Neurodiclovit is a non-steroidal anti-inflammatory agent (NSAID) in combination with group B vitamins.
Release form and composition
Dosage form - modified release capsules: size No. 1, hard gelatinous, opaque, with a light pinkish-yellow body and a pinkish-brown lid; the content is a mixture of white granulate and pink powder (10 each in a blister, in a carton of 3 blisters).
Active ingredients in 1 capsule:
- Diclofenac Sodium - 50 mg;
- Pyridoxine hydrochloride (vitamin B 6 ) - 50 mg;
- Thiamine hydrochloride (vitamin B 1 ) - 50 mg;
- Cyanocobalamin (vitamin B 12 ) - 0.25 mg.
Excipients: copolymer of methacrylic acid and ethyl acrylate (1: 1) dispersion of 30%, talc, triethyl acetate, Povidone K25.
- Body: gelatin, titanium dioxide (E171), iron dyes yellow oxide and iron red oxide;
- Lid: gelatin, titanium dioxide (E171), iron dyes, red oxide.
Indications for use
- Acute gouty arthritis;
- Neuritis and neuralgia: lumbago, cervical syndrome, sciatica;
- Rheumatic soft tissue damage;
- Degenerative and inflammatory diseases of the spine and joints: rheumatic and rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, spondylarthrosis, chronic polyarthritis;
- Pain syndrome in inflammations of non-rheumatic nature: in gynecological diseases (adnexitis, primary algomenorrhea), inflammatory diseases of the upper respiratory tract (otitis, pharyngitis, tonsillitis), after surgical and dental interventions, injuries.
- The period after coronary artery bypass surgery;
- Severe heart failure;
- Confirmed hyperkalemia;
- Inflammatory bowel disease;
- Intracranial bleeding;
- Erosive and ulcerative lesions of the gastrointestinal tract in the acute phase;
- Progressive kidney disease;
- Renal failure severe (creatinine clearance less than 30 ml / minute);
- Hematopoiesis disorders;
- Active liver disease;
- Severe liver failure;
- Gastrointestinal bleeding;
- Hemostatic disorders (including hemophilia);
- Complete or incomplete combination of bronchial asthma with intolerance to acetylsalicylic acid or other NSAIDs, nasal mucosa polyposis, and paranasal sinuses, including in the anamnesis;
- Children and adolescence;
- Hypersensitivity to the components of the drug or other vitamins or NSAIDs.
- Crohn's disease;
- Ulcerative colitis;
- A history of liver disease;
- Peptic ulcer and duodenal ulcer;
- Chronic liver failure;
- Hepatic porphyria;
- Significant reduction in circulating blood volume (including after extensive surgery);
- Bronchial asthma;
- Cerebrovascular diseases;
- Peripheral artery diseases;
- Dyslipidemia and hyperlipidemia;
- Chronic renal failure (creatinine clearance 30-60 ml / minute);
- Arterial hypertension;
- Diagnosed Helicobacter pylori infection;
- Coronary heart disease;
- Chronic heart failure;
- Severe somatic diseases;
- Old age (especially in patients with low body weight, weakened or receiving diuretics);
- Prolonged use of NSAIDs;
- Simultaneous use of selective serotonin reuptake inhibitors (including fluoxetine, citalopram, sertraline, paroxetine), anticoagulants (including warfarin), glucocorticosteroids (including prednisolone), antiplatelet agents (including clopidogrel) and acetylsalicylic acid);
Dosing and Administration
Neurodiclovit should be taken orally, swallowing the capsules whole, not chewed or opened, drinking plenty of liquid. If you want to quickly achieve the desired effect, take the drug should be 30 minutes before meals. In other cases, capsules can be taken before, during or after a meal.
At the beginning of treatment, adults are prescribed 1 capsule 3 times a day, and during maintenance therapy, 1 capsule 1-2 times a day.
The duration of therapy is determined individually, depending on the nature and severity of the disease.
- Digestive system:> 1% - increased levels of liver enzymes, nausea, diarrhea, constipation, bloating, flatulence, epigastric pain, gastrointestinal bleeding, peptic ulcer, including complications (bleeding, perforation); <1% - appearance of blood in feces, changes in appetite, melena, vomiting, pancreatitis, colitis, cirrhosis, jaundice, necrosis of the liver, cholecystopancreatitis, dry mucous membranes (including the mouth), aphthous stomatitis, esophageal lesions, hepatorenal syndrome, hepatitis ( possible lightning current);
- Nervous system:> 1% - vertigo and headache; <1% - irritability, sleep disturbance, disorientation, feeling of fear, nightmares, drowsiness, general weakness, depression, convulsions, aseptic meningitis (often in patients with systemic lupus erythematosus or other systemic connective tissue diseases);
- Sense organs:> 1% - tinnitus; <1% - a violation of taste, scotoma, diplopia, blurred vision, hearing loss (both reversible and irreversible);
- Blood system: <1% - agranulocytosis, thrombocytopenia, leukopenia, eosinophilia, thrombocytopenic purpura, anemia (including aplastic and hemolytic);
- Urinary system:> 1% - fluid retention; <1% - interstitial nephritis, hematuria, papillary necrosis, oliguria, azotemia, proteinuria, nephrotic syndrome, acute renal failure;
- Cardiovascular system: <1% - chest pain, high blood pressure, extrasystole, congestive heart failure, myocardial infarction;
- Respiratory system: <1% - laryngeal edema, bronchospasm, cough, pneumonia;
- Dermatological reactions:> 1% - rash and itching; <1% - eczema, urticaria, alopecia, increased photosensitivity, bullous rashes, petechial hemorrhages, toxic epidermal necrolysis, exudative erythema multiforme, toxic dermatitis;
- Allergic reactions: <1% - allergic vasculitis, anaphylactoid reactions, swelling of the lips and tongue, anaphylactic shock (usually develops rapidly);
- Other: <1% - worsening of the course of infectious processes, as well as the development of necrotic fasciitis.
During the period of treatment with Neurodiclovitis, the pattern of peripheral blood, kidney and liver functions should be regularly monitored; a fecal test should be carried out to check for blood in it.
In order to reduce the likelihood of side effects on the part of the digestive system, it is recommended to take the drug as short a course as possible in the minimum effective dose.
Like other NSAIDs, diclofenac, which is part of Neurodiclovitis, can cause hyperkalemia.
During treatment, it is not recommended to take multivitamin complexes containing vitamins of group B.
Since the drug can reduce the rate of reactions, patients during therapy are advised to refrain from driving and performing potentially hazardous types of work requiring quick reactions and increased attention.
- Preparations of lithium, cyclosporine, methotrexate, digoxin: their concentration in the blood plasma increases;
- Diuretics: their effectiveness decreases, the risk of hyperkalemia increases;
- Antihypertensive and hypnotic drugs: their effectiveness is reduced;
- Other NSAIDs and glucocorticosteroids: increases the likelihood of side effects, including gastrointestinal bleeding;
- Methotrexate: its toxicity increases;
- Cyclosporine: its nephrotoxicity is enhanced;
- Anticoagulants, thrombolytic agents (streptokinase, alteplaza, urokinase): the risk of bleeding increases (usually gastrointestinal);
- Acetylsalicylic acid: the concentration of diclofenac in the blood decreases;
- Paracetamol: increases the risk of nephrotoxic effects of diclofenac;
- Hypoglycemic agents: their effectiveness decreases;
- Valproic acid, cefoperazone, plicamycin, cefotetan, cefamandol: the incidence of hypoprothrombinemia increases;
- Ethanol, serotonin reuptake inhibitors, Hypericum preparations, corticotropin, colchicine: the risk of gastrointestinal bleeding increases;
- Drugs that block tubular secretion: the concentration of diclofenac and its toxicity increase;
- Gold preparations: the effect of diclofenac on the synthesis of prostaglandins in the kidneys increases, as a result of which the risk of nephrotoxicity increases;
- Levodopa: its anti-parkinsonian efficacy decreases;
- Colchicine, biguanides: reduced absorption of cyanocobalamin;
- Drugs that cause photosensitivity: their effect increases;
- Ethanol: the absorption of thiamine is sharply reduced, due to which its level in the blood can decrease by 30%.
With long-term treatment with anticonvulsants, thiamine deficiency may develop.
Terms and conditions of storage
Store at a temperature up to 25 ºС in a dark place inaccessible to children.
Shelf life - 3 years.