg is 4-8 hours. When combined therapy with opioid analgesics dexketoprofen, trometamol significantly (up to 30-45%) reduces the need for opioids.

Indications for use

Indications for the use of the drug Dexalgin injectare: relief of pain syndrome of various origins (including postoperative pain, pain in bone metastases, post-traumatic pain, pain in renal colic, algodismenorrhea, sciatica, sciatica, neuralgia, toothache); symptomatic treatment of acute and chronic inflammatory, inflammatory-degenerative and metabolic diseases of the musculoskeletal system (including rheumatoid arthritis, spondyloarthritis, arthrosis, osteochondrosis).

Mode of application

Dexalgin injectintended for intravenous and intramuscular administration. Recommended dose for adults: 50 mg every 8-12 hours. If necessary, the drug may be re-administered at 6-hour intervals. The daily dose is 150 mg. In elderly patients and patients with impaired liver and / or kidney function, therapy with Dexalgin should be started with lower doses; the daily dose is 50 mg. Dexalgin is intended for short-term (no more than 2 days) use during the period of acute pain syndrome. In the future, it is possible to transfer the patient to analgesics for oral administration.
Rules for the preparation and administration of solutions:
The contents of one ampoule (2 ml) are slowly injected deep into the / m.
The contents of one ampoule (2 ml) are administered by slow intravenous injection for at least 15 seconds.
The contents of one ampoule (2 ml) are diluted in 30-100 ml of physiological solution, glucose solution or Ringer's solution (lactate). The solution should be prepared under aseptic conditions and always protected from exposure to daylight. The diluted solution (should be clear) is administered by slow intravenous infusion for 10-30 minutes.

Side effects

From side effects from the use of the drug Dexalgin injectmay occur from the hematopoietic system: rarely - anemia; very rarely - neutropenia, thrombocytopenia.
From the side of the central nervous system: infrequently - headache, dizziness, insomnia, drowsiness; rarely - paresthesia.
From the senses: infrequently - blurred vision; rarely - tinnitus.
From the side of the cardiovascular system: infrequently - arterial hypotension, a feeling of heat, hyperemia of the skin; rarely - extrasystole, tachycardia, arterial hypertension, peripheral edema, superficial thrombophlebitis.
From the respiratory system: rarely - bradypnea; very rarely - bronchospasm, dyspnea.
From the digestive system: often - nausea, vomiting; infrequently - abdominal pain, dyspepsia, diarrhea, constipation, hematemesis, dry mouth; rarely - erosive and ulcerative lesions of the digestive tract, including bleeding and perforation, anorexia, increased activity of liver enzymes, jaundice; very rarely - damage to the pancreas, liver damage.
From the urinary system: rarely - polyuria, renal colic; very rarely - nephritis or nephrotic syndrome.
On the part of the reproductive system: rarely - in women - menstrual irregularities, in men - dysfunction of the prostate gland.
From the musculoskeletal system: rarely - muscle spasm, difficulty in movement in the joints.
Dermatological reactions: sometimes - dermatitis, rash, sweating; rarely - acne; very rarely - photosensitivity.
Allergic reactions: rarely - urticaria; very rarely - severe skin reactions (Stevens-Johnson syndrome, Lyell's syndrome), angioedema, allergic dermatitis.
From the side of metabolism: rarely - hyperglycemia, hypoglycemia, hypertriglyceridemia.
On the part of laboratory parameters: rarely - ketonuria, proteinuria.
Local and general reactions: often - pain at the injection site; infrequently - an inflammatory reaction, hematoma, hemorrhages at the injection site, a feeling of heat, chills, fatigue; rarely - back pain, fainting, fever; very rarely - anaphylactic shock, facial edema.
Others: aseptic meningitis, which occurs mainly in patients with systemic lupus erythematosus or mixed connective tissue diseases, hematological disorders (purpura, aplastic and hemolytic anemia, rarely - agranulocytosis and bone marrow hypoplasia).

Contraindications

:
Contraindications to the use of the drug Dexalgin injectare: peptic ulcer of the stomach and duodenum; a history of gastrointestinal bleeding, other active bleeding (including suspected intracranial bleeding), anticoagulant therapy; gastrointestinal diseases (Crohn's disease, ulcerative colitis); severe liver dysfunction (10-15 points on the Child-Pugh scale); severe renal dysfunction (CC< 50 мл/мин); бронхиальная астма (в т.ч. в анамнезе); тяжелая сердечная недостаточность; лечение болевого синдрома при аортокоронарном шунтировании; геморрагический диатез или другие нарушения коагуляции; детский возраст; повышенная чувствительность к декскетопрофену или другим НПВП или к любому из вспомогательных веществ, входящих в состав препарата.
Contraindicated for epidural, intrathecal or intrathecal administration due to the ethanol contained in the drug.
The drug should be used with caution in case of a history of allergic conditions; violations of the hematopoietic system; with SLE or mixed connective tissue diseases; concurrently with other medications; in case of a predisposition to hypovolemia; with ischemic heart disease; in elderly patients (over 65 years old).

Pregnancy

:
Application of the drug Dexalgin inject during pregnancy and lactation is contraindicated.

Interaction with other medicinal products

The following drug interactions are typical for all NSAIDs, including Dexalgin.
Undesirable combinations:
The simultaneous appointment of several NSAIDs, including salicylates in high doses (more than 3 g / day) increases the risk of gastrointestinal bleeding and ulcers due to synergistic action. With simultaneous use with oral anticoagulants, heparin in doses exceeding prophylactic ones, and ticlopidine, the risk of bleeding increases due to inhibition of platelet aggregation and damage to the gastrointestinal mucosa. NSAIDs increase the concentration of lithium in the blood plasma, up to toxic, and therefore this indicator must be monitored when prescribing, changing the dose and after discontinuing NSAIDs. When used with methotrexate in high doses (15 mg / week and more), there is an increase in the hematological toxicity of methotrexate due to a decrease in its renal clearance during NSAID therapy. With simultaneous use with hydantoins and sulfanilamide drugs, there is a risk of increasing the toxic effect of these drugs.
Combinations requiring caution:
If it is necessary to use it simultaneously with diuretics, ACE inhibitors, it should be borne in mind that NSAID therapy is associated with the risk of developing acute renal failure in patients with dehydration (decreased glomerular filtration due to inhibition of prostaglandin synthesis).

NSAIDs can reduce the antihypertensive effect of some drugs. When administered simultaneously with diuretics, it is necessary to make sure that the patient's water balance is adequate, and to monitor renal function before prescribing NSAIDs. With simultaneous use with methotrexate in low doses (less than 15 mg / week), an increase in the hematological toxicity of methotrexate is possible due to a decrease in its renal clearance during NSAID therapy. It is necessary to monitor the number of blood cells weekly in the first weeks of simultaneous therapy. In the presence of impaired renal function, even in a mild degree, as well as in the elderly, careful medical supervision is necessary. With simultaneous use with pentoxifylline, the risk of bleeding increases. Intensive clinical monitoring and frequent monitoring of bleeding time (blood clotting time) is necessary. With simultaneous use with zidovudine, there is a risk of an increase in the toxic effect on erythrocytes due to exposure to reticulocytes, with the development of severe anemia a week after the appointment of NSAIDs. It is necessary to control all blood cells and reticulocytes after 1-2 weeks. after starting NSAID therapy. An increase in the hypoglycemic effect of sulfonylurea derivatives is possible due to its displacement from the sites of binding to plasma proteins under the influence of NSAIDs. With simultaneous use with drugs of low molecular weight heparin, the risk of bleeding increases.
Combinations to be taken into account:
NSAIDs can reduce the hypotensive effect of beta-blockers, which is due to inhibition of prostaglandin synthesis. When used simultaneously with cyclosporine and tacrolimus, NSAIDs can increase nephrotoxicity, which is mediated by the action of renal prostaglandins. During combination therapy, it is necessary to monitor renal function. When administered simultaneously with thrombolytics, the risk of bleeding increases. With simultaneous use with probenecid, an increase in plasma concentrations of NSAIDs is possible, which may be due to inhibition of renal secretion and / or conjugation with glucuronic acid. This requires dose adjustment of NSAIDs. NSAIDs can cause an increase in the concentration of cardiac glycosides in the blood plasma. Due to the theoretical risk of changes in the effectiveness of mifepristone under the influence of inhibitors of prostaglandin synthesis, NSAIDs should not be prescribed earlier than 8-12 days after discontinuation of mifepristone. The data obtained in experimental studies on animals indicate a high risk of developing convulsions when prescribing NSAIDs against the background of high-dose ciprofloxacin therapy. Dexalgin should not be mixed in the same syringe with a solution of dopamine, promethazine, pentazocine, pethidine or hydroxyzine (a precipitate is formed). Dexalgin can be mixed in one syringe with a solution of heparin, lidocaine, morphine and theophylline. A diluted solution of the drug Dexalgin for infusion should not be mixed with promethazine or pentazocine.
Diluted solution of the drug Dexalgin for infusion is compatible with the following solutions for injection: dopamine, heparin, hydroxyzine, lidocaine, morphine, pethidine and theophylline. When storing diluted solutions of Dexalgin for infusion in plastic containers or when using infusion systems made of ethyl vinyl acetate, cellulose propionate, low density polyethylene or polyvinyl chloride, the absorption of the active substance by the listed materials does not occur.

Overdose

:
Symptoms of a drug overdose Dexalgin inject: nausea, anorexia, abdominal pain, headache, dizziness, disorientation, insomnia.
Treatment: symptomatic therapy; if necessary, gastric lavage, dialysis.

Storage conditions

The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25 ° C. The shelf life is 5 years. Use only clear and colorless solutions.
After dilution, the solution is stored for 24 hours at a temperature of 2 ° to 8 ° C, protected from light.

Release form

The solution for i / v and i / m administration is transparent, colorless, with a characteristic odor of alcohol. 2 ml - dark glass ampoules (1) - plastic pallets (1) - cardboard packs.
2 ml - dark glass ampoules (5) - plastic pallets (1) - cardboard packs.
2 ml - dark glass ampoules (10) - plastic pallets (1) - cardboard packs.

Composition

:
1 ml - 1 ampoule contains:
dexketoprofen trometamol 36.9 mg 73.8 mg, which corresponds to the content of dexketoprofen 25 mg 50 mg.
Excipients: ethanol 96% - 200 mg, sodium chloride - 8 mg, sodium hydroxide - up to pH 7.4, water d / i - up to 2 ml.

main parameters

Name:	DEKSALGIN INJECT
ATX code:	M01AE17 -

| Dexalgin

Analogs (generics, synonyms)

Advil, Algezir Ultra, Apranax, Artrozilen, Artrum, Bonifen, Brufen, Brufen retard, Burana, Bystrumgel, Bystrumkaps, Deblok, Children's Motrin, Dolgit, Ibuprom, Ibuprom Max, Ibuprom Sprint Caps, Ibuprofen, Ibuprofen, Ibuppen, Ibuprofen , Ketonal, Ketonal Duo, Ketoprofen, Ketospray, MIG 200, MIG 400, Nalgezin, Nalgezin forte, Nalfon, Naprios, Naprobene, Naproxen, Nurofen, Nurofen for children, Nurofen forte, Nurofen Express, Oruvel, Pedestan, Pronaxen, Ronaxen Sanovel, Sanaprox, Solpaflex, Strepsils Intensive, Surgam, Faspik, Fastum, Fastum gel, Febrofid, Flamax forte, Flamax, Flexen, Flugalin

Recipe (international)

Rp .: Sol. Dexketoprofeni 0,05 - 2 ml
D.t.d .: No. 5 in amp.
S .: Intramuscularly.

Rp .: Tab. Dexketoprofeni 0.025
D.t.d .: No. 10
S .: Take 1 tablet 2 times a day.

pharmachologic effect

Dexalgin is a non-steroidal anti-inflammatory agent, an inhibitor of the cyclooxygenase system.
It has anti-inflammatory, analgesic and antipyretic effects. Dexalgin begins to act when taken orally within 30 minutes. The effect lasts 3-6 hours. Cmax for oral administration is observed after 30 minutes (on average, 15-60 minutes). The half-life and the time of distribution in the tissues of the body are 1.65 and 0.35 hours, respectively.
Binds to glucuronic acid. Eliminated by the kidneys. There is no accumulation in the tissues.

Mode of application

For adults: Tablets
Set individually. The average recommended single dose is 12.5 mg (1/2 tablet) 1 to 6 times a day every 4-6 hours as needed, or 25 mg (1 tablet) 1 to 3 times a day every 8 hours.
The maximum daily dose is 75 mg (6 tablets). In patients with impaired liver or kidney function, in the elderly, the drug should be taken in lower doses - no more than 50 mg per day. The drug is not intended for long-term use: the duration of administration should not exceed 3-5 days.
Ampoules
Dexalgin is intended for intravenous and intramuscular administration. Recommended dose for adults: 50 mg every 8-12 hours. If necessary, the drug may be re-administered at 6-hour intervals.
The daily dose is 150 mg. In elderly patients and patients with impaired liver and / or kidney function, therapy with Dexalgin should be started with lower doses; the daily dose is 50 mg. Dexalgin is intended for short-term (no more than 2 days) use during the period of acute pain syndrome. In the future, it is possible to transfer the patient to analgesics for oral administration.

Rules for the preparation and administration of solutions
The contents of one ampoule (2 ml) are slowly injected deep intramuscularly.
The contents of one ampoule (2 ml) are administered by slow intravenous injection for at least 15 seconds.
The contents of one ampoule (2 ml) are diluted in 30-100 ml of physiological solution, glucose solution or Ringer's solution (lactate).
The solution should be prepared under aseptic conditions and always protected from exposure to daylight. The diluted solution (should be clear) is administered by slow intravenous infusion for 10-30 minutes.

Indications

- relief of pain syndrome of various origins (including postoperative pain, pain in bone metastases, post-traumatic pain, pain in renal colic, algomenorrhea, sciatica, sciatica, neuralgia, toothache);

- symptomatic treatment of acute and chronic inflammatory, inflammatory-degenerative and metabolic diseases of the musculoskeletal system (including rheumatoid arthritis, spondyloarthritis, arthrosis, osteochondrosis).

Contraindications

Individual hypersensitivity to trometamol dexketoprofen, other components of the drug and other non-steroidal anti-inflammatory drugs;
... erosive and ulcerative diseases of the gastrointestinal tract;
... bronchial asthma;
... severe liver dysfunction;
... coagulopathy (hemorrhagic diathesis and others);
... severe (moderate) renal impairment;
... taking anticoagulants;
... childhood;
... severe heart failure.

Side effects

From the digestive system: heartburn, abdominal pain; rarely - erosive and ulcerative lesions of the gastrointestinal tract.

From the side of the central nervous system and peripheral nervous system: headaches, dizziness, nervousness, sleep disturbance, paresthesia.

From the side of the cardiovascular system: palpitations, increased blood pressure.

Allergic reactions: skin rash, bronchospasm.
Others: chills, swelling of the extremities, photosensitivity; rarely - a change in the picture of peripheral blood, renal dysfunction.

Release form

Dexalgin inject is a solution for injection or a concentrate for the preparation of an infusion solution. It is available in packs of 1, 5, 6, 10, 20, 50 or 100 colored glass ampoules (type 1 glass); one ampoule contains 2 ml of a clear, colorless solution. Not all package sizes may be on sale.

ATTENTION!

The information on the page you are viewing was created for informational purposes only and does not in any way promote self-medication. The resource is intended to familiarize healthcare professionals with additional information about certain medications, thereby increasing their level of professionalism. The use of the drug "" without fail provides for a consultation with a specialist, as well as his recommendations on the method of application and dosage of your chosen medicine.

Instructions for use

Active ingredients

Release form

Composition

1 ampoule (2 ml) contains: Active ingredient: Dexketoprofen trometamol - 36.9 mg (which corresponds to 25.0 mg of dexketoprofen); Excipients: ethanol (96%) - 200.0 mg, sodium chloride - 8.0 mg, sodium hydroxide up to pH 7.4, water for injection up to 2.0 ml;

Pharmacological effect

Non-steroidal anti-inflammatory drug (NSAID). It has analgesic, anti-inflammatory and antipyretic effects. The mechanism of action is associated with inhibition of prostaglandin synthesis at the level of COX-1 and COX-2 .; The analgesic effect occurs 30 minutes after parenteral administration. The duration of the analgesic effect after administration at a dose of 50 mg is 4-8 hours; When combined therapy with opioid analgesics dexketoprofen, trometamol significantly (up to 30-45%) reduces the need for opioids.

Pharmacokinetics

Suction. The maximum concentration in serum (Cmax) after intramuscular administration of dexketoprofen trometamol is achieved on average after 20 minutes (10-45 minutes). The area under the concentration-time curve (AUC) after a single dose of 25-50 mg is dose-proportional for both intramuscular and intravenous administration. The corresponding pharmacokinetic parameters are similar after single and repeated intramuscular or intravenous administration, which indicates the absence of drug accumulation .; Distribution. Dexketoprofen trometamol is characterized by a high level of binding to plasma proteins (99%). The average value of the volume of distribution (Vd) is less than 0.25 l / kg, the half-distribution time is about 0.35 hours; Excretion. The main route of elimination of dexketoprofen is its conjugation with glucuronic acid followed by excretion through the kidneys. The half-life (T1 / 2) of dexketoprofen trometamol is about 1-2.7 hours.In the elderly, there is an increase in the half-life (both after a single and after repeated intramuscular or intravenous administration) to an average of 48% and a decrease in the total clearance of the drug .;

Indications

Relief of pain syndrome of various origins (including postoperative pain, pain in bone metastases, post-traumatic pain, pain in renal colic, algodismenorrhea, ishalgia, sciatica, neuralgia, toothache); - symptomatic treatment of acute and chronic inflammatory, inflammatory-degenerative and metabolic diseases of the musculoskeletal system (including rheumatoid arthritis, spondyloarthritis, arthrosis, osteochondrosis).

Contraindications

Hypersensitivity to dexketoprofen or other NSAIDs or to any of the excipients that make up the drug (see Composition); - peptic ulcer of the stomach and duodenum; - history of gastrointestinal bleeding, other active bleeding (including suspected intracranial bleeding), anticoagulant therapy; - gastrointestinal diseases (Crohn's disease, ulcerative colitis); - severe liver dysfunction (10-15 points on the Child-Pugh scale); - severe renal dysfunction (creatinine clearance

Application during pregnancy and lactation

The use of the drug Dexalgin during pregnancy and lactation is contraindicated.

Method of administration and dosage

Dexalgin is intended for intravenous and intramuscular administration; Recommended dose for adults: 50 mg every 8-12 hours. If necessary, the drug may be re-administered at 6-hour intervals. The daily dose is 150 mg; In elderly patients and patients with impaired liver and / or kidney function, therapy with Dexalgin should be started with lower doses; the daily dose is 50 mg.; Dexalgin is intended for short-term (no more than 2 days) use during the period of acute pain syndrome. In the future, it is possible to transfer the patient to analgesics for oral administration .; Rules for the preparation and administration of solutions; The contents of one ampoule (2 ml) are slowly injected deep into the / m; The content of one ampoule (2 ml) is administered by slow intravenous injection for at least 15 seconds; The contents of one ampoule (2 ml) are diluted in 30-100 ml of physiological solution, glucose solution or Ringer's solution (lactate). The solution should be prepared under aseptic conditions and always protected from exposure to daylight. A diluted solution (should be clear) is administered by slow intravenous infusion for 10-30 minutes;

Side effects

Possible side effects with the use of dexketoprofen trometamol, as with the use of other dexketoprofen drugs, are listed below in descending frequency of occurrence: often (1-10% of patients), infrequently (0.1-1% of patients) rarely (0.01-0, 1% of patients), very rarely (less than 0.01% of patients), including isolated reports .; From the circulatory and lymphatic systems; Rarely: anemia .; Very rarely: neutropenia, thrombocytopenia .; From the side of the central nervous system; Uncommon: headache, dizziness, insomnia, drowsiness.; Rarely: paresthesia .; From the senses; Uncommon: blurred vision; Rarely: tinnitus .; From the side of the cardiovascular system; Uncommon: arterial hypotension, fever, flushing of the skin.; Rarely: extrasystole, tachycardia, arterial hypertension, peripheral edema, superficial thrombophlebitis .; From the respiratory system; Rarely: bradypnea.; Very rarely: bronchospasm, dyspnea.; From the gastrointestinal tract; Often: nausea, vomiting.; Uncommon: abdominal pain, dyspepsia, diarrhea, constipation, hematemesis, dry mouth.; Rarely: erosive and ulcerative lesions of the gastrointestinal tract, including bleeding and perforation, anorexia.; Very rarely: damage to the pancreas .; From the liver and gallbladder; Rarely: increased activity of liver enzymes, jaundice .; Very rare: liver damage .; From the urinary system; Rarely: polyuria, renal colic .; Very rarely: nephritis or nephrotic syndrome .; On the part of the reproductive system; Rarely: in women - menstrual irregularities, in men - dysfunction of the prostate gland .; On the part of the musculoskeletal system; Rarely: muscle spasm, difficulty in movement in the joints.; From the skin; Uncommon: dermatitis, rash, sweating.; Rarely: urticaria, acne.; Very rare: severe skin reactions (Stevens-Johnson syndrome, Lyell's syndrome), angioedema, allergic dermatitis, photosensitivity .; From the side of metabolism; Rarely: hyperglycemia, hypoglycemia, hypertriglyceridemia .; From the laboratory parameters; Rarely: ketonuria, proteinuria.; Local and general reactions; Often: pain at the injection site; Uncommon: inflammatory reaction, hematoma, hemorrhages at the injection site; feeling of heat, chills, fatigue.; Rarely: back pain, fainting, fever.; Very rare: anaphylactic shock, swelling of the face .; Other disorders: aseptic meningitis, which occurs mainly in patients with systemic lupus erythematosus or mixed connective tissue diseases, hematological disorders (purpura, aplastic and hemolytic anemia, rarely - agranulocytosis and bone marrow hypoplasia). ;

Overdose

Symptoms: nausea, anorexia, abdominal pain, headache, dizziness, disorientation, insomnia.; Treatment: symptomatic therapy; if necessary, gastric lavage, dialysis;

Interaction with other drugs

Dexalgin should not be mixed in the same syringe with a solution of dopamine, promethazine, pentazocine, pethidine or hydroxyzine (a precipitate is formed) .; Dexalgin can be mixed in one syringe with a solution of heparin, lidocaine, morphine and theophylline .; Dexalgin - diluted solution for infusion should not be mixed with promethazine or pentazocine.; Dexalgin - diluted solution for infusion is compatible with the following injection solutions: dopamine, heparin, hydroxyzine, lidocaine, morphine, pethidine and theophylline .; When storing Dexalgin - diluted solutions for infusion in plastic containers or when using infusion systems made of ethyl vinyl acetate, cellulose propionate, low density polyethylene or polyvinyl chloride, the absorption of the active substance by the listed materials does not occur .; The following interactions are typical for all NSAIDs .; Unwanted combinations; With other NSAIDs, including salicylates in high doses (more than 3 g / day): the simultaneous administration of several NSAIDs due to a synergistic effect increases the risk of gastrointestinal bleeding and ulcers .; With oral anticoagulants, heparin in doses exceeding prophylactic ones, and ticlopidine: increased risk of bleeding due to inhibition of platelet aggregation and damage to the mucous membrane of the gastrointestinal tract .; With lithium preparations: NSAIDs increase the level of lithium in the blood, up to toxic, and therefore this indicator must be monitored when prescribing, changing the dose and after stopping NSAIDs; With methotrexate in high doses (15 mg / week or more): increased hematological toxicity of methotrexate due to a decrease in its renal clearance during NSAID therapy; With hydantoins and sulfa drugs: risk of increasing the toxic effect of these drugs .; Combinations requiring caution; With diuretics, angiotensin-converting enzyme inhibitors: NSAID therapy is associated with the risk of developing acute renal failure in dehydrated patients (decreased glomerular filtration due to decreased prostaglandin synthesis). NSAIDs can reduce the antihypertensive effect of some drugs. When administered simultaneously with diuretics, it is necessary to make sure that the patient's water balance is adequate, and to monitor renal function before prescribing NSAIDs; With methotrexate in low doses (less than 15 mg / week): increased hematological toxicity of methotrexate due to a decrease in its renal clearance during NSAID therapy. A weekly blood cell count should be performed in the first weeks of concurrent therapy. In the presence of impaired renal function, even in a mild degree, as well as in the elderly, careful medical supervision is necessary .; With pentoxifylline: increased risk of bleeding. Intensive clinical monitoring and frequent checking of bleeding time (blood clotting time) is necessary .; With zidovudine: the risk of an increase in the toxic effect on erythrocytes due to exposure to reticulocytes, with the development of severe anemia a week after the appointment of NSAIDs. It is necessary to count all blood cells and reticulocytes 1-2 weeks after starting NSAID therapy; With sulfonamide drugs: NSAIDs can enhance the hypoglycemic effect of sulfonylurea due to its displacement from the sites of binding to plasma proteins .; With drugs of low molecular weight heparin: increased risk of bleeding .; Combinations to be taken into account; With β-blockers: NSAIDs can reduce the hypotensive effect of β-blockers, which is due to inhibition of prostaglandin synthesis .; With cyclosporine and tacrolimus: NSAIDs can increase nephrotoxicity, which is mediated by the action of renal prostaglandins. During concomitant therapy, it is necessary to monitor renal function .; With thrombolytics: increased risk of bleeding .; With probenecid: plasma concentrations of NSAIDs may increase, which may be due to an inhibitory effect on renal tubular secretion and / or conjugation with glucuronic acid, which requires a dose adjustment of NSAIDs; With cardiac glycosides: NSAIDs can lead to an increase in the concentration of glycosides in plasma; With mifepristone: due to the theoretical risk of changes in the effectiveness of mifepristone under the influence of inhibitors of prostaglandin synthesis, NSAIDs should not be prescribed earlier than 8-12 days after discontinuation of mifepristone .; With ciprofloxacin: data obtained in experimental studies on animals indicate a high risk of convulsions when prescribing NSAIDs against the background of therapy with high doses of ciprofloxacin;

special instructions

Patients with a history of gastrointestinal disorders or gastrointestinal diseases require constant monitoring. In case of gastrointestinal bleeding or ulcers, therapy with Dexalgin should be canceled .; Since all NSAIDs can inhibit platelet aggregation and increase bleeding time due to a slowdown in prostaglandin synthesis, controlled clinical trials have studied the simultaneous administration of dexketoprofen trometamol and low molecular weight heparin preparations in prophylactic doses in the postoperative period. No effect on coagulation parameters was observed. However, with the simultaneous appointment of the drug Dexalgin with other drugs that affect blood clotting, careful medical supervision is required .; Like other NSAIDs, Dexalgin can lead to an increase in plasma creatinine and nitrogen levels. Like other inhibitors of prostaglandin synthesis, Dexalgin can have side effects on the urinary system, which can lead to the development of glomerulonephritis, interstitial nephritis, papillary necrosis, nephrotic syndrome and acute renal failure .; As in the case of other NSAIDs, during therapy with Dexalgin, there may be a slight transient increase in some hepatic parameters, as well as a significant increase in the level of aspartic and alanine transaminases (AST and ALT) in the blood serum. At the same time, control of hepatic and renal functions is necessary in the elderly. In case of a significant increase in the corresponding indicators, Dexalgin should be canceled .; Like other NSAIDs, dexketoprofen trometamol can mask the symptoms of infectious diseases. In case of detection of signs of a bacterial infection or deterioration of health during therapy with Dexalgin, the patient should immediately consult a doctor .; Each ampoule of the drug Dexalgin contains 200 mg of ethanol .; Influence on the ability to drive vehicles and control mechanisms; Due to possible dizziness and drowsiness during the period of taking the drug Dexalgin, the ability to concentrate and the speed of psychomotor reactions in patients may decrease .;

Dexalgin is a non-steroidal anti-inflammatory agent, analgesic. Instructions for use prescribe to take 25 mg tablets, injections in ampoules for injection in solution for severe pain conditions. Reviews of patients and recommendations of doctors indicate that this drug helps in the treatment of pain in arthrosis, arthritis, osteochondrosis.

Release form and composition

Dexalgin is available in the form of a solution for intramuscular and intravenous injections in dark glass ampoules in plastic trays of 1, 5, 10 pieces in a cardboard box with detailed instructions. The solution is a clear liquid with an alcohol smell.

The main active ingredient of the drug is dexkeprofen trometamol.

The tablets are also white, smooth, round and convex, with risks on both sides. One tablet contains 25 mg of dexketoprofen trometamol.

pharmachologic effect

Dexalgin has antipyretic, anti-inflammatory and analgesic properties. The analgesic effect occurs approximately thirty minutes after parenteral administration. As for the duration of the analgesic effect, it is 4 to 8 hours.

After oral administration of Dexalgin, the drug also begins to act after 30 minutes. After 0.5 hours, the maximum concentration of the agent in the blood is observed. The duration of the analgesic effect is on average 3 - 6 hours.

What does Dexalgin 25 help with?

Indications for the use of tablets include pain syndrome:

rheumatoid arthritis, arthrosis, bone metastases, osteochondrosis, spondyloarthritis.
after operations;
toothache, menstrual pain;
algodismenorrhea, radiculitis;
sciatica and neuralgia.

Injections of the drug are prescribed when the use of tablets is impossible or unjustified, for example, for postoperative pain, after serious injury, with renal colic.

Instructions for use

Dexalgin tablets 25 mg are prescribed according to individual indications. The average recommended single dose is 12.5 mg (1/2 tablet) 1 to 6 times a day every 4-6 hours as needed or 25 mg (1 tablet) 1 to 3 times a day every 8 hours. The maximum daily dose is 75 mg (6 tablets).

In patients with impaired liver or kidney function, in the elderly, the drug should be taken in lower doses - no more than 50 mg per day. The drug is not intended for long-term use: the duration of administration should not exceed 3-5 days.

Ampoules

Dexalgin is intended for intravenous and intramuscular administration. Recommended dose for adults: 50 mg every 8-12 hours. If necessary, the drug may be re-administered at 6-hour intervals. The daily dose is 150 mg.

In elderly patients and patients with impaired liver and / or kidney function, therapy with Dexalgin should be started with lower doses; the daily dose is 50 mg.

The drug is intended for short-term (no more than 2 days) use during the period of acute pain syndrome. In the future, it is possible to transfer the patient to analgesics for oral administration.

Rules for the preparation and administration of solutions

The content of one ampoule (2 ml) is slowly injected deep intramuscularly or by slow intravenous injection for at least 15 seconds.

Diluted in 30-100 ml of physiological solution, glucose solution or Ringer's solution (lactate). The solution should be prepared under aseptic conditions and always protected from exposure to daylight. The diluted solution (should be clear) is administered by slow intravenous infusion for 10-30 minutes.

Contraindications

The use of Dexalgin should be abandoned by patients with:

severe heart failure;
erosive and ulcerative lesions of the digestive tract;
bronchial asthma;
hypersensitivity to the components of the drug Dexalgin, from which 25 mg tablets and injections can cause side effects;
hemorrhagic diathesis;
severe impairment of liver or kidney function.

According to the instructions, Dexalgin is contraindicated in children, pregnant and lactating women, as well as in patients taking drugs that prevent the formation of blood clots and blood coagulation (anticoagulants).

Side effects

With strict adherence to the recommendations specified in the instructions and the prescribed dose, side effects in patients do not develop so often. With hypersensitivity to the constituent components of the drug, as well as with prolonged use of the drug, the patient may develop the following side effects:

From the side of the heart and blood vessels - a decrease in blood pressure indicators, tachycardia, a feeling of heat and blood flow to the face, in rare cases, a violation of the heart rhythm.
Changes in the clinical picture of blood - anemia, thrombocytopenia, neutropenia.
Blood clotting disorder.
Violation of the menstrual cycle in women, dysfunction of the prostate in men.
From the organs of the digestive tract - nausea, vomiting, stool disturbances, severe pain in the epigastric region, lack of appetite, dry mouth.
Bronchospasm, breathing disorder.
Allergic skin reactions - rash, redness, inflammation of the injection site, Quincke's edema, or the development of anaphylactic shock.
Painful seals at the site of intramuscular injection of the drug.
Headaches, sleep disturbances, dizziness, in very rare cases, decreased sensitivity, paresthesia.
Thrombophlebitis or pain along the vein with intravenous administration of the drug.
Faintness.
Muscle pain.

Children, during pregnancy and breastfeeding

The use of the drug Dexalgin during pregnancy and lactation is contraindicated. Forbidden in childhood.

special instructions

Patients with a history of digestive disorders or gastrointestinal diseases require constant monitoring. In the event of gastrointestinal bleeding or ulcerative lesions, therapy with Dexalgin should be canceled.

With the simultaneous appointment with other drugs that affect blood clotting, careful medical supervision is required. The medication can lead to an increase in the level of creatinine and nitrogen in the blood plasma. Like other inhibitors of prostaglandin synthesis, Dexalgin can have side effects on the urinary system, which can lead to the development of glomerulonephritis, interstitial nephritis, papillary necrosis, nephrotic syndrome and acute renal failure.

During therapy with Dexalgin, there may be a slight transient increase in some hepatic parameters, as well as a significant increase in the level of AST and ALT in the blood serum. At the same time, monitoring of liver and kidney functions is necessary in elderly patients.

In case of a significant increase in the corresponding indicators, Dexalgin should be canceled. Dexketoprofen trometamol may mask the symptoms of infectious diseases.

In the event of symptoms of a bacterial infection or deterioration of health during therapy with the drug, the patient should inform the doctor about this.

Each ampoule contains 200 mg of ethanol. Due to possible dizziness and drowsiness during treatment, it is possible to reduce the ability to concentrate and the speed of psychomotor reactions.

Drug interactions

Do not mix solution for injection in a syringe with pethidine, prometesine, hydroxyzine, dopamine, pentazocine. Can be mixed with morphine, heparin, theophylline and lidocaine.

Dexalgin 25 (tablets) when combined with salicylates, anticoagulants, ticlopidine, heparin, other NSAIDs, citalopram, low molecular weight heparin drugs, pentoxifylline, sertraline and fluoxetine increases the risk of bleeding.

Use with caution with sulfonamides, methotrexate, lithium preparations, hydantoins due to increased toxic effects on the body. Zidovudine, quinolones, cardiac glycosides, thrombolytics, cyclosporin, sulfonylurea derivatives and tacrolimus should not be combined with the drug without medical supervision.

When mixing the solution for infusion, avoid combining with promethazine and pentazocine. But it is quite compatible with pethidine, dopamine, hydroxyzine, morphine, heparin, lidocaine and theophylline.

The combination with diuretics and ACE inhibitors can cause acute renal failure.

Drug analogs

The derivatives of propionic acid include analogues:

Ibuprom Sprint Caps.
Nalgezin.
Ketospray.
Profenide.
Naproxen.
Surgam.
Nurofen Express.
Pedea.
Flamax.
Fastcaps.
Nurofen forte.
Children's Motrin.
Sanaprox.
Nurofen for children.
Flamax forte.
Pronaxen.
Strepsils Intensive
Bystrumgel.
Flugalin.
Advil.
Fastum gel.
MIG 400.
Febrofid.
Ketonal.
Ibufen.
Nalfon.
Ibuprom.
Ypren.
Oruvel.
Ibusan.
Nalgezin forte.
Apranax.
Algezir Ultra.
Brufen retard.
Ketoprofen.
Deblock.
Ibutop gel.
Rakstan Sanovel.
Naprobene.
Fastum.
Faspik.
Ibuprom Max.
Burana.
Brufen.
Solpaflex.
Bonifen.
MIG 200.
Long.
Naprios.
Flexen.
Ketonal Duo.
Artrum.

Vacation conditions and price

The average price of Dexalgin (25 mg tablets No. 25) in Moscow is 360 rubles, injections - 285 rubles for 5 ampoules of 2 ml. Dispensed by prescription.

Store in a dark place and out of reach of children at a temperature not higher than + 25 ° C. Use only clear and colorless solutions. After dilution, store the solution for no more than 1 day at a temperature of + 2… + 8 ° С. The shelf life is 5 years.

Post Views: 2 942

Dexalgin (non-proprietary name Dexketoprofen) belongs to the group of non-steroidal anti-inflammatory drugs.

Manufactured in Germany, distributor: Berlin-Chemie. The solution is used for intramuscular and intravenous administration, acts as an analgesic, anti-inflammatory, and antipyretic agent.

1 ampoule contains the active substance: dexketoprofen tromethanol 73.8 mg (respectively 50 mg dexketoprofen). Auxiliary components: 96% ethyl alcohol - 200 mg; sodium chloride - 8 mg; sodium hydroxide - up to pH 7.4; water for injection - up to 2 ml.

Transparent colorless solution, there is a characteristic smell of alcohol, dose 25 mg / ml. 2 ml of solution in dark glass ampoules (type I), there is a white dot in the upper part. 5 ampoules in a plastic support are placed in a cardboard box.

Pharmacodynamically, the mechanism of action depends on the ability of dexketoprofen to inhibit the synthesis of PG at the level of COX-1 and COX-2.

The analgesic effect develops 30 minutes after injection and can last up to 5-7 hours after administration when using a dose of 50 mg. When combined therapy with opioid analgesics, it can significantly reduce the need for these drugs (up to 30-45%).

Pharmacokinetically, the maximum concentration after intramuscular injection of dexketoprofen is reached within 10 to 45 minutes. AUC after a single dose of 25-50 mg is dose-proportional in the case of both intramuscular and intravenous infusion.

Pharmacokinetic parameters are close after a single and repeated intramuscular or intravenous injection, this indicates the absence of accumulation of the substance. Dexketoprofen trometamol has an extremely high level of binding to plasma proteins (up to 99%). The average Vd is less than 0.25 l / kg, the half-life is approximately 22 minutes.

The main way of excretion of dexketoprofen is its conjugation with glucuronic acid, after which excretion occurs through the kidneys. In elderly patients, T1 / 2 is lengthened (both after a single and after repeated intramuscular and intravenous administration) to an average of 48%, and the total clearance of the drug is reduced.

Content:

Indications

Dexalgin is able to relieve pain syndrome of various origins. For example, with toothache, renal colic, in cases of post-traumatic, postoperative pain, as well as sciatica, radiculitis, pain in bone metastases, in the case of algomenorrhea.

As an anti-inflammatory agent, dexalgin is used to eliminate symptoms in both acute and chronic inflammatory diseases, as well as in disorders of the musculoskeletal system of an inflammatory, degenerative and metabolic nature. For example, in the case of rheumatoid arthritis, with spondyloarthritis, as well as arthrosis, etc.

Contraindications

Dexalgin is contraindicated in case of allergy to dexketoprofen or other non-steroidal anti-inflammatory drugs, as well as to any of the components.

Contraindicated in the presence of gastric ulcer or duodenal ulcer, especially in the presence of gastrointestinal bleeding history, with other bleeding in the active stage (including with suspected hemorrhagic stroke or subdural / epidural hematoma), in the case of ongoing anticoagulant therapy, in the presence of hemorrhagic diathesis and with other disorders of the blood coagulation system.

Dexalgin is not used for Crohn's disease, ulcerative colitis. With existing severe violations of liver function (score 10-15 points on the generally accepted Child-Pugh scale) and kidney (creatinine clearance less than 50 ml per minute).

It is not used if the patient has aspirin-dependent bronchial asthma (including a history), in severe heart failure, as well as for the treatment of pain during coronary artery bypass grafting.

Dexalgin is not used in pediatric practice.

Dexalgin is contraindicated for pregnant and lactating women.Due to the fact that Dexalgin contains ethanol, the drug is not used for neuraxial administration (intrathecal, epidural, intrathecal).

It should be used with caution if there is a history of allergic conditions; in cases of hematopoietic disorders; with systemic lupus erythematosus, mixed connective tissue diseases; if other medicines are taken at the same time, if there is a predisposition to hypovolemia; ischemic heart disease is present; should be used with caution over the age of 65 years.

Mode of application

Dexalgin solution is intended for intravenous and intramuscular administration.

For adults, a dose of 50 mg is usually used every 8-12 hours. If necessary, the dose is re-administered at intervals of 6 hours. The daily dose is 150 mg.

Elderly patients, as well as patients with impaired renal or liver function, the drug is prescribed in lower doses, and the daily dose in these cases is in the limit of 50 mg.

In the case of intramuscular injection, 2 ml is slowly injected deep intramuscularly.

For intravenous administration of Dexalgin, the contents of 1 ampoule are administered by slow intravenous injection, the duration of which is at least 15 seconds.

Also, infusion of Dexalgin is used, in which the contents of 1 ampoule are diluted in 30-150 ml of saline, glucose or Ringer's solution. The solution is prepared under aseptic conditions and must be protected from light.

The prepared diluted solution should be clear. It is administered by slow intravenous infusion, the duration of which is about 20 minutes.

Side effects

When applied, various side effects may appear. Most of the listed negative drug phenomena are characteristic of all NSAIDs.

From the side of the central nervous system: dizziness with headache, insomnia or drowsiness is possible; less often paresthesia, blurred vision, tinnitus may appear.

From the side of the cardiovascular system: fluctuations in blood pressure, a feeling of heat, as well as flushing of the skin may occur infrequently; rarely - the occurrence of tachycardia or extrasystole, peripheral edema, and superficial thrombophlebitis.

From the gastrointestinal tract, nausea, up to vomiting, can often develop; less often abdominal pain, dry throat, dyspeptic symptoms, diarrhea or constipation, symptoms of hematemesis; rare erosive and ulcerative lesions of the digestive tract, including wall perforation and bleeding, anorexia; very rarely the pancreas can be affected. Occasionally, the activity of liver enzymes may increase, jaundice may appear; very rarely the liver can be affected.

On the part of the musculoskeletal system: muscle spasms are rarely possible, as well as difficulty in the motor function of the joints.

From the side of the skin, sweating, dermatitis, and also a rash can rarely occur; rarely acne, urticaria may appear; very rare cases of severe skin reactions (including Lyell's, Stevens-Johnson's syndromes), allergic dermatitis, photosensitivity, as well as the occurrence of angioedema.

Cases of anemia are rare; manifestations of neutropenia or thrombocytopenia are very rare.

On the part of the respiratory system: rarely - the appearance of bradypnea; very rarely - dyspnea, bronchospasm.

Rare are cases of hyper- or hypoglycemia, hypertriglyceridemia.

From the genitourinary system: renal colic, polyuria, nephritis or nephrotic syndrome, menstrual irregularities in women, and prostate dysfunctions in men can rarely occur.

Laboratory readings can occasionally show the presence of protein and ketone bodies in the urine.

Also, pain at the injection site may often appear; infrequently - inflammation, feeling of heat or chills, hematoma or hemorrhagic manifestations at the injection site, fatigue; rarely, there may be a feeling of back pain, fever, fainting; anaphylactic shock is very rarely possible, as well as facial edema.

Other disorders may cause aseptic meningitis, mainly in patients with systemic lupus erythematosus or mixed connective tissue diseases, hematological disorders are also possible (aplastic anemia, as well as hemolytic anemia, purpura); the probability of agranulocytosis, bone marrow hypoplasia is rare.

Overdose

The following symptoms may indicate an overdose: dizziness or headache, abdominal pain, as well as the appearance of nausea, insomnia, disorientation, and cases of anorexia may occur.

special instructions

There are a number of special instructions that must be strictly followed.

It is forbidden to mix in one syringe Dexalgin solution and solutions of such drugs as pethidine, dopamine, promethazine, hydroxyzine, pentazocine, since a precipitate is formed during such mixing.

It is allowed to mix Dexalgin and a solution of such drugs as morphine, heparin, theophylline or lidocaine in one syringe.

Diluted solution of Dexalgin for infusion should not be mixed with solutions of promethazine or pentazocine.

It is permissible to store diluted Dexalgin solutions in a plastic container or when using infusion systems that are made of materials such as cellulose propionate, ethyl vinyl acetate, LDPE or PVC, as this does not involve absorption of the active substance by these materials.

The following interactions are common for all NSAIDs. In particular, there are a number of undesirable combinations:

Dexalgin and other NSAIDs, including salicylates in high doses (more than 3 grams per day), since with the simultaneous administration of several NSAIDs, a synergistic effect appears, as a result of which the risk of gastrointestinal ulcers and bleeding becomes higher.
Dexalgin with oral anticoagulants, as well as heparin, in doses higher than prophylactic, ticlopidine, in this case, the risk of bleeding is higher as a result of inhibition of platelet aggregation and damage to the gastrointestinal mucosa.
Dexalgin and lithium preparations. Due to the fact that NSAIDs are able to increase the level of lithium in the blood up to toxic, this indicator is monitored both when prescribing or changing the dose, and after discontinuation of NSAIDs.
With methotrexate in high doses (15 mg / week or more), there is an increase in the hematological toxicity of methotrexate due to a decrease in its renal clearance during therapy with any anti-inflammatory drugs.
With hydantoins and sulfonamides, there is a risk of increasing the toxic effects of these drugs.

There are combinations that require caution when using:

With diuretics, ACE inhibitors. In this case, with NSAID therapy, there is a risk of developing acute renal failure in patients with dehydration (decreased glomerular filtration due to decreased synthesis of PG). NSAIDs can reduce the antihypertensive effect of some drugs. When co-administered with diuretics, it should be ensured that the patient is not hydrated, and monitoring of renal function is required before prescribing NSAIDs.
With methotrexate in low doses (less than 15 mg per week), an increase in the hematological toxicity of methotrexate is possible. It is required to perform a blood cell count once a week in the first weeks of simultaneous use.
It is necessary to properly monitor the condition of elderly patients, patients with impaired renal function, including mild ones.
With pentoxifylline, the risk of bleeding is increased. Both clinical monitoring should be carried out and the clotting time should be constantly checked.
With zidovudine, effects on reticulocytes can occur, as a result of which there is a risk of increased toxicity to erythrocytes, with the development of severe anemia within a week after the appointment of NSAIDs. In this case, it is necessary to count reticulocytes, as well as all blood cells after 1-2 weeks from the start of NSAID treatment.
When using sulfonamide drugs and NSAIDs, the latter can enhance the hypoglycemic effect of sulfonylurea, due to its displacement from the sites of binding to plasma proteins.
NSAIDs and low molecular weight heparin drugs - the risk of bleeding is increased.

There are also combinations that must be taken into account when treating with Dexalgin:

With β-blockers, in this case, NSAIDs are able to reduce the hypotensive effect of β-blockers, this is due to the inhibition of PG synthesis.
With cardiac glycosides, due to the fact that the use of NSAIDs increases the concentration of glycosides in the blood plasma.
When conducting simultaneous therapy with cyclosporine and tacrolimus, monitoring of renal function is required, since NSAIDs contribute to an increase in nephrotoxicity, which is mediated by the action of renal PG.
With thrombolytics, due to the increased risk of bleeding.
When used with probenecid, an increase in the concentration of NSAIDs in plasma is possible, this may be due to an inhibitory effect on renal tubular secretion, as well as conjugation with glucuronic acid, as a result of which NSAID dosage adjustment is necessary.
With mifepristone, there is a theoretical risk that the effectiveness of mifepristone may be altered by inhibitors of PG synthesis. NSAIDs are not prescribed earlier than 8-12 days after discontinuation of mifepristone.
Caution is required when used with ciprofloxacin, since on the basis of experimental studies on animals, the likelihood of convulsions was revealed when NSAIDs and ciprofloxacin were prescribed in high doses.

It should also be remembered that the combined use of Dexalgin and other drugs that affect blood clotting requires careful medical supervision.

The use of Dexalgin is able to increase the level of creatinine and nitrogen in plasma. Dexalgin, like other inhibitors of GHG synthesis, can have a side effect on the urinary organs, which can result in interstitial nephritis, glomerulonephritis, papillary necrosis, as well as a state of acute renal failure or nephrotic syndrome.

While taking Dexalgin, a slight increase in some liver parameters is possible, which subsequently passes, as well as a significant increase in the level of AST and ALT in the blood serum. In this case, it is required to monitor renal and hepatic functions in elderly patients. Cancellation required

Dexalgin with a significant increase in these indicators.

Dexalgin can mask the symptoms of infectious diseases. If you notice signs of a bacterial infection, as well as if your health worsens during therapy with Dexalgin, a doctor's consultation is required.

Each ampoule of the drug contains 200 mg of ethyl alcohol.

When using Dexalgin, there is a possibility of dizziness, as well as a feeling of drowsiness, in this regard, patients may have a decrease in attention and speed of psychomotor reactions.

Storage conditions

Dexalgin must be stored in a dark place, at a temperature not exceeding 25 ° C, with limited access to children. The shelf life is five years. Immediately after preparation, the solution is stored for 24 hours (in a dark place and at a temperature of 2-8 ° C).