– повышенная чувствительность к диклофенаку или другим компонентам препарата;
– полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза носа и околоносовых пазух, непереносимость салицилатов или других НПВП (в том числе в анамнезе);
При наружном применении диклофенак хорошо проникает через кожу, преимущественно концентрируясь в очаге воспаления и синовиальной жидкости. Количество диклофенака, которое всасывается через кожу, пропорционально времени контакта геля с кожей и площади его нанесения, зависит от суммарной дозы препарата и от степени гидратации кожи. При рекомендуемом способе нанесения абсорбция составляет не более 6 %. Связь с белками плазмы крови – 99,7 %. Выводится почками. При нанесении на область пораженного сустава концентрация в синовиальной жидкости выше, чем в плазме.
Показания к применению
– посттравматическое воспаление мягких тканей, например, вследствие растяжений, перенапряжений, ушибов, травм;
– ревматические заболевания и отечность мягких тканей (тендовагинит, бурсит, поражение периартикулярных тканей, лучезапястный синдром);
– боли в суставах (суставы пальцев рук, коленные и др.) при остеоартрозе;
– боли в спине при воспалительных и дегенеративных заболеваниях позвоночника (остеоартроз, радикулит, люмбаго, ишиас).
Препарат предназначен для симптоматической терапии, уменьшения боли и воспаления на момент использования, на прогрессирование заболевания не влияет.
Противопоказания
– повышенная чувствительность к диклофенаку или другим компонентам препарата;
– полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза носа и околоносовых пазух, непереносимость салицилатов или других НПВП (в том числе в анамнезе);
– беременность (III триместр);
– период грудного вскармливания;
– детский возраст (до 12 лет);
– нарушение целостности кожных покровов в предполагаемом месте нанесения.
С осторожностью
Печёночная порфирия (обострение), эрозивно-язвенные поражения желудочно-кишечного тракта (в том числе язвенная болезнь желудка и двенадцатиперстной кишки), тяжелые нарушения функции печени и почек, хроническая сердечная недостаточность, нарушения свёртываемости крови (в том числе гемофилия, удлинение времени кровотечения, склонность к кровотечениям), бронхиальная астма, пожилой возраст, беременность I и II триместр.
Применение при беременности и в период грудного вскармливания
Препарат нельзя применять в III триместре беременности.
Использование в I и II триместрах возможно только после консультации с врачом, если ожидаемая польза для матери превышает потенциальный риск для плода.
В связи с отсутствием данных о проникновении препарата в грудное молоко, не рекомендуется его применение в период грудного вскармливания. Если все же необходимо применение препарата, то не следует наносить его на молочные железы или на большую поверхность кожи и не применять длительно.
Если вы беременны или предполагаете, что вы могли бы быть беременной, или планируете беременность, перед применением диклофенака необходимо проконсультироваться с врачом.
Способ применения и дозы
Наружно.
Взрослым и детям старше 12 лет препарат наносят тонким слоем на кожу в очаге воспаления 2-3 раза в сутки в дозе 2 г (около 4 см при полностью открытой горловине тубы) и слегка втирают.
Разовая доза препарата – 2 г.
Максимальная суточная доза препарата не должны превышать 6 г.
После нанесения препарата руки необходимо вымыть.
Курс лечения – не более 14 дней. Необходимость более длительного применения определяет врач.
Применять в минимально эффективных дозах минимально коротким курсом.
Применять диклофенак только согласно тем показаниям, тому способу применения и в тех дозах, которые указаны в инструкции.
Побочное действие
Частота встречаемости нежелательных реакций классифицирована следующим образом: очень часто (≥1/10), часто (от ≥1/100 до <1/10), нечасто (от ≥1/1000 до <1/100), редко (от ≥1/10000 до <1/1000), очень редко (<1/10000), включая отдельные сообщения.
Местные реакции: нечасто – мультиформная экссудативная эритема (включая синдром Стивенса-Джонсона), экзема; редко – буллезный дерматит; очень редко – контактный дерматит (зуд, гиперемия, отечность обрабатываемого участка кожи, пустулезная сыпь, папулезно-везикулезные высыпания, шелушения).
При нанесении геля на большие поверхности кожных покровов, в течение длительного периода времени, возможно развитие системных побочных эффектов диклофенака.
Системные реакции: редко – генерализованная кожная сыпь, аллергические реакции (крапивница, ангионевротический отек, бронхоспастические реакции), астма, фотосенсибилизация; очень редко – анафилактические реакции (включая шок).
В случае если любые из указанных побочных реакций усугубляются или вы заметили любые другие, не указанные в инструкции, сообщите об этом врачу.
Передозировка
В виду низкой системной абсорбции при аппликации геля передозировка маловероятна.
При случайном приеме внутрь возможно развитие системных побочных реакций.
Гемодиализ и форсированный диурез не эффективны ввиду степени связывания диклофенака с белками плазмы крови (около 99,7 %).
Взаимодействие с другими лекарственными средствами
Не рекомендуется применение препарата с другими НПВП. Диклофенак может усиливать действие препаратов, вызывающих фотосенсибилизацию. Клинически значимого взаимодействия с другими лекарственными препаратами не описано.
Особые указания
Применять только наружно. Гель следует наносить только на неповрежденную кожу, избегая попадания на открытые раны. После нанесения геля не следует накладывать окклюзионную повязку.
При применении пациентам с язвенной болезнью желудка и двенадцатиперстной кишки, нарушениями функции печени, почек или системы кроветворения, а также при одновременных применениях других НПВП необходимо проконсультироваться с врачом.
При использовании препарата совместно с другими лекарственными формами диклофенака следует учитывать максимальную суточную дозу.
При длительном применении и/или нанесении на обширные поверхности возможно развитие системных побочных реакций вследствие резорбтивного действия.
Следует избегать попадания препарата в глаза, на слизистые оболочки или открытые раны.
Влияние на способность управлять автомобилем и движущимися механизмами
Препарат не оказывает влияние на способность управлять транспортными средствами и другими механизмами.
Форма выпуска
Гель для наружного применения 5 %.
По 30 г, 50 г, 100 г в тубы алюминиевые с навинченными полимерными бушонами или в тубы ламинатные с навинченными полимерными бушонами. Каждую тубу с инструкцией по медицинскому применению помещают в пачку из картона.
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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туба, 1 шт, 5 %, для наружного применения, для суставов, для взрослых","short":"Гель, 1 шт, 5 %","package":"1 шт, 5 %"},"prescription":true,"catalog_section_id":78,"manufacturer":{"id":823,"title":"Синтез","slug":"sintez_ako_823","logo":{"isTouch":{"retina":null,"default":null},"isFromTablet":{"retina":null,"default":null}}},"is_advert":false,"product_form":"Гель","slug":"111436-diklofenak","attributes":{"count":"1 шт","dose":"5 %","volume":"","spf":"","size":""},"image":{"isTouch":{"retina":"https://vseapteki.ru/cropping/thumbnails/101/19234/phoneMedium_retina/","default":"https://vseapteki.ru/cropping/thumbnails/101/19234/phoneMedium_default/"},"isFromTablet":{"retina":"https://vseapteki.ru/cropping/thumbnails/101/19234/tabletLarge_retina/","default":"https://vseapteki.ru/cropping/thumbnails/101/19234/tabletLarge_default/"}},"image_thumb":{"isTouch":{"retina":"https://vseapteki.ru/cropping/thumbnails/101/19234/previewTouch_retina/","default":"https://vseapteki.ru/cropping/thumbnails/101/19234/previewTouch_default/"},"isFromTablet":{"retina":"https://vseapteki.ru/cropping/thumbnails/101/19234/previewDesktopMedium_retina/","default":"https://vseapteki.ru/cropping/thumbnails/101/19234/previewDesktopMedium_default/"}},"available":true,"price":{"min":"648","max":"648"},"counters":null,"description":{"data":[{"id":2,"name":"Торговое название препарата","slug":"","body":[{"type":"header","data":{"text":"Диклофенак-Синтез гель для наружного применения 5 %","level":4}}]},{"id":3,"name":"Лекарственная форма","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?drug_form=gel_dlya_naruzhnogo_primeneniya\"\u003eгель для наружного применения\u003c/a\u003e"}}]},{"id":4,"name":"Состав","slug":"ingredients","body":[{"type":"paragraph","data":{"text":"Действующее вещество: диклофенак натрия – 5,0 г."}},{"type":"paragraph","data":{"text":"Вспомогательные вещества: этанол (спирт 96 %), пропиленгликоль, гидроксиэтилцеллюлоза (гиэтеллоза, натросол), лаванды масло, вода очищенная."}}]},{"id":5,"name":"Описание","slug":"common_description","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=revmatoidnyy_artrit\"\u003eРевматоидный артрит\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=periartrit\"\u003eПериартрит\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=vyvikhi_i_rastyazheniya\"\u003eВывихи и растяжения\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=adneksit\"\u003eАднексит\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=lyumbago\"\u003eЛюмбаго\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=podagra\"\u003eПодагра\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=vospalenie_sukhozhiliy\"\u003eВоспаление сухожилий\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=bursit\"\u003eБурсит\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=oteki_posle_travm_i_operatsiy\"\u003eОтеки после травм и операций\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=artrit\"\u003eАртрит\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=artroz\"\u003eАртроз\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=osteoartroz\"\u003eОстеоартроз\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?indications=ishias\"\u003eИшиас\u003c/a\u003e"}}]},{"id":6,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?appointment=beremennym_i_i_ii_trimestr_po_naznacheniyu_vracha\"\u003eБеременным I и II триместр по назначению врача\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?appointment=dlya_vzroslykh\"\u003eДля взрослых\u003c/a\u003e, \u003ca href=\"https://www.eapteka.ru/goods/drugs/other/inflammation/?appointment=detyam_starshe_6_let\"\u003eДетям старше 6 лет\u003c/a\u003e"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"Фармакотерапевтическая группа: нестероидный противовоспалительный препарат (НПВП)."}},{"type":"paragraph","data":{"text":"Код АТХ: М02АА15"}},{"type":"paragraph","data":{"text":"Фармакологические свойства"}},{"type":"paragraph","data":{"text":"Фармакодинамика"}},{"type":"paragraph","data":{"text":"Фармакокинетика"}},{"type":"paragraph","data":{"text":"При наружном применении диклофенак хорошо проникает через кожу, преимущественно концентрируясь в очаге воспаления и синовиальной жидкости. Количество диклофенака, которое всасывается через кожу, пропорционально времени контакта геля с кожей и площади его нанесения, зависит от суммарной дозы препарата и от степени гидратации кожи. При рекомендуемом способе нанесения абсорбция составляет не более 6 %. Связь с белками плазмы крови – 99,7 %. Выводится почками. При нанесении на область пораженного сустава концентрация в синовиальной жидкости выше, чем в плазме."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"– посттравматическое воспаление мягких тканей, например, вследствие растяжений, перенапряжений, ушибов, травм;"}},{"type":"paragraph","data":{"text":"– ревматические заболевания и отечность мягких тканей (тендовагинит, бурсит, поражение периартикулярных тканей, лучезапястный синдром);"}},{"type":"paragraph","data":{"text":"– боли в суставах (суставы пальцев рук, коленные и др.) при остеоартрозе;"}},{"type":"paragraph","data":{"text":"– боли в спине при воспалительных и дегенеративных заболеваниях позвоночника (остеоартроз, радикулит, люмбаго, ишиас)."}},{"type":"paragraph","data":{"text":"Препарат предназначен для симптоматической терапии, уменьшения боли и воспаления на момент использования, на прогрессирование заболевания не влияет."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"– повышенная чувствительность к диклофенаку или другим компонентам препарата;"}},{"type":"paragraph","data":{"text":"– полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза носа и околоносовых пазух, непереносимость салицилатов или других НПВП (в том числе в анамнезе);"}},{"type":"paragraph","data":{"text":"– беременность (III триместр);"}},{"type":"paragraph","data":{"text":"– период грудного вскармливания;"}},{"type":"paragraph","data":{"text":"– детский возраст (до 12 лет);"}},{"type":"paragraph","data":{"text":"– нарушение целостности кожных покровов в предполагаемом месте нанесения."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Печёночная порфирия (обострение), эрозивно-язвенные поражения желудочно-кишечного тракта (в том числе язвенная болезнь желудка и двенадцатиперстной кишки), тяжелые нарушения функции печени и почек, хроническая сердечная недостаточность, нарушения свёртываемости крови (в том числе гемофилия, удлинение времени кровотечения, склонность к кровотечениям), бронхиальная астма, пожилой возраст, беременность I и II триместр."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Препарат нельзя применять в III триместре беременности."}},{"type":"paragraph","data":{"text":"Использование в I и II триместрах возможно только после консультации с врачом, если ожидаемая польза для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"В связи с отсутствием данных о проникновении препарата в грудное молоко, не рекомендуется его применение в период грудного вскармливания. Если все же необходимо применение препарата, то не следует наносить его на молочные железы или на большую поверхность кожи и не применять длительно."}},{"type":"paragraph","data":{"text":"Если вы беременны или предполагаете, что вы могли бы быть беременной, или планируете беременность, перед применением диклофенака необходимо проконсультироваться с врачом."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Наружно."}},{"type":"paragraph","data":{"text":"Взрослым и детям старше 12 лет препарат наносят тонким слоем на кожу в очаге воспаления 2-3 раза в сутки в дозе 2 г (около 4 см при полностью открытой горловине тубы) и слегка втирают."}},{"type":"paragraph","data":{"text":"Разовая доза препарата – 2 г."}},{"type":"paragraph","data":{"text":"Максимальная суточная доза препарата не должны превышать 6 г."}},{"type":"paragraph","data":{"text":"После нанесения препарата руки необходимо вымыть."}},{"type":"paragraph","data":{"text":"Курс лечения – не более 14 дней. Необходимость более длительного применения определяет врач."}},{"type":"paragraph","data":{"text":"Применять в минимально эффективных дозах минимально коротким курсом."}},{"type":"paragraph","data":{"text":"Применять диклофенак только согласно тем показаниям, тому способу применения и в тех дозах, которые указаны в инструкции."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота встречаемости нежелательных реакций классифицирована следующим образом: очень часто (≥1/10), часто (от ≥1/100 до <1/10), нечасто (от ≥1/1000 до <1/100), редко (от ≥1/10000 до <1/1000), очень редко (<1/10000), включая отдельные сообщения."}},{"type":"paragraph","data":{"text":"Местные реакции: нечасто – мультиформная экссудативная эритема (включая синдром Стивенса-Джонсона), экзема; редко – буллезный дерматит; очень редко – контактный дерматит (зуд, гиперемия, отечность обрабатываемого участка кожи, пустулезная сыпь, папулезно-везикулезные высыпания, шелушения)."}},{"type":"paragraph","data":{"text":"При нанесении геля на большие поверхности кожных покровов, в течение длительного периода времени, возможно развитие системных побочных эффектов диклофенака."}},{"type":"paragraph","data":{"text":"Системные реакции: редко – генерализованная кожная сыпь, аллергические реакции (крапивница, ангионевротический отек, бронхоспастические реакции), астма, фотосенсибилизация; очень редко – анафилактические реакции (включая шок)."}},{"type":"paragraph","data":{"text":"В случае если любые из указанных побочных реакций усугубляются или вы заметили любые другие, не указанные в инструкции, сообщите об этом врачу."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"В виду низкой системной абсорбции при аппликации геля передозировка маловероятна."}},{"type":"paragraph","data":{"text":"При случайном приеме внутрь возможно развитие системных побочных реакций."}},{"type":"paragraph","data":{"text":"Симптомы: тошнота и рвота."}},{"type":"paragraph","data":{"text":"Лечение: промывание желудка, индукция рвоты, активированный уголь, симптоматическая терапия."}},{"type":"paragraph","data":{"text":"Гемодиализ и форсированный диурез не эффективны ввиду степени связывания диклофенака с белками плазмы крови (около 99,7 %)."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Не рекомендуется применение препарата с другими НПВП. Диклофенак может усиливать действие препаратов, вызывающих фотосенсибилизацию. Клинически значимого взаимодействия с другими лекарственными препаратами не описано."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Применять только наружно. Гель следует наносить только на неповрежденную кожу, избегая попадания на открытые раны. После нанесения геля не следует накладывать окклюзионную повязку."}},{"type":"paragraph","data":{"text":"При применении пациентам с язвенной болезнью желудка и двенадцатиперстной кишки, нарушениями функции печени, почек или системы кроветворения, а также при одновременных применениях других НПВП необходимо проконсультироваться с врачом."}},{"type":"paragraph","data":{"text":"При использовании препарата совместно с другими лекарственными формами диклофенака следует учитывать максимальную суточную дозу."}},{"type":"paragraph","data":{"text":"При длительном применении и/или нанесении на обширные поверхности возможно развитие системных побочных реакций вследствие резорбтивного действия."}},{"type":"paragraph","data":{"text":"Следует избегать попадания препарата в глаза, на слизистые оболочки или открытые раны."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат не оказывает влияние на способность управлять транспортными средствами и другими механизмами."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Гель для наружного применения 5 %."}},{"type":"paragraph","data":{"text":"По 30 г, 50 г, 100 г в тубы алюминиевые с навинченными полимерными бушонами или в тубы ламинатные с навинченными полимерными бушонами. Каждую тубу с инструкцией по медицинскому применению помещают в пачку из картона."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре от 15 до 25 °С."}},{"type":"paragraph","data":{"text":"Замораживание не допускается."}},{"type":"paragraph","data":{"text":"Хранить в местах, недоступных для детей."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. Не применять по истечении срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Без рецепта"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/manufacturer/sintez/\"\u003eСинтез ОАО, Россия\u003c/a\u003e"}}]}],"source":null},"description_toggle":false,"short_description":"Фармакотерапевтическая группа: нестероидный противовоспалительный препарат (НПВП). 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