Neurodiclovit - instructions for use, analogs, testimonials and release forms (capsules or tablets) drugs for the treatment of pain in arthritis, arthrosis, sciatica, lumbago in adults, children and pregnancy. composition and alcohol. Tablets "Neurodiclovit": instructions

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Neurodiclovitis is a combined anti-inflammatory and analgesic drug with vitamins of group B. The drug is used for the symptomatic treatment of pain in non-infectious inflammatory processes.

Composition and forms of release

Neurodiclovit is currently available in the form capsules for oral administration. There are conventional capsules and capsules with modified release of active substances, however, this difference is not too significant, since both versions of the same dosage form are used according to the same rules.

Sometimes there is a mention of Neurodiclovit injections, but this dosage form is not on the Russian pharmaceutical market.

The composition of the capsules Neurodiclovit as active ingredients includes the following substances:

Diclofenac - 50 mg;
Thiamine hydrochloride (vitamin B 1) - 50 mg;
Pyridoxine hydrochloride (vitamin B 6) - 50 mg;
Cyanocobalamin (vitamin B 12) - 250 mcg.

As auxiliary components Neurodiclovit contains the following substances:

Titanium dioxide;
Gelatin;
Iron oxide red;
Iron oxide yellow;
Copolymer of methacrylic acid and ethyl acrylate (Eudragit NE30D);
Silicone antifoam agent SE2 MC;
Talc;
Triethyl acetate.

Neurodiclovit capsules have a gelatin shell, the body of which is painted pink-yellow, and the cap is brown. The inside of the capsules contains a mixture of white granules (diclofenac) and pink powder (B vitamins). Capsules are available in packs of 30 pieces.

From what the drug Neurodiclovit (therapeutic effect)

Neurodiclovit contains diclofenac and B vitamins as active ingredients. Diclofenac belongs to the group of NSAIDs - non-steroidal anti-inflammatory drugs and, accordingly, has anti-inflammatory, analgesic, antipyretic and antiplatelet effects.

Anti-inflammatory action consists in stopping the inflammatory process, reducing its severity and limiting the volume of tissues involved in inflammation. That is, diclofenac suppresses both the inflammation itself and reduces its size in various organs and tissues.

Analgesic action consists in stopping the pain syndrome caused by the inflammatory process in various tissues and organs.

Antipyretic action diclofenac is to reduce elevated body temperature.

Antiplatelet action is to prevent platelets from sticking together, which improves blood flow and reduces the risk of thrombosis.

All these effects of diclofenac are provided by its ability to stop the work of cyclooxygenase (COX) - an enzyme that produces biologically active substances called prostaglandins. Namely, prostaglandins ensure the development and maintenance of the inflammatory process in any tissue or organ, regardless of the cause that caused it. Therefore, blocking COX stops the production of prostaglandins, as a result of which the inflammatory process cannot be maintained and quite naturally fades away, and the area of affected tissues decreases.

Diclofenac in rheumatic diseases reduces the severity of inflammation, relieves pain, eliminates morning stiffness and swelling of the joints, which significantly improves the condition and functioning of the affected joints. With injuries, as well as after operations, diclofenac relieves pain and relieves swelling.

Vitamin B 1 (thiamine) is involved in metabolism, and is also necessary for the transmission of nerve impulses.

Vitamin B 6 (pyridoxine) ensures the normal functioning of the peripheral and central nervous system, as it is involved in the production of biologically active substances - neurotransmitters, such as dopamine, serotonin, norepinephrine, adrenaline, histamine and GABA. These neurotransmitters ensure the normal course of various processes in the nervous tissue, including maintaining a balanced psychological state, emotional stability, etc.

Vitamin B 12 (cyanocobalamin) ensures the formation of red blood cells in the bone marrow, and also takes part in the formation of DNA and proteins and in the metabolism of amino acids, carbohydrates and fats. In addition, cyanocobalamin has a beneficial effect on the state of the central nervous system, ensuring the stability of nerve cell membranes, as well as stimulating their renewal.

With regard to the combined drug Neurodiclovit, we can say that B vitamins enhance the effects of diclofenac. In addition, the presence of B vitamins provides the effects of diclofenac in relation to the nervous tissue, that is, the drug is able to relieve pain in neuritis, neuralgia, etc.

Indications for use

Neurodiclovit is indicated for symptomatic therapy in the following conditions or diseases:

1. Pain relief in inflammatory diseases of various non-rheumatic organs (not joints):

The period after injury;
The period after surgical operations;
The period after dental interventions (for example, tooth extraction, cleaning of gum pockets, etc.);
Gynecological diseases of a non-infectious nature, for example, pain during menstruation, adnexitis, etc.;
Inflammatory diseases of the ENT organs - pharyngitis, tonsillitis, otitis media, sinusitis, etc.

2. Reducing the severity and volume of inflammation, as well as relief of pain in inflammatory and degenerative diseases of the joints and spine:

Chronic polyarthritis;
rheumatoid arthritis;
Rheumatoid arthritis;
ankylosing spondylitis;
Spondylarthrosis;
Acute gouty arthritis.

3. Relief of pain syndrome and inflammation in the following diseases of the nervous system:

cervical syndrome;
Lumbago;

4. Rheumatic affection of soft tissues (muscles, connective tissue, etc.).

Neurodiclovit - instructions for use

General provisions

Neurodiclovit capsules must be taken orally during meals, swallowed whole, not chewed, not cracked or opened, but washed down with plenty of non-carbonated water (at least a glass). If you need to get a quick therapeutic effect, then the capsules should be taken not during, but half an hour before meals.

Neurodiclovit is recommended to take one capsule 1 to 3 times a day. At the initial stages of therapy, it is optimal to take 1 capsule 3 times a day, and when the desired result is achieved - the relief of pain and inflammation, they switch to Neurodiclovit in a maintenance dosage of 1 capsule 1-2 times a day. The duration of the main stage of therapy is determined by the rate of disappearance of the symptoms of inflammation and pain. Taking the drug at a maintenance dosage can be carried out for a long time, for several weeks in a row, to ensure a stable therapeutic effect.

Use during pregnancy and breastfeeding

The drug is contraindicated for use throughout pregnancy and breastfeeding. If a woman who is breastfeeding needs to take Neurodiclovit for any reason, then the child should be transferred to artificial mixtures, refusing to breastfeed.

Since Neurodiclovit adversely affects fertility, the drug is not recommended for women planning a pregnancy.

Women undergoing examination or treatment for infertility are also advised to stop taking Neurodiclovit.

special instructions

During the entire period of therapy with Neurodiclovit, one should systematically monitor the blood picture (general blood test with a leukoformula), the functioning of the liver and kidneys, and also examine the stool for the presence of occult blood.

If, while taking Neurodiclovit, the activity of transaminases (AST, ALT) increases or symptoms of liver damage appear, such as nausea, fatigue, drowsiness, diarrhea, pruritus, jaundice, then you should stop the drug and consult a doctor.

In order to reduce the risk of side effects from the digestive tract, it is recommended to take Neurodiclovit in the minimum dosage, minimizing the duration of the course of therapy.

Renal function should be especially closely monitored when using Neurodiclovit in people suffering from renal or heart failure, as well as in elderly patients (over 65 years old) taking diuretics. In addition, kidney function must be monitored when there is a decrease in circulating blood volume, which can occur when taking diuretics, after surgery, vomiting, diarrhea, and other situations associated with loss of body fluid.

Neurodiclovitis can provoke the development of hyperkalemia (the level of potassium in the blood is higher than normal).

Influence on the ability to control mechanisms

Neurodiclovit adversely affects the ability to control mechanisms, reducing the speed of psychomotor reactions. Therefore, while taking the drug, you should abandon any activities that require a high speed of reactions and concentration.

Overdose

An overdose of Neurodiclovit is possible and is manifested by the following symptoms:

Vomit;
Lethargy;
Increased blood pressure;
respiratory depression;
Clouding of consciousness;

In children, the following symptoms may additionally occur with an overdose of Neurodiclovit:

Convulsions are myoclonic;
Nausea;
Bleeding from the organs of the gastrointestinal tract;
Violation of the liver and kidneys (including liver or kidney failure).

To treat an overdose, you should first wash the stomach, then take a sorbent (for example, activated carbon, Polysorb, Polyphepan, Filtrum, Laktofiltrum, etc.). After that, give plenty of fluids and diuretics (Furosemide) to ensure the speedy removal of the drug from the body. If necessary, carry out symptomatic therapy aimed at maintaining the normal functioning of vital organs.

In case of an overdose of Neurodiclovit, hemodialysis should not be performed, since this manipulation does not accelerate the excretion of the drug from the body.

Interaction with other drugs

Neurodiclovit increases the concentration in the blood of Digoxin, Methotrexate, Cyclosporine and lithium preparations, so a reduction in the dosage of the latter may be required.

Neurodiclovit weakens the effect of Levodopa, diuretics, hypotensive (lowering blood pressure), hypoglycemic (lowering blood glucose levels) and sleeping pills.

With the simultaneous use of Neurodiclovit with potassium-sparing diuretics (for example, Veroshpiron, Triamteren, Spironolactone, etc.), the risk of developing hyperkalemia (increased levels of potassium in the blood) increases.

When using Neurodiclovit with anticoagulants (Warfarin, Dicumarin, etc.), thrombolytics (Streptokinase, Urokinase, Alteplase, etc.), ethanol, Colchicine, Corticotropin, St. John's wort (Deprim, Hypericum, etc.) and serotonin reuptake inhibitors (Alprazolam, Xanax, Citalopram, Dapoxetine, etc.) increases the risk of gastrointestinal bleeding.

Taking Neurodiclovit with drugs of the NSAID group (Ibuprofen, Nimesulide, Aspirin, Nurofen, Ketorol, etc.) and glucocorticosteroids (Betamethasone, Prednisolone, Dexamethasone, etc.) increases the likelihood of side effects of these drugs.

Neurodiclovit enhances the toxicity of Methotrexate and Cyclosporine. And Paracetamol, Cyclosporine and gold preparations increase the toxic effect of Neurodiclovit on the kidneys.

Aspirin and other drugs containing acetylsalicylic acid reduce the concentration of diclofenac in the blood.

The incidence of hypoprothrombinemia (the level of prothrombin in the blood is below normal) increases when Neurodiclovit is taken simultaneously with Cefamandol, Cefoperazone, Cefotetan, Plikamycin and valproic acid.

Neurodiclovit enhances the effect of drugs that provoke photosensitivity.

Ethanol and anticonvulsants (Convulex, Lamotrigine, valproates, etc.) impair the absorption of vitamin B 1, and Colchicine and biguanides (Metformin, Fetformin, etc.) - vitamin B 12.

Neurodiclovitis and alcohol

Alcohol enhances the inhibitory effect of Neurodiclovit on the central nervous system, so it is not recommended to combine the medication with the use of alcoholic beverages. In addition, thanks to Neurodiclovit, alcohol can penetrate into the brain tissue faster and in large quantities, respectively, causing damage to more neurons, which has a very negative effect on the general condition and functional activity of the brain tissue. This factor also speaks in favor of the need to avoid alcoholic beverages while taking Neurodiclovit.

Side effects

Neurodiclovitis can provoke the following side effects from various organs and systems:

1. From the gastrointestinal tract:

Stomach ache;
Feeling of bloating;
Diarrhea or constipation;
Nausea;
Flatulence (increased gas formation in the intestines);
Increased activity of liver enzymes (AsAT, AlAT, alkaline phosphatase, etc.);
Peptic ulcer of the stomach with a risk of bleeding or perforation;
gastrointestinal bleeding;
Vomit;
Jaundice;
Melena (black feces);
Damage to the tissues of the esophagus;
Aphthous stomatitis;
hepatorenal syndrome;
Change in appetite;
cholecystopancreatitis;
Colitis.

2. From the nervous system:

Headache;
Dizziness;
Sleep disturbance;
Drowsiness;
Aseptic meningitis (usually in people with systemic lupus erythematosus or other connective tissue diseases);
General weakness;
Disorientation;
Nightmares;
Fears.

3. From the sense organs:

Noise in ears;
Blurred vision;
Diplopia (double vision);
Violation of taste;
Hearing loss, which may or may not be reversible;
Scotoma.

4. From the side of the skin and soft tissues:

Skin itching;
Skin rash ;
Alopecia (baldness);
Toxic dermatitis;
Erythema multiforme exudative (Stevens-Johnson syndrome);
Toxic epidermal necrolysis (Lyell's syndrome);
photosensitivity;
Spot hemorrhages.

5. From the genitourinary system:

Fluid retention in the body;
nephrotic syndrome;
Proteinuria (protein in the urine);
Oliguria (reduced amount of urine excreted);
Hematuria (blood in the urine);
Interstitial nephritis;
papillary necrosis;
Acute renal failure;
Azotemia (the level of residual nitrogen in the blood is higher than normal);
Deterioration of libido.

6. Blood system:

Anemia;
Leukopenia (the total number of white blood cells is below normal);
Thrombocytopenia (the total number of platelets in the blood is below normal);
Eosinophilia (the number of eosinophils in the blood is higher than normal);
Agranulocytosis (lack of neutrophils, basophils and eosinophils in the blood);
Aggravation of the course of chronic infectious diseases.

7. From the respiratory system:

Bronchospasm;
swelling of the larynx;
Pneumonitis.

8. From the side of the cardiovascular system:

Raise

Macrobolic-MRP is a fully balanced meal replacement providing carbohydrates, proteins and fats in the most digestible ratio: 45/35/20. The result of its use is to create an optimal anabolic environment within your body for muscle growth and recovery and weight control. Contains three essential nutrient complexes that are the basis for muscle growth, fat reduction, endurance and recovery.
GLYCEMIX LGI is a unique combination of low glycemic index (GI) carbohydrates that provides long-lasting energy, accelerates glycogen replenishment and helps control weight. This complex was specially created to stabilize blood sugar levels and evenly supply glucose to working muscles.
PROBOLIC is a protein complex consisting of soy protein, whey protein concentrate and caseinate. Contains a high level of essential essential amino acids: glutamine, arginine, leucine, isoleucine, valine. This complex provides a continuous supply of amino acids to the blood through a combination of "fast" and "slow" proteins, thereby maintaining an optimal anabolic environment for muscle recovery and building, as well as preventing the process of catabolism.
LIPOBOLIC is a complex of essential fatty acids derived from sources such as: borage oil, flax seeds, evening primrose oil. This complex contains Medium Chain Triglycerides (MCTs), an ideal source of energy, as well as CLA, which has been shown to reduce body fat and increase lean muscle mass.

Flavors:
chocolate, vanilla.

Properties:
the optimal ratio of carbohydrates / proteins / fats: 45/35/20.
32g of high quality Probolic® protein for muscle recovery and growth.
complex of carbohydrates with a low glycemic index Slow Carb ™ to replenish energy losses.
essential fatty acid complex to support healthy metabolism and weight control.

Mode of application:
Mix the contents of one sachet with 300 ml of cold water. Take two to three servings throughout the day between main meals.

Warning:
Do not use if the protective film on the package is damaged.

Compound:
low glycemic carbohydrate complex GLYCEMIX LGI® (barley and oat fiber)
PROBOLIC® protein complex (Supro®-soy soy protein isolate with calcium phosphate and lecithin, calcium caseinate, whey protein concentrate, leucine, isoleucine, valine)
safflower oil
sodium caseinate (from milk)
di-potassium phosphate
mono- and diglycerides
lecithin
tocopherols
natural flavor
silicon dioxide)
lipid complex:
medium chain triglycerides
essential fatty acid blend (borage seed oil (GLA) conjugated linoleic acid (CLA)
evening primrose oil (GLA)
flax seed powder (ALA)
omega-3 complex (EPA and DHA)
xanthan gum
carrageenan
acesulfame potassium
salt
vitamin complex (ascorbic acid, dl-alpha tocopherol acetate, retinol palmitate, niacinamide, calcium pantothenate, cholecalciferol, pyridoxine hydrochloride, riboflavin, thiamine mononitrate, cyanocobalamin, folic acid, biotin)
Banaba leaf extract (Lagestroemia speciosa).

Terms and conditions of storage:
Store in a dry place at a temperature of 15-30°C.

Release form:
Packing 20 bags of 90 g (1800 g).

pharmachologic effect

NSAIDs in combination with B vitamins. diclofenac It has anti-inflammatory, analgesic, antiplatelet and antipyretic effects. Indiscriminately inhibiting COX-1 and COX-2, disrupts the metabolism of arachidonic acid, reduces the amount of prostaglandins in the focus of inflammation. In rheumatic diseases, the anti-inflammatory and analgesic effect of diclofenac contributes to a significant decrease in the severity of pain, morning stiffness, swelling of the joints, which improves the functional state of the joint. With injuries, in the postoperative period, diclofenac reduces pain and inflammatory edema.

Thiamine (vitamin B 1) in the human body, as a result of phosphorylation processes, it turns into cocarboxylase, which is the coenzyme of many enzymatic reactions. Vitamin B1 plays an important role in carbohydrate, protein and fat metabolism. Actively participates in the processes of nerve excitation in synapses.

Pyridoxine (vitamin B 6) necessary for the normal functioning of the central and peripheral nervous system. In the phosphorylated form, it is a coenzyme in the metabolism of amino acids (decarboxylation, transamination). It acts as a coenzyme for the most important enzymes that act in nerve tissues. Participates in the biosynthesis of many neurotransmitters - such as dopamine, serotonin, norepinephrine, epinephrine, histamine and GABA.

Cyanocobalamin (Vitamin B 12) necessary for normal hematopoiesis and maturation of red blood cells, and also participates in a number of biochemical reactions that ensure the vital activity of the body - in the transfer of methyl groups, in the synthesis of nucleic acids, protein, in the metabolism of amino acids, carbohydrates, lipids. It has a beneficial effect on processes in the nervous system (nucleic acid synthesis and lipid composition of cerebrosides and phospholipids). The coenzymatic forms of cyanocobalamin, methylcobalamin and adenosylcobalamin, are essential for cell replication and growth.

The combination of B vitamins potentiates the analgesic effect of diclofenac.

Pharmacokinetics

diclofenac

Suction

Absorption of diclofenac is fast and complete. Food slows down the rate of absorption by 1-4 hours and reduces Cmax by 40%. After oral administration of diclofenac at a dose of 50 mg, Cmax is reached after 2-3 hours and is 1.4 μg / ml. Plasma concentration is linearly related to the dose taken. Bioavailability - 50%.

Distribution

Changes in the pharmacokinetics of diclofenac against the background of repeated administration are not observed, do not cumulate. Plasma protein binding - more than 99% (most associated with albumin). Penetrates into the synovial fluid. Cmax in synovial fluid is observed 2-4 hours later than in plasma. Diclofenac is excreted in breast milk. V d - 550 ml / kg.

Metabolism

50% of the active substance is metabolized during the "first pass" through the liver. Metabolism occurs as a result of multiple or single hydroxylation and conjugation with glucuronic acid. The CYP2C9 isoenzyme takes part in the metabolism of the drug. The pharmacological activity of metabolites is lower than that of diclofenac.

breeding

T 1 / 2 from the synovial fluid is 3-6 hours. The concentration of diclofenac in the synovial fluid 4-6 hours after taking the drug is greater than in plasma, and remains higher than the plasma values for another 12 hours. The relationship of the concentration of the drug in the synovial fluid with the clinical efficacy of the drug has not been elucidated. Systemic clearance is 350 ml/min. T1 / 2 from plasma - 2 hours. 65% of the administered dose is excreted as metabolites by the kidneys, less than 1% is excreted unchanged, the rest of the dose is excreted as metabolites in the bile.

In patients with severe renal insufficiency (CK<10 мл/мин) увеличивается выведение метаболитов с желчью, при этом увеличения их концентрации в крови не наблюдается.

In patients with chronic hepatitis or compensated liver cirrhosis, the pharmacokinetic parameters of diclofenac do not change.

Vitamins B 1, B 6, B 12

The vitamins that make up Neurodiclovit are water-soluble, which excludes the possibility of their accumulation in the body.

Thiamine and pyridoxine are absorbed in the upper small intestine, metabolized in the liver and excreted by the kidneys (about 8-10% unchanged). The degree of absorption depends on the dose, with an overdose, the excretion of thiamine and pyridoxine through the intestine increases significantly.

The absorption of cyanocobalamin depends to a large extent on the presence of an internal factor in the body (in the stomach and upper small intestine), further delivery of the vitamin to the tissues is determined by the transport protein transcobalamin. After metabolism in the liver, cyanocobalamin is excreted mainly with bile, the degree of excretion by the kidneys is variable - from 6 to 30%.

Indications

- pain syndrome with inflammation of a non-rheumatic nature (after injuries, surgical and dental interventions; with gynecological diseases - primary algomenorrhea, adnexitis; with inflammatory diseases of the upper respiratory tract - pharyngitis, tonsillitis, otitis media);

- inflammatory and degenerative diseases of the joints and spine (chronic polyarthritis, rheumatic and rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, spondylarthrosis);

- neuritis and neuralgia (cervical syndrome, lumbago, sciatica);

- acute gouty arthritis;

- rheumatic affection of soft tissues.

Dosing regimen

Capsules should be taken orally with meals, without chewing and with plenty of liquid.

Adults Neurodiclovit is prescribed 1 capsule 3 times / day at the beginning of treatment, as a maintenance dose - 1-2 times / day. The duration of therapy depends on the nature and severity of the disease.

Side effect

From the digestive system: > 1% - epigastric pain, feeling of bloating, diarrhea, nausea, constipation, flatulence, increased levels of liver enzymes, peptic ulcer with possible complications (bleeding, perforation), gastrointestinal bleeding;<1% – рвота, желтуха, мелена, появление крови в кале, поражение пищевода, афтозный стоматит, сухость слизистых оболочек (в т.ч. рта), гепатит (возможно молниеносное течение), некроз печени, цирроз, гепаторенальный синдром, изменение аппетита, панкреатит, холецистопанкреатит, колит.

From the nervous system:>1% - headache, dizziness;<1% - нарушение сна, сонливость, депрессия, раздражительность, асептический менингит (чаще у больных системной красной волчанкой и другими системными заболеваниями соединительной ткани), судороги, общая слабость, дезориентация, кошмарные сновидения, ощущение страха.

From the sense organs:>1% - tinnitus;<1% - нечеткость зрения, диплопия, нарушение вкуса, обратимое или необратимое снижение слуха, скотома.

Dermatological reactions:>1% - skin itching, skin rash;<1% - алопеция, крапивница, экзема, токсический дерматит, многоформная экссудативная эритема (в т.ч. синдром Стивенса-Джонсона), токсический эпидермальный некролиз (синдром Лайелла), повышенная фоточувствительность, мелкоточечные кровоизлияния, буллезные высыпания.

From the urinary system:>1% - fluid retention;<1% – нефротический синдром, протеинурия, олигурия, гематурия, интерстициальный нефрит, папиллярный некроз, острая почечная недостаточность, азотемия.

From the hematopoietic system: <1% – анемия (в т.ч. гемолитическая и апластическая анемии), лейкопения, тромбоцитопения, эозинофилия, агранулоцитоз, тромбоцитопеническая пурпура.

From the respiratory system:<1% – кашель, бронхоспазм, отек гортани, пневмония.

From the side of the cardiovascularsystems: <1% – повышение АД, застойная сердечная недостаточность, экстрасистолия, боль в грудной клетке, инфаркт миокарда.

Allergic reactions:<1% - анафилактоидные реакции, анафилактический шок (обычно развивается стремительно), отек губ и языка, аллергический васкулит.

Others: <1% – ухудшение течения инфекционных процессов (в т.ч. развитие некротического фасциита).

Contraindications for use

- erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);

- gastrointestinal bleeding;

- intracranial bleeding;

- complete or incomplete combination of bronchial asthma, recurrent polyposis of the nasal mucosa and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including history);

- violations of hematopoiesis;

- violations of hemostasis (including hemophilia);

- inflammatory bowel disease;

- severe liver failure;

- active liver disease;

- severe renal failure (CC less than 30 ml / min);

- progressive kidney disease;

- severe heart failure;

- the period after coronary artery bypass grafting;

- confirmed hyperkalemia;

- pregnancy;

- lactation period (breastfeeding);

- childhood;

- hypersensitivity to the components of the drug;

- Hypersensitivity to other NSAIDs or vitamins.

FROM caution: peptic ulcer of the stomach and duodenum, ulcerative colitis, Crohn's disease, a history of liver disease, hepatic porphyria, chronic liver failure, chronic heart failure, arterial hypertension, a significant decrease in BCC (including after major surgery), elderly patients (including those receiving diuretics, debilitated patients and those with low body weight), bronchial asthma, concomitant use of corticosteroids (including prednisone), anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline), ischemic heart disease, cerebrovascular disease, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, chronic renal failure (CC 30-60 ml / min), the presence of Helicobacter pylori infection, long-term use of NSAIDs, alcoholism, severe somatic diseases, smoking nie.

Use during pregnancy and lactation

The drug is contraindicated during pregnancy and lactation (breastfeeding).

Due to the negative effect on fertility, it is not recommended to prescribe the drug to women planning to become pregnant.

In patients with infertility (including those undergoing examination), it is recommended to discontinue the drug.

Use in children

Contraindicated: children's age .

Overdose

Symptoms: vomiting, bleeding from the gastrointestinal tract, epigastric pain, diarrhea, dizziness, tinnitus, lethargy, convulsions; rarely - increased blood pressure, acute renal failure, hepatotoxic effect, respiratory depression, coma.

Treatment: gastric lavage, activated charcoal, symptomatic therapy aimed at eliminating the increase in blood pressure, impaired renal function, convulsions, gastrointestinal irritation, respiratory depression. Forced diuresis, hemodialysis are ineffective (due to significant binding to plasma proteins and intensive metabolism).

drug interaction

With the simultaneous use of Neurodiclovit increases the plasma concentration of digoxin, methotrexate, lithium preparations and cyclosporine.

With the simultaneous use of Neurodiclovit reduces the effect of diuretics, against the background of potassium-sparing diuretics, the risk of hyperkalemia increases.

With the simultaneous use of Neurodiclovit and anticoagulants, thrombolytic agents (alteplase, streptokinase, urokinase), the risk of bleeding (often gastrointestinal bleeding) increases.

With the simultaneous use of Neurodiclovit reduces the effects of antihypertensive and hypnotic drugs.

With the simultaneous use of Neurodiclovit increases the likelihood of side effects of other NSAIDs and corticosteroids (gastrointestinal bleeding), methotrexate toxicity and cyclosporine nephrotoxicity.

Acetylsalicylic acid reduces the concentration of diclofenac in the blood.

Simultaneous use of Neurodiclovit with paracetamol increases the risk of nephrotoxic effects of diclofenac.

With the simultaneous use of Neurodiclovit reduces the effect of hypoglycemic agents.

With simultaneous use with Neurodiclovit, cefamandol, cefoperazone, cefotetan, valproic acid and plicamycin increase the incidence of hypoprothrombinemia.

Cyclosporine and gold preparations increase the effect of diclofenac on the synthesis of prostaglandins in the kidneys, which increases the risk of nephrotoxicity.

The simultaneous appointment of Neurodiclovit with ethanol, colchicine, corticotropin, serotonin reuptake inhibitors and St. John's wort increases the risk of gastrointestinal bleeding.

Diclofenac enhances the effect of drugs that cause photosensitivity.

Drugs that block tubular secretion increase the plasma concentration of diclofenac, thereby increasing its toxicity.

Neurodiclovit reduces the antiparkinsonian efficacy of levodopa.

Ethanol sharply reduces the absorption of thiamine (blood levels can decrease by 30%).

Long-term treatment with anticonvulsants can lead to thiamine deficiency.

The use of colchicine and biguanides reduces the absorption of cyanocobalamin.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

The drug should be stored out of the reach of children, dry, dark place at a temperature not exceeding 25°C. Shelf life - 3 years.

Application for violations of liver function

FROM caution a drug for hepatic insufficiency should be prescribed.

Application for violations of kidney function

FROM caution the drug should be prescribed for renal failure.

Use in elderly patients

FROM caution should be prescribed to elderly patients.

special instructions

During the period of drug treatment, a systematic monitoring of the picture of peripheral blood, liver and kidney function, and a study of feces for the presence of blood should be carried out.

To reduce the risk of adverse events in the gastrointestinal tract, the drug should be used in the minimum effective dose for the shortest possible course.

In order to quickly achieve the desired therapeutic effect, the tablets are taken 30 minutes before a meal. In other cases, take before, during or after a meal, without chewing, drinking plenty of water.

Due to the important role of prostaglandins in maintaining renal blood flow, special care should be taken when prescribing to patients with heart or renal insufficiency, as well as in the treatment of elderly patients receiving diuretics and patients who, for any reason, have a decrease in BCC (including hours after extensive surgery). If diclofenac is prescribed in such cases, it is recommended to monitor renal function as a precautionary measure.

If, while taking the drug, an increase in liver transaminase activity persists or increases, if clinical symptoms of hepatotoxicity (including nausea, fatigue, drowsiness, diarrhea, pruritus, jaundice) are noted, treatment should be discontinued.

Diclofenac (like other NSAIDs) can cause hyperkalemia.

Influence on the ability to drive vehicles and control mechanisms

During the period of treatment, a decrease in the speed of mental and motor reactions is possible, so patients should refrain from driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.

Neurodiclovit and its analogues quickly and effectively eliminate pain in diseases of the musculoskeletal system. Neurodiclovit is a combination drug from the Austrian company Gerot Lannach Pharma. The drug consists of diclofenac sodium and B vitamins.

For example, with osteochondrosis of the spine, which affects more than half of humanity, there may be a sharp pain in the back. Because of it, a person literally freezes in one position, since an attempt to make any movement will only increase the pain. This condition is the result of compression of the spinal nerves. This is the result of degenerative cartilage damage and reactive changes occurring in the vertebrae.

What are Neurodiclovit and its analogues used for?

Neurodiclovit is convenient to use, as it saves the patient from taking a number of drugs and reduces the duration of treatment. The results of studies have shown that when using vitamins B with diclofenac, the pain goes away faster. And since diclofenac has many side effects, it is preferable to take a shorter course of treatment with this medicine. In this case, this drug is the most suitable remedy that copes with disorders of the musculoskeletal system and the nervous system.

Diseases for which this drug is indicated:

neuralgia;
neuritis;
polyarthritis;
sciatica;
arthritis (of various origins);
arthrosis;
lumbago;
osteochondrosis (cervical, thoracic, lumbosacral).

The drug is also used with an increase in temperature, the formation of edema and swelling.

Each capsule contains:

diclofenac (50 mg) - active ingredient;
vitamin B1 (thiamine hydrochloride);
vitamin B6 (pyridoxine hydrochloride);
vitamin B12 (cyanocobalamin);
auxiliary components.

Similar drugs

There are no analogues, which would simultaneously include vitamins of group B and NSAIDs. Therefore, if necessary, the most suitable substitutes are selected.

Similar drugs, the trade names of which sound different, but their main substance is the same, with which Neurodiclovit can be replaced:

Bioran;
Voltaren;
Voltaren Akti;
Voltaren Rapid - powder, a suspension is prepared from it;
Diklak;
Diclovit;
Diclogen;
Dicloran;
Dicloran SR;
Diclofenac;
Diclofenac Bufus - solution for injection;
Diclofenac Retard - long-acting tablets;
Dolomin;
Naklofen;
Naklofen Duo - modified release capsules;
Naklofen SR - long-acting tablets;
Naklofen Protect;
Ortofen;
Panoxen;
Rapten Duo;
Rapten Rapid;
Swiss Jet Duo;
Tabuk Dee;
Flotak;
Movalis;
Meloxicam;
Ketorolac;
Lornoxicam.

In various preparations, the dose of diclofenac is different, therefore, when selecting an analogue, this fact must be taken into account. Since each drug has its own specifics and contraindications, a doctor's consultation is required.

Treatment with Neurodiclovitis is often continued with Neuromultivit. This drug contains similar vitamins, but without diclofenac. Neuromultivit is prescribed for the treatment of neurological diseases. When the question arises of replacing Neurodiclovit, the fact of the presence of neuritis is taken into account. If such therapy is necessary, Neuromultivit can be used instead of Neurodiclovit.

Thiamine (B1) - is involved in metabolic processes and the transport of nerve impulses.
Pyridoskin (B6) - is found in substances responsible for the functioning of the nervous system. These include dopamine, adrenaline, serotonin, histamine. All of them ensure the normal state of the nervous tissue.
Cyanocobalamin (B 12) - has a positive effect on the blood, in particular on the formation of red blood cells in the bone marrow, promotes the renewal of nerve cells.

In complex treatment, these vitamins enhance the properties of diclofenac. Due to this, this combination of drugs quickly relieves pain of a neuralgic nature.

Who is assigned

Also indications for use are:

Post-traumatic pain.
The rehabilitation period after the operation.
Dental treatment.
Gynecological pain, not having an infectious nature.
Respiratory diseases.

All nonsteroidal drugs have side effects, and diclofenac is no exception.

Possible adverse reactions

Digestive system:

flatulence and abdominal pain;
stool disorder - diarrhea or constipation;
nausea and urge to vomit;
overloaded liver;
jaundice.

From the side of the nervous system, the following side effects are possible:

headache and dizziness;
insomnia or increased sleepiness;
increased nervous excitability;
depression and stress;
increased sense of fear;
lack of coordination;
muscle cramps.

Sense organs:

extraneous noise in the ears;
blurred vision;
change in taste;
hearing impairment (serious attention should be paid to this, since after discontinuation of the drug this phenomenon can become chronic).

the appearance of itching;
allergic rash, urticaria;
hair loss;
eczema.

Urogenital system:

deterioration of kidney function;
the appearance of edema;
excretion of protein in the urine;
reduction in the amount of urine excreted;
the appearance of blood in urine;
decreased libido.

Complications from chronic diseases are possible.

Respiratory system:

the appearance of a cough;
spasms from the bronchi;
pneumonia;
swelling of the larynx.

Contraindications for use

hypersensitivity to any of the components contained in the preparation;
hypersensitivity to any nonsteroidal drug;
exacerbation of gastrointestinal diseases;
bleeding (any);
asthmatic cough;
hematopoietic disorders (poor clotting);
pathology of the kidneys or liver;
heart problems;
after open heart surgery;
high levels of potassium in the blood;
pregnancy;
children's age and adolescents under 18;
acceptance of alcoholic beverages;
diabetes.

Price difference

Often, when doctors prescribe medications to a patient, the question arises of replacing drugs with more affordable ones. Many people think that Russian analogues are cheaper because they are not subject to additional import duties.

The price of similar drugs manufactured by different companies can differ tenfold. And the buyer has a natural question, if the active substance is the same, then why such a difference in cost.

The manufacturer spends a lot of money on the original drug - research, advertising, etc. Therefore, the manufacturer tries to compensate for the losses by selling the drug at a high price. And generics are no longer being researched and produced using the same technology, but under a different name.

The next aspect that significantly increases the price is the packaging. The more beautiful and better it is, the higher the price. But this does not affect the quality of the medicine. As for the choice between a domestic product and an imported one, it is known that foreign analogues are produced using higher technologies, therefore the quality of such drugs is much higher.

Neurodiclovit is a drug that belongs to non-steroidal anti-inflammatory drugs, it contains diclofenac and vitamins of group B. Thanks to this combination of active substances, pain caused by neurological, musculoskeletal (sometimes gynecological and otolaryngic) diseases is reduced.

Diclofenac has anti-inflammatory, analgesic and antipyretic effects, also relieves swelling and swelling. The therapeutic effect is carried out by indiscriminate inhibition of cyclooxygenase-1 and cyclooxygenase-2, which causes a violation of the metabolism of arachidonic acid and a decrease in prostaglandins (pain mediators) in the inflammatory focus. Thus, with rheumatic pathologies, taking the drug eliminates morning stiffness, relieves inflammation and swelling of the joint.

After injury and in the postoperative period, Neurodiclovit reduces pain and swelling, prevents the development of fever.

Neurodiclovit, photo of capsules

B vitamins have effects:

1. Thiamine (B1). Participates in carbon, lipid, energy and protein metabolism, regulates the activity of the nervous system (in particular, is responsible for the mechanism of nerve impulse conduction).

2. Pyroxidine (B6). Improves the contractility of the heart muscle, promotes the conversion of folic acid into an active form. Also, the vitamin is involved in the synthesis of neurotransmitters, regulates the functioning of the nervous system, promotes the absorption of glucose by nerve cells, reduces spasms and muscle cramps, and improves the passage of impulses from receptors to the brain. In addition, pyroxidine synthesizes neurotransmitters such as dopamine, serotonin, norepinephrine, epinephrine, histamine.

3. Cyanocobalamin (B12). Participates in the hematopoietic process, the formation of neurons, has a positive effect on metabolism, synthesizes nucleic acids necessary for the normal functioning of the nervous system.

The drug is released in capsules. Ingredients: diclofenac (50 milligrams), thiamine (50 milligrams), pyroxidine (50 milligrams), cyanocobalamin (1/4 milligrams).

Indications for use

What is Neurodiclovit used for? It is prescribed for the following diseases:

Inflammatory and degenerative-dystrophic pathologies of the ridge and bone joints, accompanied by severe pain and inflammation (osteochondrosis, spondylarthrosis, osteoarthritis, chronic polyarthritis);
Neuritis (inflammation of the occipital, intercostal or facial nerve, as well as the nerves of the limb) and neuralgia (severe pain along the innervation of the nerve - sciatica, lumbago, trigeminal attack);
Acute gouty arthritis;
Rheumatic extra-articular lesion of periarticular tissues.

Also, the drug is prescribed if there is a pronounced pain syndrome after surgical or dental implantation, with painful menstruation, sore throat caused by tonsillitis, tonsillitis, pharyngitis.

Instructions for use Neurodiclovit, dosages

The drug is taken orally, the capsules are not chewed or opened. Drink enough water. Neurodiclovit is recommended to be taken immediately after a meal.

The dosage is prescribed by the attending physician on an individual basis. According to the instructions for the use of Neurodiclovit, the recommended amount is:

Adults, one capsule three times a day, maintenance therapy - one capsule per day;
Adolescents (from 12-18 years old, if body weight is more than 40 kg) one capsule twice a day, maintenance therapy - one capsule every other day;
Patients over 65 years of age require dosage adjustment. Before prescribing a medication, a detailed study of the function of the liver and kidneys is carried out.

If the indicators are slightly deviated to the side, then the dosage is prescribed, as for adolescents.

It should be borne in mind that the drug reduces the effect of diuretics, therefore, the risk of developing hyperkalemia (potassium release from cells and the body) increases. If the patient is being treated with coagulants or thrombolytic drugs, there is a high risk of hemorrhage (most often in the stomach or intestines). The effect of antihypertensive and sedative drugs is reduced if Neurodiclovit is used simultaneously with them.

Contraindications and overdose

The drug is not prescribed for the following diseases and features:

intolerance to any component;
the presence of the aspirin triad in history (simultaneous aspirin intolerance, nasal polyps and bronchial asthma);
porphyrin disease (disturbance of pigment metabolism);
diseases of the blood and blood-forming organs, including hemorrhagic diathesis (the tendency of the body to bleed and hemorrhage);
stomach ulcer and duodenal ulcer (acute form), including perforation of the ulcer; Crohn's disease, bleeding in the stomach or intestines;
heart failure (moderate and severe form);
thromboembolism, erythremia, erythrocytosis;
allergic manifestations of moderate and severe severity.

Neurodiclovit is also contraindicated in children under 12 years of age, women who are carrying a fetus and breastfeeding.

Relative contraindications include:

- seasonal fever;
- high blood pressure, ischemia, impaired peripheral and cerebral circulation;
- angina pectoris, malignant neoplasms.

During treatment, the patient may experience side effects of varying severity. Reactions to Neurodiclovitis are most often:

heart and blood vessels (hypertension, fluid retention in the body, myocardial infarction, cardiac arrhythmias);
from the side of the central nervous system - convulsive syndrome, sleep disturbance, migraine, trembling fingers, anxiety, deterioration of visual acuity;
gastrointestinal system - the formation or progression of an ulcer, abdominal pain, pathological changes in stool (diarrhea or constipation), flatulence;
urinary system - insufficiency of renal function, urinary retention, protein and hematuria;
skin - small rash, focal redness, itching, severe hyperemia.

An overdose occurs when an incorrect dose of the drug is taken or as a result of long-term treatment with it. The patient is diagnosed with renal failure and symptoms of hepatotoxicity (nausea, vomiting, jaundice of the skin). Also, an overdose leads to the development of neurotoxic signs (neuropathy, convulsions, cardiac arrhythmias).

Neurodiclovit analogues, list of drugs

Today, there are many analogues of Neurodiclovit, the most common:

Dolex,
Naklofen,
Ortofen,
Flotak.

Important - instructions for use Neurodiclovit, price and reviews do not apply to analogues and cannot be used as a guide for the use of drugs of similar composition or action. All therapeutic appointments must be made by a doctor. When replacing Neurodiclovit with an analogue, it is important to get expert advice, it may be necessary to change the course of therapy, dosages, etc. Do not self-medicate!

Doctor's review of Neurodiclovit: “The drug perfectly relieves pain, is sold in a pharmacy without a prescription, it can even be used as an ambulance at home. However, due to the large list of contraindications, it is not prescribed for every patient, so it is necessary to prescribe analogues, the therapeutic effect of which is sometimes much worse.