Lertus CD Diclofenac sodium and Codeine 50/50 mg 20 Tabs

Lertus CD - NSAID, a derivative of phenylacetic acid. The main effects of the drug are antipyretic (moderate), analgesic, and anti-inflammatory. The analgesic effect is due to the peripheral and central mechanisms. 

Pharmacological action

The drug relieves the painful syndrome, which occurs during post-operative and post-traumatic inflammatory phenomena.  Swelling is reduced during the use of the medication.

In rheumatic pathologies, the use of the drug helps to remove the morning stiffness of the joints and reduce pain, which occurs both when moving and at rest.

Additionally, platelet aggregation is suppressed. With prolonged therapy, taking the medication promotes a desensitizing effect. 

When the drug is prescribed

 Lertus CD (50mg) is prescribed for:

• Arthritis (all types)
• Pain associated with injuries to the musculoskeletal system or after surgery
• Any pain in the spine
• Tendovaginitis
• Bursitis
• Osteoarthritis

Allowed to take the drug for biliary and renal cramps. In small doses, you can take it in severe migraine attacks. 

Who is contraindicated by the drug

In pregnancy (3rd trimester) and with the presence of an allergy to Diclofenac and other components of the drug, you cannot take it.

People suffering from gastrointestinal, cardiac, renal, hepatic diseases, bleeding, hemostasis disorders, and confirmed hyperkalemia are forbidden to drink this drug. 

How the drug is used?

Lertus CD is used intramuscularly. The single dosage is 75 g. In severe cases (in acute inflammation accompanied by severe pain) 2 injections are put in. The interval between the first and the second injection is 2-5 hours.

If necessary, after 12 hours, it is possible to re-inject the drug in the same dosage.

The duration of therapy is 48 hours. Then the injectable form is replaced by the oral form.

During a migraine attack, the drug is administered by injection (the dosage is the same - 75 mg).

Then, if necessary, a person takes suppositories (dosage - 100 mg).

The daily dosage on the first day of therapy should not exceed 175 mg. 

Lertus CD: Side effects

Some patients complain of abdominal pain syndrome. It is often accompanied by nausea, dizziness, and (sometimes) stool disturbances.

There are often complaints of headaches. Their character is often shingling, but more often patients complain of aching at the temples, or unpleasant - pulling or squeezing sensations in the back of the head or forehead.

Insomnia is less common, and disorientation is even rarer. Some patients become irritable while taking the drug, some become lethargic and sleepy.

Patients older than 45 years complain of painful sensations in the chest, and in the heart area. Sometimes this condition is accompanied by increased heartbeat and increased blood pressure.

Sometimes there is a thickening in the injection site, accompanied by tolerable pain. Much less often, swelling forms in this area, even more rarely - necrosis. 

Compatibility with alcohol

Do not drink alcoholic beverages while using Lertus CD (50mg): mixed with ethanol, the active substance has adverse effects on the gastrointestinal tract, heart, and nervous system.

There is a risk of internal bleeding. Against the background of increased peristalsis, the effect of the drug is reduced.

The negative effect on the nervous system is that a person becomes more agitated and aggressive. But some people, on the contrary, complain of the sluggishness of reactions and "failures" of memory. 

Storage conditions and shelf life

Lertus CD is recommended to store at a temperature of +25 degrees - in a dry place protected from sunlight, children, and animals.

The shelf life of the injectable solution and suppositories is 2 years, and the tablets - are 3 years. At the end of the period of validity, the unused drug should be disposed of. 

In our online pharmacy, you can buy Lertus CD (50mg) without a prescription. Send the product to the cart and provide your name and address in the application. Shipping is available to all cities in Mexico and the United States.

Diclofenac

What is Diclofenac?

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) from the phenylacetic acid derivatives group. This drug reduces substances in the body that cause pain and inflammation by reducing prostaglandin levels.

Diclofenac is used to treat mild to moderate pain as well as signs and symptoms of osteoarthritis or rheumatoid arthritis, ankylosing spondylitis (a chronic inflammatory disease of the spine), and menstrual cramps.

Diclofenac sodium 50 mg tablets can be used to treat a migraine attack, but only for the beginning headache, so it is not prescribed for preventive purposes.

Diclofenac side effects

Although you can buy Diclofenac without a prescription, the drug has side effects. Seek immediate emergency medical attention if you show the following signs of an allergic reaction to Diclofenac:

• skin rash ( urticarial );
• difficulty breathing, swelling of the face or throat;
• fever, sore throat, burning eyes, itching and painful skin sensations, blistering of the skin surface and peeling.

Common side effects of Diclofenac may include:

• flatulence (gasiness in the intestines);
• nausea, vomiting, stomach pain, diarrhea, constipation;
• headache, dizziness, drowsiness;
• deterioration of laboratory tests;
• itching, sweating;
• nasal congestion;
• high blood pressure;
• swelling or pain in the arms or legs.

If one or more side effects occur, stop taking the drug and consult your doctor.

Diclofenac interactions

Before using Diclofenac tablets, consult your doctor if you are taking the following drugs:

1. Digoxin, Phenytoin or Lithium preparations. There is an increased risk of adverse reactions.

2. Diuretics and hypotensive drugs. The effectiveness of these medications is reduced.

3. Potassium-saving diuretics. Hyperkalemia is observed.

4. Other NSAIDs and glucocorticoids. The risk of gastrointestinal side effects increases.

5. Acetylsalicylic acid. A decrease in the effectiveness of Diclofenac is observed.

6. Antidiabetic agents. May cause changes in blood sugar levels.

7. Methotrexate. Diclofenac increases the toxicity of Methotrexate.

8. Cyclosporine (may increase kidney toxicity).

9. Anticoagulants (regular monitoring of blood clotting is necessary).

10   Mifepristone (NSAIDs should not be used within 8-12 days of taking Mifepristone, so as not to reduce the effectiveness of Mifepristone).

11. Antibacterials of the quinoline series. May provoke seizures.

12. Colestipol, Cholestyramine (absorption of Diclofenac is reduced, so you should take these drugs at intervals of several hours).

Other drugs may interact with Diclofenac tablets, including prescription and over-the-counter drugs, vitamins and various phytopreparations. Consult your doctor for more detailed advice on taking several medicines at the same time.

How long can I take Diclofenac?

The interval between doses is at least 4 hours. The duration of treatment is no more than 5-7 days and depends on the course of the disease. The maximum daily dose of the drug for adults and children over 14 years of age is not more than 3 tablets.

Dosage of Diclofenac

The tablets are taken orally during or after meals. For the first 3 days, Diclofenac is prescribed 25-50 mg 2-3 times a day, sometimes the daily dose is increased to 100-150 mg (4-6 doses).

Children over 6 years of age and adolescents are prescribed the drug in a dosage of 0.5-2 mg/kg per day in 2-3 doses. In the treatment of juvenile rheumatoid arthritis, it is allowed to increase the dose to 3 mg/kg per day, which corresponds to the maximum daily dose.

Diclofenac: Warnings

Gastrointestinal bleeding, ulcers, and perforations are possible with all NSAIDs and can be life-threatening and can develop gradually or acutely.

To reduce the risk of gastrointestinal toxicity, you should start with the lowest effective dose and stick to it thereafter. When prescribing this medication to a patient, doctors warn that the drug interacts very aggressively with the stomach. Therefore, in order to protect the walls of the stomach from destruction, it is recommended to take the drug together with drugs from the proton pump inhibitors group, (they reduce the impact of acid on the mucosa of the digestive tract).

NSAIDs with prolonged use or in high doses (150 mg/day) may increase the risk of serious cardiovascular thrombotic events, myocardial infarction and stroke, which can be life-threatening. Diclofenac use is contraindicated in patients with established congestive heart failure, coronary heart disease, peripheral artery disease or cerebrovascular disease.

Patients with significant risk factors for cardiovascular complications (e.g., arterial hypertension, hyperlipidemia, diabetes mellitus, smoking) Diclofenac is prescribed after careful evaluation of the patient.

Severe, life-threatening skin reactions, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have very rarely been reported when taking NSAIDs, including Diclofenac. Diclofenac should be discontinued at the first manifestation of a skin rash, mucous membrane ulcers or any other manifestation of hypersensitivity.

Patients who have not previously taken Diclofenac medicine may develop allergic reactions during treatment. More often manifested in patients suffering from bronchial asthma, pollinosis, obstructive bronchitis, and skin rashes. Particular caution should be exercised when treating such patients.

Diclofenac should be used with caution in elderly patients. Weakened patients and patients with low body weight are recommended to take the lowest effective dose.

In case of long-term use of Diclofenac or other NSAIDs, patients with liver disease should be regularly examined for its functions: the level of liver enzymes may increase. If the abnormalities of liver function persist or intensify, develop complaints or symptoms indicating liver disease, Diclofenac should be discontinued.

Diclofenac, like other NSAIDs, may temporarily inhibit platelet aggregation, so patients with hemostasis disorders need careful monitoring of relevant laboratory parameters.

Dosage of Diclofenac for adults

Adults: initial daily dose is 75 - 150 mg in several doses, the number of doses depends on the disease severity. On achieving a therapeutic effect, prescribe 25 mg 3 times a day. The daily dose of Diclofenac should not exceed 150 mg.

In dysmenorrhea, the daily dose is 50-150 mg. Treatment should be started after the appearance of the first pain symptoms.

How long does Diclofenac remain in your body?

Diclofenac sodium 50 mg tablet is well absorbed through the mucous membrane of the gastrointestinal tract and reaches the maximum concentration in plasma within 1-2 hours after intake. It is rapidly metabolized in the liver and excreted in the urine and, to a lesser extent, in the bile. The plasma elimination half-life is 1.8 to 2 hours. From synovial fluid - 3-6 hours. Does not accumulate in the body if the recommended time between doses is observed.

Diclofenac and alcohol

Diclofenac is absolutely incompatible with alcohol and this combination is strictly forbidden. This combination affects the digestive system, disrupts the heart and blood vessels, and increases blood pressure.

The main danger of taking Diclofenac and alcohol together is a chemical reaction that forms a compound of sodium ethylate - a poisonous substance that is harmful to the body.

In case of poisoning by alcohol and Diclofenac:

1. Lay the patient horizontally on his side (surface is hard).

2. Clean the oral cavity of vomit, fix the tongue if necessary.

3. Give inside any adsorbents (Smecta, Enterosgel). With the help of such drugs, toxins are removed from the body, creating a barrier to the subsequent absorption of alcohol.

4. Give the patient plenty of fluids to replenish the water balance. Indicated - strong black tea, juices diluted with water, kissel or morsel, still mineral water. Fluid should be taken often, but in small portions (to avoid repeated vomiting).

5. Severe condition (convulsions, loss of consciousness, disorientation) requires immediate call for an ambulance.

Diclofenac vs Meloxicam

These two drugs belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs). They are effective in controlling inflammation and relieving pain.

Name	Diclofenac	Meloxicam
Side effects	Gastrointestinal (nausea, vomiting, diarrhea), drowsiness, dizziness, hypertension, stuffy nose.	Digestive system: nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea; Bronchospasm. Stomatitis. Skin rash. Hypertension.
Half-life	1.8 to 2 hours	13 to 25 hours
Testimony	As an analgesic for neuralgia, muscle pain, lumbosyphoidalgia, after injuries, for headaches (including migraines), pelvic pain, toothache.	Symptomatic treatment of osteoarthritis; rheumatoid arthritis; ankylosing spondylitis (Behterev's disease), other degenerative joint diseases accompanied by pain syndrome.
Contraindications	Gastric and duodenal ulcer, liver and urinary system disorders, third trimester of pregnancy and lactation in women, allergic reactions to the drug, age under 6 years.	Allergic reactions to the active ingredient, gastrointestinal ulcers, renal, hepatic and cardiac failure, under 15 years of age.

 

Diclofenac, due to its non-selective activity, has ulcerogenic effects (negative effects on the gastrointestinal tract), so for people who have a history of gastropathy (gastrointestinal diseases), it is recommended to use selective NSAIDs, such as Meloxicam.

Diclofenac: muscle relaxant

Diclofenac is used to relieve pain and swelling (inflammation) in various mild to moderate painful conditions. The drug also relieves muscle spasms in sports injuries and menstruation. Diclofenac without a prescription can be ordered in our pharmacy. You can always find out the cost and availability of the drug you are interested in.

Diclofenac for back pain

The high anti-inflammatory and analgesic effectiveness of Diclofenac sodium allows the use of this drug in patients with different-intensity of pain syndromes, and the rapid onset of the analgesic action is the basis for the appointment of Diclofenac for relieving acute back pain.

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