The symptoms of gastro-intestinal tract, hypotension, renal toxicity (up to acute renal failure), dizziness, headache, hyperventilation, dizziness; children – myoclonic seizures, nausea, vomiting, abdominal pain, bleeding, liver and kidney. Treatment: symptomatic and supportive, aimed at addressing the symptoms. Forced masteron diuresis, hemodialysis ineffective.
Interaction with other drugs Lithium, digoxin: while the use of diclofenac may increase the concentration of lithium and digoxin in the blood plasma. Diuretic and antihypertensive agents: Diclofenac, like other NSAIDs, when taken with diuretics or antihypertensive agents (eg, beta- blockers, angiotensin converting enzyme inhibitors) can reduce the severity of antihypertensive action. Concomitant use of potassium-sparing diuretics may increase potassium levels in the blood serum. NSAIDs and corticosteroids: The masteron simultaneous use of diclofenac and other systemic NSAIDs or corticosteroids may increase the incidence of adverse effects on the gastrointestinal tract. Anticoagulants and platelet aggregation inhibitors: require special care, because in simultaneous administration of diclofenac with these drugs increases the risk of bleeding. antidiabetic drugs: clinical studies have shown that is possible to simultaneously and diclofenac oral antidiabetic drugs, with the latter efficacy is not changed. However, aware of individual cases of development as hypoglycemia and hyperglycemia, which required changing the dose of antidiabetic drugs during the use of diclofenac.
Methotrexate: Caution should be exercised in the appointment in less than 24 hours before or after taking methotrexate, as in such cases may increase the concentration of methotrexate in the blood and increases its toxicity. cyclosporin: the effect on the synthesis of prostaglandins in the kidney may enhance the nephrotoxicity of cyclosporine. Antibacterial agents, quinolone derivatives: there are isolated reports of seizures develop in patients treated simultaneously quinolone derivatives. Antacids as for example. aluminum hydroxide and magnesium, may slow the absorption of diclofenac, but does not affect the total amount of absorbed drug. Selective serotonin reuptake inhibitors: concomitant therapy with selective serotonin reuptake inhibitors (such as citalopram, fluoxetine, paroxetine, sertraline), accompanied by an increase in the development of gastrointestinal risk -kishechnyh bleeding. Interactions with food: the level of absorption of diclofenac is reduced when taking it with food. For this reason it is not recommended to take the drug during or immediately after a meal.
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When receiving there is a possibility of gastrointestinal bleeding, gastrointestinal ulcers, sometimes complicated perforations, without prior symptoms or the presence of such attacks in the patient’s history. These complications can have serious consequences especially for the elderly. If you have any of these symptoms should immediately cancel the drug.
The risk of gastrointestinal bleeding increases with increasing doses in patients with ulcer history, especially in the case of complications of the disease bleeding and perforation, as well as in elderly patients. To reduce the risk of complications of therapy should be initiated and maintained at the lowest effective dose, taking into account the possibility of using combination therapy with sacrificial means (eg, proton pump inhibitors or misoprostol).
In the appointment of diclofenac in patients with existing gastrointestinal disorders (ulcers, bleeding, perforation) a history, it is necessary to conduct therapy under careful medical supervision and compliance with special caution.
caution is recommended to observe patients who are concurrently taking drugs that may increase the risk of ulcers or gastrointestinal bleeding, such as systemic corticosteroids, anticoagulants, platelet aggregation inhibitors or selective reverse inhibitors serotonin reuptake.
Patients suffering from ulcerative colitis masteron disease, therapy should be under close medical supervision, as a result of taking diclofenac may occur exacerbation of these diseases.
The use of diclofenac should be discontinued at the first sign of a skin rash, lesions of the mucous membranes and in the event of other symptoms of hypersensitivity.
During application of diclofenac, as well as other , in rare cases may arise allergy, including anaphylactic / anaphylactoid reactions in patients who have not previously been used diclofenac.
diclofenac, like other , in due to their pharmacological properties, may mask symptoms of the infectious disease.
avoid the simultaneous application of diclofenac with systemic(including selective inhibitors of cyclooxygenase-2), since no data supporting the beneficial effect as a result of synergism and Has no data possible side effects.
caution should be exercised when using the drug in elderly patients. Weakened or having a low body weight for older people recommended to prescribe the drug in the lowest effective dose.
In patients suffering from bronchial asthma, seasonal allergic rhinitis, swelling of the nasal mucosa (polyps of the nasal mucosa), chronic obstructive pulmonary disease or chronic infection repiratornogo tract (especially related to allergic rhinitis-like symptoms), reactions to drugs from the masteron group in the form of attacks of asthma, urticaria, angioedema, or swelling develops more often than usual. Therefore patients are advised to take special care (readiness for urgent medical measures).
In the appointment of diclofenac in patients with hepatic impaired function must be carefully monitored, since the state of these patients may worsen. During the application Rapten Rapida, like other may increase the level of one or more liver enzymes. Therefore, long-term drug therapy shown to regular liver function tests.
If violations of the function of the liver persist or increase, or if developing complaints or symptoms suggestive of liver disease, as well as if there are other side effects (eg, eosinophilia , rash, etc.), the drug should be discontinued. It must be borne in mind that hepatitis in patients receiving diclofenac may occur without prodromal phenomena.
Caution must be exercised in patients with hepatic porphyria, since diclofenac intake may provoke an attack. how much to inject for weight loss
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