Voltalin-SR
Generic Name
Diclofenac Sodium Extended-Release Tablet
Manufacturer
Novartis
Country
Switzerland
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| voltalin sr 75 mg tablet | ৳ 11.03 | ৳ 110.30 |
Description
Overview of the medicine
Voltalin-SR 75 mg tablet is an extended-release formulation of Diclofenac Sodium, a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, and inflammation associated with various conditions such as arthritis, musculoskeletal injuries, and other painful inflammatory disorders. The sustained-release formula allows for once or twice daily dosing.
Uses & Indications
Dosage
Adults
Usually 75 mg once or twice daily. Maximum recommended dose is 150 mg daily.
Elderly
Lower doses may be considered. Monitor for adverse effects, especially gastrointestinal and renal.
Renal_impairment
Use with caution. Dosage reduction may be necessary in severe impairment. Not recommended in severe renal failure.
How to Take
Take the tablet whole with a glass of water, preferably with or after food, to minimize gastrointestinal upset. Do not crush, chew, or break the extended-release tablet.
Mechanism of Action
Diclofenac inhibits cyclooxygenase (COX-1 and COX-2) enzymes, which are responsible for the synthesis of prostaglandins. Prostaglandins are mediators of inflammation, pain, and fever. By inhibiting their synthesis, diclofenac reduces these symptoms.
Pharmacokinetics
Onset
Analgesic effect typically begins within 1-2 hours.
Excretion
Approximately 60% of the dose is excreted in the urine as metabolites, and about 30-40% is excreted in the bile/feces.
Half life
Plasma elimination half-life is approximately 1-2 hours, but the therapeutic effect of the extended-release formulation lasts longer due to prolonged absorption.
Absorption
Well absorbed from the gastrointestinal tract; absorption is delayed but not reduced with the extended-release formulation. Peak plasma levels are reached in about 4-6 hours.
Metabolism
Extensively metabolized in the liver, primarily by hydroxylation via the CYP2C9 enzyme, followed by glucuronidation and sulfation. Undergoes significant first-pass metabolism.
Side Effects
Contraindications
- Hypersensitivity to diclofenac or any other NSAIDs (including aspirin-induced asthma or urticaria)
- Active gastrointestinal bleeding or peptic ulcer
- Severe heart failure
- Severe renal or hepatic impairment
- Third trimester of pregnancy
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
Drug Interactions
Digoxin
Increased plasma digoxin levels.
Lithium
Increased plasma lithium levels, leading to toxicity.
Cyclosporine
Increased risk of nephrotoxicity.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects, increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Increased risk of gastrointestinal bleeding.
Antiplatelet agents (e.g., Aspirin, Clopidogrel)
Increased risk of bleeding.
ACE inhibitors/Angiotensin receptor blockers (ARBs)
Reduced antihypertensive effect, increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, hypertension, acute renal failure, respiratory depression, and coma. Management is primarily supportive and symptomatic. Gastric lavage or activated charcoal may be considered within the first hour of ingestion. There is no specific antidote.
Pregnancy & Lactation
Pregnancy: Category C in first and second trimesters; Category D in third trimester (due to risk of premature closure of fetal ductus arteriosus). Avoid use in late pregnancy. Lactation: Diclofenac passes into breast milk in small amounts. Use during breastfeeding should be avoided or used with caution after consulting a doctor.
Side Effects
Contraindications
- Hypersensitivity to diclofenac or any other NSAIDs (including aspirin-induced asthma or urticaria)
- Active gastrointestinal bleeding or peptic ulcer
- Severe heart failure
- Severe renal or hepatic impairment
- Third trimester of pregnancy
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
Drug Interactions
Digoxin
Increased plasma digoxin levels.
Lithium
Increased plasma lithium levels, leading to toxicity.
Cyclosporine
Increased risk of nephrotoxicity.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects, increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Increased risk of gastrointestinal bleeding.
Antiplatelet agents (e.g., Aspirin, Clopidogrel)
Increased risk of bleeding.
ACE inhibitors/Angiotensin receptor blockers (ARBs)
Reduced antihypertensive effect, increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, hypertension, acute renal failure, respiratory depression, and coma. Management is primarily supportive and symptomatic. Gastric lavage or activated charcoal may be considered within the first hour of ingestion. There is no specific antidote.
Pregnancy & Lactation
Pregnancy: Category C in first and second trimesters; Category D in third trimester (due to risk of premature closure of fetal ductus arteriosus). Avoid use in late pregnancy. Lactation: Diclofenac passes into breast milk in small amounts. Use during breastfeeding should be avoided or used with caution after consulting a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture when stored properly.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of diclofenac in various inflammatory and painful conditions. Ongoing post-marketing surveillance and studies continue to monitor its long-term effects and safety profile.
Lab Monitoring
- Complete Blood Count (CBC) for signs of anemia or other blood dyscrasias, especially with long-term use.
- Liver function tests (ALT, AST) periodically, particularly with prolonged therapy.
- Renal function tests (serum creatinine, BUN, urine output) for patients at risk of renal impairment or with prolonged use.
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Monitor for signs and symptoms of GI bleeding or cardiovascular events, especially in high-risk patients.
- Assess renal function before initiating treatment and periodically thereafter, particularly in elderly patients or those with pre-existing renal impairment.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Swallow the tablet whole; do not crush, chew, or break it.
- Take with food or milk to minimize stomach upset.
- Do not exceed the recommended dose.
- Inform your doctor about any other medications you are taking, especially blood thinners or other NSAIDs.
- Seek medical attention if you experience severe abdominal pain, black/tarry stools, unusual bleeding/bruising, or swelling.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness, drowsiness, or visual disturbances. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Avoid or limit alcohol consumption while taking this medication, as it may increase the risk of stomach bleeding.
- Maintain adequate hydration to support kidney function.
- Consult your doctor before engaging in strenuous activities, especially if you have a history of cardiovascular issues.
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