Выбрать, Диклофенак или Вольтарен для лечения, помогут данные о механизме действия препарата, безопасности использования, рекомендации лечащего врача.
Характеристика Диклофенака
Лекарственное средство относится к группе ненаркотических анальгетиков. Ликвидирует боль и признаки воспаления. Фармакологическая активность действующего вещества в отношении медиаторов воспаления используется в терапии ряда заболеваний воспалительного характера, а также состояний, сопровождающихся выраженным болевым синдромом.
Действующее вещество представляет собой растворимый в спиртах кристаллический порошок. Производители лекарственных форм используют дополнительные вещества, которые обеспечат фармакологический эффект препарата.
Разные варианты выпуска расширяют спектр применения лекарственного средства. Дженерики назначаются для лечения суставов, острых и хронических воспалительных процессов.
Сильное противовоспалительное и обезболивающее действие вещества используется в хирургической практике, лечении гинекологической патологии.
Относится к группе лекарств короткого действия. Связь с белками плазмы максимальная. Концентрация активного вещества в крови зависит от дозы, введенной в организм. Обладает низкой токсичностью. Не вызывает проблем в пределах использования терапевтического окна.
Имеет ряд противопоказаний, которые необходимо учитывать при назначении препарата. Длительный прием лекарственного средства повышает риск развития осложнений со стороны печени, сердечно-сосудистой системы. Вызывает раздражительность, нарушения сна.
Диклофенак легко проникает через плацентарный барьер. Противопоказан беременным девушкам в связи с угрозой выкидыша, формированием пороков развития у плода. Не используется в раннем детском возрасте.
Характеристика Вольтарена
Представляет группу нестероидных противовоспалительных средств. Обладает мощным терапевтическим эффектом.
Вольтарен является оригинальным препаратом, прошедшим необходимые клинические испытания. Имеет высокий уровень безопасности, низкую токсичность.
Быстро оказывает болеутоляющее, антипиретическое, противоотечное действие в очаге воспаления. Назначается для лечения суставной патологии. Создает максимальную концентрацию действующего вещества в синовиальной жидкости. Эта особенность используется в терапии ревматических заболеваний.
Вольтарен действует на обе формы циклооксигеназы, подавляя ферментативную активность изомеров в равной степени. Поэтому вызывает меньше побочных эффектов по сравнению с другими нестероидными противовоспалительными препаратами.
Многократное введение лекарства при соблюдении интервала между приемами разовых доз не изменяет его фармакологические характеристики. Кумуляции действующего вещества в организме не происходит.
Для ликвидации воспалительных явлений, устранения боли препарат используют в комплексном лечении заболеваний щитовидной железы. Отмечается положительная динамика при назначении различных вариантов лекарственного препарата для наружного применения.
Назначается в комплексной терапии заболеваний как симптоматическое средство. Разнообразие вариантов выпуска разрешает комбинировать пути введения лекарственного средства, добиваясь положительного результата с минимальным риском осложнений.
Болезни печени и сердечно-сосудистой системы не являются противопоказанием для применения, но требуют постоянного врачебного контроля.
Сходства составов
Лекарственные препараты выпускаются в следующих вариантах:
- растворы для парентерального введения;
- таблетки, имеющие кишечнорастворимую оболочку;
- гели;
- мази;
- ректальные суппозитории.
Швейцарский производитель выпускает пластыри дермальные. Диклофенак можно приобрести в виде глазных капель.
Оригинальный препарат и дженерики содержат в своем составе одно и то же активное вещество. Лекарственные формы дозированы одинаково, имеют вторичную упаковку и подробную инструкцию по применению.
Дополнительные компоненты при производстве лекарств могут несколько отличаться. Все производители используют только качественное сырье.
Основной состав дополнительных ингредиентов, применяемых при производстве таблеток, одинаковый. В этот перечень входят:
- крахмал картофельный;
- стеарат магния;
- сахароза;
- кремния диоксид коллоидный;
- повидон;
- натрия карбоксиметилкрахмал.
В производстве препаратов используют спирты, полусинтетические глицериды.
В состав оболочки выпускаемых таблеток входят следующие соединения:
- краситель желтый;
- тальк;
- оксид железа;
- титана диоксид.
Приготовление растворов включает использование стабилизаторов и консервантов.
Качество сырья влияет на скорость всасывания, создание необходимой концентрации активного вещества в очаге воспаления. Дженерики обладают хорошим качеством, необходимыми свойствами. Доступны для большинства пациентов. По механизму действия лекарственные средства не отличаются друг от друга.
В чем разница между Диклофенаком и Вольтареном
Состав оригинального препарата отличается содержимым дополнительных компонентов, используемых при производстве разных лекарственных форм. Вольтарен производится на качественном оборудовании с применением специальных способов очистки химических веществ. Подвергался необходимым клиническим испытаниям, прошел контроль безопасности.
Технологии позволяют производителям дженериков добавлять любые химические вещества в качестве наполнителей. Клинических испытаний препарат не проходит. Такая ситуация повышает риск возникновения нежелательных реакций на фоне применения Диклофенака.
Кишечнорастворимая оболочка оригинального лекарства производится путем последовательного напыления слоев, что позволяет действующему веществу равномерно всасываться в кровь.
Оболочки таблетированных форм дженериков создаются методом прессования, что ускоряет процесс всасывания, но увеличивает риск агрессии активного вещества на слизистую пищеварительного тракта.
Инъекционные формы Вольтарена подвергаются качественной промышленной очистке, проходят обязательный контроль безопасности. Учитывая особенности действия препарата, назначать его должен лечащий врач.
Что лучше — Диклофенак или Вольтарен
При выборе препарата необходимо учитывать следующие моменты:
- Продолжительность использования.
- Применяемую лекарственную форму.
- Наличие аллергических реакций в анамнезе.
- Имеющуюся сопутствующую патологию.
Выбирая лекарство, лучше посоветоваться с лечащим врачом.
При необходимости использования инъекционной формы лекарства лучше выбрать Вольтарен. Внутримышечное введение препарата используется не более 2 суток, редко вызывает побочные реакции при правильном введении.
Парентеральное введение можно сочетать с другими лекарственными формами, не превышая суточную дозу действующего вещества.
Растворы Диклофенака чаще вызывают побочные реакции, негативно влияют на клетки печени. Препараты этой группы требуют строгого соблюдения правил введения инъекционных форм.
Таблетки короткого и пролонгированного действия покрыты кишечнорастворимой оболочкой. Вещества, входящие в состав оболочки Диклофенака, часто провоцируют развитие аллергических реакций.
Таблетки Диклофенака оказывают более агрессивное воздействие на слизистую пищеварительного тракта, чем оригинальный препарат.
Вольтарен, предназначенный для наружного применения, доказал свою эффективность. Терапевтическое действие мазей, трансдермальных пластырей, гелей проявляется быстрее, чем у препаратов дженериков.
Отзывы врачей
Егорова, ревматолог, Москва: «Диклофенак эффективен при синовитах, артритах, тендовагинитах. Назначается пациентам с заболеваниями опорно-двигательной системы. Часто использую для купирования боли и воспаления. В первые 3 дня болезни назначаю уколы в дозе 75 мг один раз в сутки. Потом рекомендую прием таблеток. Важно не превышать суточную дозу лекарства.
При сопутствующей патологии пищеварительного тракта добавляю ингибиторы протонной помпы. Можно назначать при компенсированной гипертонии. Препарат не вызывает повышения артериального давления».
Карташова, кардиолог, Краснодар: «Вольтарен, выпускаемый в форме геля, доказал свою эффективность при устранении воспаления и болевых ощущений. Побочных эффектов не наблюдала. Удобен при использовании, впитывается хорошо, следов на одежде не оставляет.
Помогает при травмах, ушибах, растяжениях. Быстро купирует боль разной интенсивности».
Кричевцов, невролог, Санкт-Петербург: «Диклофенак является надежным средством при артритах, острых радикулитах. Более эффективными считаю инъекционные формы лекарства.
Чтобы предотвратить негативное влияние на слизистую желудка назначаю одновременный прием Омеза. Лучше использовать минимально эффективные дозы в течение короткого периода».
Наземцева, гинеколог, Краснодар: «Диклофенак часто назначаю в комплексной терапии воспалений органов малого таза. Использование ректальных суппозиториев побочных эффектов не вызывает, быстро купирует боль. Цена доступная.
Хорошие результаты отмечаются при использовании геля. Впитывается быстро, нет побочных реакций. Может назначаться на длительное время».
Отзывы пациентов о Диклофенаке и Вольтарене
Галина, 32 года, Москва: «Давно использую Диклофенак из-за частых болей в спине. Применяю ректальные свечи. Быстро снимают боль, не вызывают нежелательных реакций. Препарат недорогой».
Анна, 41 год, Пенза: «Часто испытываю боли в спине после травмы. По назначению терапевта принимала Вольтарен. Курс состоял из 5 инъекций по 3 мл. Никаких негативных реакций не испытывала. Боль прошла.
Мужу назначали курс инъекций после травмы позвоночника. После нескольких уколов появились боли в желудке. Дополнительно принимал Омез».
Ксения, 28 лет, Саратов: «Часто беспокоят боли в спине. Врач диагностировал остеохондроз с корешковым синдромом. Принимала комплексное лечение с использованием разных лекарственных форм Диклофенака. Мазь действует быстро. После курса инъекций разболелся желудок.
По совету врача использовала согревающий пластырь при кашле. Действует эффективно, побочных реакций не было».
Виктор, 48 лет, Псков: «Повредил сухожилия мышц руки. Развился отек, гематома. Лечащий врач назначил Вольтарен в форме геля. Отлично снимает боль, удобен в применении. Дает стойкий эффект. Никаких отрицательных моментов не было».
Сравнение Вольтарена с Диклофенаком, все плюсы и минусы. Что же лучше брать?
Привет всем.
Мой отзыв о наболевшем. в прямом и переносном смысле.
Остеохондроз дает о себе знать, к тому же весеннее обострение, начали суставы болеть и на тренировках моя травма обострилась. Подумала, что у меня ревматизм, пошла сдавать анализы, результаты оказались отрицательными. Пришлось прибегать к определенным мерам. Инъекции никогда не приходилось делать. Но тут уж не пришлось выбирать, начали с уколов "Комбилипена".
Мне посоветовали "Диклофенак".
Так как проблема не решилась, я все таки вернулась к инъекциям. В этот раз перешла на "Вольтарен", хотя он и на несколько порядков дороже, да и состав идентичен, действующее вещество — диклофенак.
Мое мнение о данном препарате:
"Вольтарен" подошел мне больше, чем предыдущий, я его лучше переношу, менее болезненно, как-то "мягче" он работает. Диклофенак всасывается немедленно. После укола сохраняется трудоспособность, примерно через час, возможно, немного раньше я "чувствую себя человеком", уходит болевой синдром. Такого действия мне хватает на день.
Показания к применению:
Инъекции препарата Вольтарен не следует применять более двух дней подряд 
Препарат вводят глубоко внутримышечно в верхний наружный квадрат ягодичной области. Доза — 1 ампула, т.е. 75 мг.
Для тех, кто хорошо видит полная инструкция (перед тем как принимать, внимательно изучите):
Наличие боли требует не только устранение ее причины, но и назначения обезболивающей терапии. Диклофенак и Вольтарен содержат действующее вещество, способное не только уменьшить активность воспаления, но и снизить интенсивность неприятных ощущений.
Диклофенак
Механизм действия
Все формы выпуска препарата (таблетки, мази, свечки и т.д.) проникают в кровь, за исключением одной – глазные капли. После попадания в кровоток или закапывания в глаз Диклофенак замедляет выработку Простагландинов – воспалительных веществ. Это приводит к следующим положительным эффектам:
- При некоторых болезнях снижается интенсивность воспалительной реакции;
- Уменьшается дискомфорт и болевые ощущения в пораженных тканях;
- Диклофенак борется с покраснением кожи и воспалительным отеком.
Из-за проникновения в кровь фармакопрепарат прекращает создание ряда полезных веществ (Простациклин, Тромбоксан, ПГE2 и других). При неконтролируемом приеме приводит к ряду негативных реакций:
- Нарушается слизистый барьер желудка, предохраняющий его от кислоты;
- Увеличивается риск кровотечения;
- Возрастает давление в артериях (АД).
Продолжительность и скорость действия Диклофенака сильно зависят от формы введения. Производитель определил следующие временные рамки до достижения максимального эффекта:
- При приеме внутрь обычных форм – 1-2 часа;
- При приеме внутрь лекарства продленного действия – около 5-ти часов;
- После введения свечки в прямую кишку – 30-40 минут;
- При нанесении на кожу – несколько часов (точных данных нет);
- При закапывании в глаз – около 30 минут;
- После внутримышечного укола – 10-15 минут.
Через несколько часов после поступления в кровь, Диклофенак проникает внутрь сустава в достаточном количестве. Время действия составляет 8-11 часов.
Показания
- Болезненные ощущения в суставах, мягких тканях (связок, мышц, влагалищ мышц);
- Боль, вследствие поражения нервов — невралгии;
- Травмы и ранения, в том числе послеоперационные раны;
- Головная боль, в том числе при мигрени;
- Подагрический приступ;
- Болевые ощущения средней/сильной интенсивности в период менструации, при аднексите (воспаление фаллопиев труб и яичников);
- Инфекционные патологии уха, носа, горла – с целью обезболивания и уменьшения воспалительных признаков;
- Колики печеночная/почечная.
Противопоказания
- Аллергия на Диклофенак и другие лекарства, производные уксусной к-ты: Ацеклофенак, Ацеметацин, Кеторолак, Индометацин и т.д.;
- Возраст младше 6-ти лет;
- Состояния, сопровождающиеся усиленной кровоточивостью;
- Язва желудка/12-ти перстной кишки;
- Бронхиальная астма, обостряющаяся от применения противовоспалительных средств («Аспириновая астма»);
- Воспалительные патологии пищеварительного тракта: заболевание Крона, колит язвенной природы.
При беременности в первые 2 триместра (до 30-й недели) использование Диклофенака не рекомендуется – допустимо только по назначению доктора. В 3-й триместр строго противопоказано.
Побочное действие
- тошнота, послабление стула, легкая рвота;
- поражение желудочной стенки с образованием малоболезненных (скрытых) язв;
- повреждение поджелудочной железы и печеночной ткани, с разрушением ее клеток и развитием желтухи.
- воспаление органа из-за токсического действия лекарства – интерстициальный нефрит;
- очень редко – острая почечная недостаточность.
- покраснение кожи, сопровождающееся зудом;
- повышение чувствительности к ультрафиолету (солнечные лучи, солярий, кварцевые лампы);
- очень редко – жизнеугрожающие состояния: шок, синдром Лайелла, синдром Стивенса-Джонсона.
- усиление кровоточивости;
- нарушение выработки иммунных клеток (лейкоцитов), тромбоцитов и эритроцитов (клеток-переносчиков кислорода).
Формы выпуска и цены
Таблетки обычного действия:
- 25 мг, 10-50 шт., 35-80 руб.
- 50 мг, 10-300 шт., 30-250 руб.
- 100 мг, 10-50 шт., 35-90 руб.
Таблетки пролонгированного (удлиненного) действия:
- 1%, 15-100 гр., 39-154 руб.
- 5%, 25-100 гр., 45-160 руб.
Раствор для внутримышечных уколов:
- 25 мг/мл, 5-75 ампул, 24-80 руб.
- 1%, 30-100 гр., 25-180 руб.
- 2%, 30 гр., 35-70 руб.
Свечи для прямой кишки:
- 25 мг, 10 шт., 34-60 руб.
- 50 мг, 5-10 шт., 54-160 руб.
- 100 мг, 5-10 шт., 98-250 руб.
Вольтарен
Действующее вещество фармакопрепарата – натрия Диклофенак. Поэтому показания, противопоказания, фармакологические эффекты и побочные действия будут аналогичны у препаратов «Вольтарен» и «Диклофенак», что отражено в инструкции к данным лекарствам. Возникает вопрос – «В чем разница между свечами Вольтарена, Диклофенака и другими лекарственными формами?».
Важно акцентировать внимание на таких лекарственных формах, как гели и мази. Наряду со всеми формами выпуска лекарства, они действуют через кровь, практически не оказывая местного эффекта на мышцы, суставы и сухожилия.
Формы выпуска и цены
Таблетки обычного действия:
- 25 мг, 20-30 шт., 220-260 руб.
- 50 мг, 20-30 шт., 270-310 руб.
Таблетки пролонгированного действия:
- 15 мг/сутки, 2-10 шт., 170-290 руб.
- 30 мг/сутки, 2-10 шт., 180-330 руб.
Трансдермальная терапевтическая система — вариант доставки фармакопрепарата через кожу, имеет вид пластырей или пленок:
- 30 мг/сутки, 2-10 шт., 160-280 руб.
Спрей для накожного применения:
Раствор для внутримышечных уколов:
- 25 мг/мл, 5 ампул, 240-310 руб.
Свечи в прямую кишку:
- 25 мг, 10 шт., 280-320 руб.
- 50 мг, 10 шт., 285-380 руб.
- 100 мг, 5 шт., 360-400 руб.
В инструкции к свечам Вольтарена-Диклофенака определены дозировки, необходимые для получения желаемого эффекта. 50-75 мг препарата используются для обезболивающего эффекта и снижения температуры, 100 мг – для противовоспалительного действия.
Вольтарен и Диклофенак в чем разница?
От чего используются Диклофенак и Вольтарен? Показания к использованию данных фармакопрепаратов одинаковые – это борьба с болью и лихорадкой.
Отличия заключаются в ряде важных нюансов:
- Оригинальность препарата. Впервые вещество «Натрия Диклофенак» было создано швейцарской компанией Ciba-Geidgy в 1964 г. Лекарство получило название «Вольтарен» и с тех пор препарат выпускается под данным торговым наименованием. Другие фармакопрепараты, содержащие Диклофенак, являются дженериками – копиями;
- Переносимость препарата. По результатам анализа к.м.н. Г.Р.Имаметдиновой, дженерики имеют выше частоту побочных реакций, чем оригинальный препарат. Причина — менее качественная система очистки и наличие дополнительных примесей (потенциальных аллергенов и токсинов);
- Максимальная концентрация лекарства в кровеносном русле. Этот показатель отражает эффективность действия лекарства. В исследовании доктора Хупера было определено, что эффективность дженерики в 2,5-3 раза ниже, чем Вольтарена;
- Биодоступность – критерий, отражающий количество вещества, которое доходит до своей «мишени». Доктор Хупер и соавторы также определили, что биодоступность оригинального формакопрепарата в 2-3 раза выше его копий.
Лекарство «Диклофенак» является дженериком. Согласно опубликованным исследованиям, его биодоступность, максимальная концентрация в кровотоке меньше, чем у Вольтарена. При этом частота нежелательных реакций выше, а переносимость фармакопрепарата хуже.
Однако, у дженерика большее количество лекарственных форм, включая глазные капли, гели и крема. И в отличие от Вольтарена, цена на Диклофенак в 2-5 раз дешевле оригинального лекарства, в зависимости от формы и дозировки. При этом их область применения одинаковая – устранение боли различных локализаций и снижение активности воспаления. В том числе в гинекологии, где Диклофенак и Вольтарен используются в свечах, таблетках и инъекциях для устранения боли при менструации, аднексите и других воспалительных процессах в женских половых органах.
Вольтарен и Диклофенак — что эффективней?
Вольтарен имеет лучшие показатели, в сравнение с Диклофенаком. Фармакопрепарат достигает более высоких концентраций в крови за счет лучшего всасывания, в том числе с поверхности кожи. Соответственно – демонстрирует лучшую эффективность. Лекарство в больших количествах достигает различных органов, в том числе суставов и мягких тканей. Это дополнительно увеличивает степень выраженности положительных эффектов.
Вольтарен имеет меньшее количество посторонних примесей, за счет более совершенной процедуры очистки. Таким образом, достигается лучшая переносимость лекарства и меньшая частота негативных реакций в организме пациента. Это касается любых форм выпуска, независимо для чего применяются свечи Вольтарена, таблетки, трансдермальные системы и другие виды препарата. Однако лекарство не выпускается в виде глазных капель – поэтому при лечении глаз назначается Диклофенак.
Что лучше – Диклофенак или Вольтарен в форме мази/геля? Учитывая большую способность к всасыванию оригинального препарата, в том числе с поверхности кожи, ответ – фармакопрепарат «Вольтарен».
Какие свечи из этих препаратов лучше? Вольтарен, так как у данного лекарства лучше способность к всасыванию и выше эффективность.
Аналоги
Существует большое количество аналогов, с похожими на Вольтарен и Диклофенак эффектами от использования. Чтобы его подобрать наилучший вариант, необходимо определиться с преследуемой целью.
Если необходим препарат для человека, больного сердечно-сосудистой патологией, безопаснее обезболивающее Напроксен. При поражении желудка и/или двенадцатиперстной кишки, рекомендуется более безопасная группа противовоспалительных средств:
Наличие исключительно головной боли или мигрени – показание для назначения Парацетамола, в качестве противоболевого средства.
Отзывы врачей
Анализ отзывов докторов различных специальностей позволил сделать следующие выводы:
- Частота негативных реакций на оба препарата достаточно невысокая, однако при использовании Вольтарена такие случаи фиксируются реже;
- Диклофенак является более доступным фармакопрепаратом, благодаря его стоимости. Также существуют упаковки Диклофенака, в которых больше ампул, чем у Вольтарена – это еще одна причина, по которой стационарные больницы чаще закупают Диклофенак. При этом его обезболивающего эффекта, в большинстве случаев, достаточно для потребностей пациента;
- Что лучше из уколов – Вольтарен или Диклофенак? Отзывы докторов позволяют сделать вывод об аналогичной эффективности лекарств, но при этом у Диклофенака чаще наблюдается негативное действие на пищеварительные органы.
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