Neurodiclovit: instructions for use, reviews, price. Indications for use of the drug

Pharmacodynamics and pharmacokinetics

Diclofenac sodium is characterized as an anti-inflammatory , antiplatelet , analgesic and antipyretic agent. It has a non-selective inhibitory effect on COX-1 and COX-2 , reduces the content of prostaglandins at the site of inflammation, and also interferes with the metabolism of arachidonic acid . For rheumatic diseases, this substance helps reduce swelling of the joints, pain, and the severity of morning stiffness. This significantly improves the functional state of the joints.

Pyridoxine hydrochloride normalizes the functioning of the nervous system. It serves as a coenzyme for important enzymes found in nerve tissues. In addition, it takes part in the biosynthesis of many neurotransmitters .

Thiamine hydrochloride, entering the human body, is converted into cocarboxylase . It is a coenzyme for many enzymes. It is an important component of metabolic processes in the body. Actively participates in the processes of nervous excitation at synapses .

Cyanocobalamin is a means for stabilizing hematopoiesis and maturation of red blood cells, which takes part in many biochemical reactions necessary for the normal functioning of the body. It also has a beneficial effect on processes occurring in the nervous system. Coenzyme forms of this substance are needed for cell renewal and growth.

The combination of B vitamins found in Neurodiclovit (pyridoxine, thiamine, cyanocobalamin) potentiates the analgesic properties of diclofenac.

Diclofenac is characterized by rapid and complete absorption upon entering the body. However, food intake slows down this process by 1-4 hours, and also reduces the maximum concentration of the active component by 40%. After taking the capsules orally, the maximum concentration of this substance is achieved in the body after 2-3 hours. It is linearly dependent on the amount of the administered dose.

The degree of bioavailability of the drug is 50%. Strong connection with blood plasma proteins. The half-life of elimination from synovial fluid is approximately 4-5 hours. The maximum concentration in synovial fluid is reached approximately 3 hours later than in plasma.

50% of the active component is broken down in the liver. Metabolic processes occur after hydroxylation and conjugation with glucuronic acid . The enzyme system P450 CYP2C9 is involved in the breakdown of Neurodiclovit . 65% of the drug is excreted through the kidneys in the form of metabolites , less than 1% - unchanged. The remaining part is excreted through bile, also in the form of metabolites .

Systemic clearance – 350 ml/min. The plasma half-life is 2 hours. Diclofenac may pass into breast milk.

The B vitamins included in the preparation are water-soluble. Absorption of pyridoxine and thiamine occurs in the upper part of the small intestine. This process largely depends on the dosage. In the body, they are broken down in the liver and excreted mainly through the kidneys. Only about 9% is excreted unchanged. At higher doses, the excretion of pyridoxine and thiamine through the intestines increases.

The absorption of cyanocobalamin largely depends on the presence of intrinsic factor in the stomach and upper small intestine. The transport of this substance is determined by transcobalamin . After breakdown in the liver, it is excreted primarily in bile. Only about 6-30% of cyanocobalamin is excreted through the liver.

Pharmacological properties of the drug Neurodiclovit

Pharmacodynamics . Neurodiclovit is a combination drug containing diclofenac sodium and vitamins B1, B6 and B12. B vitamins function as coenzymes in metabolism, in particular in nervous tissue, which enhances the analgesic effect of diclofenac. Like other NSAIDs, dilofenac inhibits the activity of the COX enzyme, which is involved in the formation of prostaglandins from arachidonic acid. Diclofenac also inhibits the activity of the enzyme lipoxygenase. The analgesic, anti-inflammatory and antipyretic effect of diclofenac is due to inhibition of prostaglandin synthesis. Pharmacokinetics. After oral administration, dliclofenac is well and completely absorbed from the gastrointestinal tract. Bioavailability is not affected by concomitant food intake. The maximum concentration in the blood plasma is achieved 1–2 hours after administration (when taken on an empty stomach, it is achieved faster than when taking the drug with food). The therapeutic concentration of the drug in blood plasma is 0.7–2.0 mg/l. Almost 99% of diclofenac is bound to plasma proteins, mainly albumin. The half-life of diclofenac from blood plasma is about 2 hours. The total systemic clearance of diclofenac from blood plasma is about 250 ml/min. Approximately 60% of the administered dose of the drug is excreted by the kidneys in the form of active metabolites; ≤1% of diclofenac is excreted unchanged. About 30% of the drug dose is excreted in the form of metabolites in bile and feces. Impaired renal function does not cause accumulation of the active substance due to increased excretion in the bile. Absorption, metabolism and excretion of the drug do not depend on the patient's age. The vitamins included in the drug are absorbed in the intestine thanks to active and passive transport mechanisms. Distribution and excretion are similar to those for vitamins obtained from food.

Contraindications

The medicine should not be taken in case of hypersensitivity to its components, bleeding from the gastrointestinal tract, bronchial asthma with polyposis of the nasal mucosa, hemostasis , pregnancy , breastfeeding , hematopoietic disorders, intracranial bleeding, erosive and ulcerative lesions of the gastrointestinal tract (especially during exacerbation). In addition, it is not recommended to give this drug to patients in childhood.

Neurodiclovit is prescribed with caution for congestive heart failure, anemia , coronary heart disease, bronchial asthma , liver or kidney failure , diabetes mellitus , inflammatory bowel diseases, inducible porphyria , alcoholism, diverticulitis , arterial hypertension , systemic connective tissue diseases, edema syndrome , old age . It is also necessary to carefully monitor the patient's condition if the drug is prescribed after extensive surgery.

Side effects

The use of capsules may be accompanied by the following side effects:

gastrointestinal tract and liver : increased levels of liver enzymes, abdominal pain , diarrhea , constipation , bleeding in the gastrointestinal tract, feeling of bloating, nausea, flatulence , peptic ulcer (complications are possible);
sense organs : tinnitus;
genitourinary system : oliguria , fluid retention, interstitial nephritis , nephrotic syndrome , acute renal failure , proteinuria , papillary necrosis , hematuria , azotemia ;
nervous system : dizziness , headache ;
skin : rash, itching ;
immune system and hematopoietic organs : agranulocytosis , worsening infectious processes, leukopenia , anemia , eosinophilia , thrombocytopenia , thrombocytopenic purpura .

In addition, in rare cases, disorders such as vomiting, melena , esophageal damage, liver necrosis , dry mucous membranes, hepatorenal syndrome , colitis , jaundice , aphthous stomatitis , hepatitis , cirrhosis , changes in appetite, cholecystopancreatitis appear in the gastrointestinal tract and liver .

Rarely, the central nervous system may also cause sleep disturbance , depression , aseptic meningitis , general weakness, nightmares, drowsiness , irritability, convulsions, disorientation, and increased anxiety. And on the part of the skin - alopecia , increased photosensitivity, eczema , toxic dermatitis , exudative erythema multiforme , urticaria , Lyell's syndrome , pinpoint hemorrhages.

Very rarely, side effects such as increased blood pressure, blurred vision, taste disturbance, scotoma , diplopia , hearing impairment, laryngeal edema, cough, bronchospasm , pneumonitis , extrasystole , myocardial infarction , congestive heart failure , pain in the chest, anaphylactoid reactions are noted. , swelling of the lips and tongue, anaphylactic shock , allergic vasculitis .

Side effects of the drug Neurodiclovit

The drug is usually well tolerated, although in some cases the following side effects may develop: gastrointestinal disorders (epigastric pain, anorexia, hiccups, nausea, diarrhea, hidden bleeding), headache, dizziness, fatigue, tinnitus, eczema , skin rash, itching, sodium and water retention in the body, peripheral edema (mainly in patients with hypertension (arterial hypertension)); uncommon - gastrointestinal ulcers with severe bleeding and perforation, anemia, insomnia, anxiety, irritability, allergic reactions (bronchospasm, urticaria, anaphylactic/anaphylactoid systemic reactions), acute renal failure (isolated cases), nephrotic syndrome, hematuria, isolated cases of hepatitis (jaundice, increased level of transaminases in the blood serum), hematopoietic disorders (leukopenia, thrombocytopenia, aplastic anemia, pancytopenia, thrombocytopenic purpura, agranulocytosis, hemolytic anemia); rarely - reversible alopecia, Stevens-Johnson syndrome, Lyell's syndrome, Hebra's disease, seizures, visual impairment (blurred vision, diplopia), hearing impairment, interstitial nephritis, papillary necrosis.

Instructions for use of Neurodiclovit (Method and dosage)

For those who have been prescribed Neurodiclovit, the instructions for use recommend swallowing the capsules whole during meals, with sufficient liquid. Dosages may vary depending on the severity of the disease. On average, the dose is designed to take 1-3 capsules per day, that is, about 100 mg of diclofenac.

Instructions for use of Neurodiclovit indicate that adult patients are usually prescribed 2-3 capsules per day to begin the course. But the maximum dosage should not exceed three capsules. Maintenance dose – 1 capsule 1-2 times during the day.

Elderly patients should use this drug with caution.

Children over the age of 14 years can be prescribed Neurodiclovit, but its maximum dosage should not exceed 1 capsule 2 times a day.

The duration of the course is determined by a specialist.

Overdose

When taking the drug in increased dosages, the following symptoms may be observed: vomiting, headache , clouding of consciousness, dizziness , shortness of breath . Patients in childhood may experience myoclonic convulsions , abdominal pain , liver and kidney dysfunction, nausea, and bleeding.

Treatment includes gastric lavage, forced diuresis , and activated charcoal. Therapy is symptomatic. Hemodialysis is almost ineffective.

Special instructions for the use of the drug Neurodiclovit

The drug should not be used in the third trimester of pregnancy and during breastfeeding. During the 1st–2nd trimester of pregnancy, the drug can be used only according to strict indications in the minimum effective dose. It is not recommended for use in children under 14 years of age due to the high content of the active ingredient in the capsules. During long-term treatment with Neurodiclovit, it is recommended to monitor the peripheral blood picture, functional indicators of the liver and kidneys, and also conduct a stool test for occult blood. Patients with gastric and duodenal ulcers, a history of dyspeptic symptoms, severe liver disease, kidney disease, heart failure and hypertension (arterial hypertension) should be under strict medical supervision. The drug should be used with caution in patients with asthma, hay fever, nasal polyposis and chronic infectious diseases of the respiratory tract. Although no negative effect on the ability to drive vehicles or operate machinery was noted when taking the drug, it cannot be ruled out that the reaction rate may be reduced due to the negative effect of diclofenac on the central nervous system (dizziness, fatigue).

Interaction

Prescribing this medication may cause an increase in:

lithium level when combined with lithium preparations;
severity of adverse reactions when using other NSAIDs;
the likelihood of bleeding in the gastrointestinal tract in combination with glucocorticoids ;
the effectiveness of potassium-sparing diuretics and drugs that inhibit platelet aggregation ;
concentrations and toxicity of Methotrexate .

In addition, the effectiveness of Neurodiclovit is reduced when interacting with loop diuretics and antihypertensive drugs . The concentration of its active substance (diclofenac) also decreases when combined with acetylsalicylic acid . The absorption of cyanocobalamin is reduced when taken with Colchicine , Neomycin , PAS and antidiabetic drugs such as Biguanidine .

Neurodiclovit should not be used simultaneously with Levodopa , as it can dull the severity of its antiparkinsonian effect. In addition, it may reduce the antihypertensive effect of diuretics or antihypertensive drugs . So this combination is prescribed with caution. In this case, it is imperative to control blood pressure . In addition, it is necessary to consume a sufficient amount of fluid, and at the beginning and after completion of the course, monitoring of kidney function is necessary, as nephrotoxicity .

serotonin reuptake inhibitors, the risk of bleeding from the gastrointestinal tract increases.

The dosage of hypoglycemic drugs while using Neurodiclovit should be carefully monitored.

Combination with Colestipol or Kolestyramine reduces the degree of absorption of diclofenac by approximately 30-60%. So between taking these medications it is necessary to take an interval of several hours. In addition, the concentration of diclofenac can be reduced by some drugs that stimulate enzymes ( Rifampicin , Phenytoin , Carbamazepine , St. John's wort ).

It should also be taken into account that thiamine is inactivated by 5-fluorouracil , and antacids , in turn, reduce the degree of its absorption . Loop diuretics can inhibit tubular reabsorption of thiamine and, with a long course of treatment, reduce its concentration.

Neurodiclovit capsules No. 30

Compound

One capsule contains: active substances:
diclofenac sodium 50.0 mg,
mixture of vitamins:
thiamine hydrochloride 50.0 mg, pyridoxine hydrochloride 50.0 mg, cyanocobalamin 0.25 mg,
excipients:
povidone K 25 8.42 mg, methacrylic acid and ethyl acrylate copolymer (1: 1) dispersion 30% 5.60 mg, triethyl citrate 0.60 mg, talc 3.08 mg,
capsule shell: body:
titanium dioxide (E 171) 0.9240 mg, red iron oxide dye ( E 172) 0.0061 mg, yellow iron oxide dye (E 172) 0.0924 mg, gelatin 45.1775 mg,
cap:
titanium dioxide (E 171) 0.7186 mg, red iron oxide dye (E 172) 0, 5144 mg, gelatin 29.5670 mg.

Pharmacokinetics

Absorption of diclofenac is rapid and complete; food slows the rate of absorption by 1 to 4 hours and reduces the maximum concentration by 40%. After oral administration of 50 mg, the maximum concentration (Cmax) of 1.4 mcg/ml is achieved after 2-3 hours. The plasma concentration is linearly dependent on the size of the administered dose.

No changes in the pharmacokinetics of diclofenac are observed during repeated administration and do not accumulate.

Bioavailability - 50%. Communication with plasma proteins is more than 99% (most of it is associated with albumin). Penetrates into synovial fluid, the maximum concentration in synovial fluid is observed 2-4 hours later than in plasma. The half-life from synovial fluid is 3-6 hours (the concentration of the active substance in synovial fluid 4-6 hours after administration of the drug is higher than in plasma, and remains higher for another 12 hours). The relationship between the concentration of the drug in the synovial fluid and the clinical effectiveness of the drug has not been clarified. Metabolism: 50% of the active substance is metabolized during the first passage through the liver. Metabolism occurs as a result of multiple or single hydroxylation and conjugation with glucuronic acid. The enzyme system P450 CYP2C9 takes part in the metabolism of the drug. The pharmacological activity of the metabolites is lower than that of diclofenac. Systemic clearance is 350 ml/min, volume of distribution is 550 ml/kg. The half-life from plasma is 2 hours. 65% of the administered dose is excreted in the form of metabolites by the kidneys, less than 1% is excreted unchanged, the rest of the dose is excreted in the form of metabolites in the bile. In patients with severe renal failure (creatinine clearance less than 10 ml/min), the excretion of metabolites in bile increases, but no increase in their concentration in the blood is observed.

In patients with chronic hepatitis or compensated liver cirrhosis, the pharmacokinetic parameters of diclofenac do not change. Diclofenac passes into breast milk.

The vitamins included in Neurodiclovit are water-soluble, which eliminates the possibility of their accumulation in the body. Thiamine and pyridoxine. absorbed in the upper part of the small intestine, metabolized in the liver and excreted by the kidneys (about 8-10% unchanged). The degree of absorption depends on the dose; in case of overdose, the excretion of thiamine and pyridoxine through the intestines significantly increases. The absorption of cyanocobalamin depends to a large extent on the presence of an internal factor in the body (in the stomach and upper small intestine); further delivery of the vitamin to the tissue is determined by the transport protein transcobalamin. After metabolism in the liver, cyanocobalamin is excreted mainly in bile, the degree of excretion by the kidneys is variable - from 6 to 30%.

Indications for use

— Pain syndrome due to inflammation of non-rheumatic nature

— after injuries, surgical and dental interventions,

- for gynecological diseases - primary algodismenorrhea,

adnexitis,

- for inflammatory diseases of the ENT area - pharyngitis, tonsillitis, otitis media

— Inflammatory and degenerative diseases of the joints and spine (chronic polyarthritis, osteoarthritis, spondylarthrosis)

— Neuritis and neuralgia (cervical syndrome, lumbago, lumboischalgia)

— Acute gouty arthritis

Contraindications

Symptoms: vomiting, bleeding from the gastrointestinal tract (GIT), epigastric pain, diarrhea, dizziness, tinnitus, lethargy, convulsions, rarely - increased blood pressure, acute renal failure, hepatotoxic effect, respiratory depression, coma.

Treatment: gastric lavage, activated charcoal, symptomatic therapy aimed at eliminating increased blood pressure. renal dysfunction, seizures, gastrointestinal irritation, respiratory depression. Forced diuresis and hemodialysis are ineffective (due to the significant connection with proteins and intensive metabolism).

Directions for use and doses

Capsules should be taken orally during meals, without chewing and with plenty of liquid.

Usually the drug is prescribed 1 capsule 1-3 times a day.

For adults, Neurodiclovit is prescribed 1 capsule - at the beginning of treatment 3 times a day, as a maintenance dose - 1-2 times a day. The duration of therapy depends on the nature and severity of the disease.

Storage conditions

In a dry place, protected from light, at a temperature not exceeding 25 C. Keep out of the reach of children!

Best before date

3 years.

Do not use after expiration date.

special instructions

During treatment with the drug, systematic monitoring of peripheral blood patterns, liver and kidney function, and stool examination for the presence of blood should be carried out.

To reduce the risk of developing adverse events from the gastrointestinal tract, the minimum effective dose should be used in the shortest possible short course. In order to quickly achieve the desired therapeutic effect, the tablets are taken 30 minutes before meals. In other cases, take before, during or after meals, without chewing, with a sufficient amount of water. Because of the important role of prostaglandins in maintaining renal blood flow, special caution should be exercised when prescribing to patients with cardiac or renal failure, as well as when treating elderly patients taking diuretics and patients who for any reason have a decrease in circulating blood volume (in including after extensive surgery). If diclofenac is prescribed in such cases, it is recommended to monitor renal function as a precaution. If, while taking the drug, the increase in the activity of liver transaminases persists or increases, if clinical symptoms of hepatotoxicity are noted (including nausea, fatigue, drowsiness, diarrhea, itching, jaundice), treatment should be discontinued. Diclofenac (like other NSAIDs) can cause hyperkalemia. Due to the negative effect on fertility, the drug is not recommended for women planning to become pregnant. In patients with infertility (including those undergoing examination), it is recommended to discontinue the drug.

Description

Hard gelatin capsules No. 1, body: light pinkish-yellow, opaque, cap: pinkish-brown, opaque. Capsule contents: a mixture of white granules (diclofenac sodium) and pink powder (thiamine hydrochloride, pyridoxine hydrochloride, cyanocobalamin).

Conditions for dispensing from pharmacies

On prescription

Dosage form

Modified release capsules.

Pharmacodynamics

Diclofenac has anti-inflammatory, analgesic, antiplatelet and antipyretic effects. By indiscriminately inhibiting cyclooxygenase 1 and 2, it disrupts the metabolism of arachidonic acid and reduces the amount of prostaglandins at the site of inflammation.

In rheumatic diseases, the anti-inflammatory and analgesic effect of diclofenac helps to significantly reduce the severity of pain, morning stiffness, and swelling of the joints, which improves the functional state of the joint. For injuries, in the postoperative period, diclofenac reduces pain and inflammatory swelling. Thiamine (vitamin B1) in the human body, as a result of phosphorylation processes, is converted into cocarboxylase, which is a coenzyme of many enzymatic reactions. Vitamin B1 plays an important role in carbohydrate, protein and fat metabolism. Actively participates in the processes of nerve excitation in synapses.

Pyridoxine (vitamin B6) is necessary for the normal functioning of the central and peripheral nervous system. In its phosphorylated form, it is a coenzyme in the metabolism of amino acids (decarboxylation, transamination, etc.). Acts as a coenzyme for the most important enzymes operating in nerve tissues. Participates in the biosynthesis of many neurotransmitters - such as dopamine, serotonin, norepinephrine, adrenaline, gamma-aminobutyric acid (GABA).

Cyanocobalamin (vitamin B12) is necessary for normal hematopoiesis and maturation of red blood cells, and also participates in a number of biochemical reactions that ensure the vital functions of the body - in the transfer of methyl groups, in the synthesis of nucleic acids, proteins, in the metabolism of amino acids, carbohydrates, lipids. It has a beneficial effect on processes in the nervous system (synthesis of nucleic acids and lipid composition of cerebrosides and phospholipids). Coenzyme forms of cyanocobalamin - methylcobalamin and adenosylcobalamin are necessary for cell replication and growth. The combination of B vitamins potentiates the analgesic effect of diclofenac.

Side effects

Gastrointestinal tract:

more often than 1% - epigastric pain, a feeling of bloating, diarrhea, nausea, constipation, flatulence, increased aminotransferase activity, peptic ulcer with possible complications (bleeding, perforation), gastrointestinal bleeding,

less than 1% - vomiting, jaundice, melena, blood in the stool, damage to the esophagus, aphthous stomatitis, dry mucous membranes (including the mouth), hepatitis (possibly fulminant), liver necrosis, cirrhosis, hepatorenal syndrome, changes in appetite, pancreatitis , cholecystopancreatitis, colitis.

Nervous system:

more often than 1% - headache, dizziness,

less than 1% - sleep disturbance, drowsiness, depression, irritability,

aseptic meningitis (more often in patients with systemic lupus erythematosus and other

systemic connective tissue diseases), seizures, general weakness,

disorientation, nightmares, feeling of fear.

Sense organs:

more often than 1% - tinnitus,

less than 1% - blurred vision, diplopia, impaired taste,

reversible or irreversible hearing loss, scotoma.

Skin:

more often 1% - skin itching, skin rash,

less often 1% - alopecia, urticaria, eczema, toxic dermatitis, multiforme

exudative erythema (including Stevens-Johnson syndrome), toxic

epidermal necrolysis (Lyell's syndrome), increased photosensitivity,

pinpoint hemorrhages, bullous rashes.

Genitourinary system:

more often than 1% - fluid retention,

less than 1% - nephrotic syndrome, proteinuria, oliguria, hematuria, interstitial nephritis, papillary necrosis, acute renal failure, azotemia.

Hematopoietic organs and immune system:

less than 1% - anemia (including hemolytic and aplastic anemia), leukopenia, thrombocytopenia, eosinophilia, agranulocytosis, thrombocytopenic purpura, worsening of infectious processes (including the development of necrotizing fasciitis).

Respiratory system:

less than 1% - cough, bronchospasm, laryngeal edema, pneumonia.

The cardiovascular system:,

less than 1% - increased blood pressure, heart failure, extrasystole, chest pain, myocardial infarction.

Allergic reactions:

less often 1%

- anaphylactoid reactions, anaphylactic shock (usually develops rapidly), swelling of the lips and tongue, allergic vasculitis.

Use during pregnancy and breastfeeding

The use of the drug is contraindicated during pregnancy and breastfeeding.

Interaction

The drug increases plasma concentrations of digoxin, methotrexate, lithium and cyclosporine.

Reduces the effect of diuretics; against the background of potassium-sparing diuretics, the risk of hyperkalemia increases; against the background of anticoagulants, thrombolytic agents (alteplase, streptokinase, urokinase) - the risk of bleeding (usually from the gastrointestinal tract).

Reduces the effects of antihypertensive and hypnotic drugs. Increases the likelihood of side effects of other NSAIDs and glucocorticosteroids (bleeding in the gastrointestinal tract), the toxicity of methotrexate and the nephrotoxicity of cyclosporine. Acetylsalicylic acid reduces the concentration of diclofenac in the blood. Concomitant use with paracetamol increases the risk of developing nephrotoxic effects of diclofenac. Reduces the effect of hypoglycemic drugs.

Cefamandole, cefoperazone, cefotetan, valproic acid and plicamycin increase the incidence of developed hypoprothrombinemia.

Cyclosporine and gold preparations increase the effect of diclofenac on the synthesis of prostaglandins in the kidneys, which increases nephrotoxicity. Concomitant use with ethanol, colchicine, corticotropin, serotonin reuptake inhibitors and St. John's wort increases the risk of bleeding in the gastrointestinal tract.

Diclofenac enhances the effect of drugs that cause photosensitivity.

Antibacterial drugs from the quinolone group - the risk of developing seizures.

Drugs that block tubular secretion increase the plasma concentration of diclofenac, thereby increasing its toxicity. The drug reduces the antiparkinsonian effectiveness of levodopa. Ethanol sharply reduces the absorption of thiamine (blood levels can decrease by 30%). Long-term treatment with anticonvulsants can lead to thiamine deficiency. The use of colchicine and biguanides reduces the absorption of cyanocobalamin. While taking the drug, it is not recommended to take multivitamin complexes containing B vitamins.

Overdose

Release form

Modified release capsules.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, the speed of mental and motor reactions may decrease, so it is necessary to refrain from driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Analogues of Neurodiclovit

Level 4 ATC code matches:
Voltaren

Rapten

Zerodol

Dickloberl Retard

Dikloberl N 75

Dicloberl

Ketanov

Dolak

Panoxen

Ketorolac

Naklofen Duo

Naklofen

Olfen-100

Olfen-75

Nizilat

Fanigan

Aertal

Methindol retard

Ortofen

In pharmacies you can find the following analogues of Neurodiclovit:

Blockium B12;
Bol-Ran;
Dilocaine;
Diclofenac;
Diclofenac S Paracetomol;
Dolex;
Maxigesik;
Olfen-75;
Fanigan;
Flamidez;
Cynepar.

Why tablets offered as analogues of this remedy help in each specific case is best checked with your doctor.

Neurodiclovit price, where to buy

The price of Neurodiclovit, on average, is about 220 rubles for a package containing 30 capsules. In Ukraine, the cost of this product is about 70 hryvnia. It is worth noting that the price of Neurodiclovit is lower than many of its analogues.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine

LuxPharma* special offer

Neurodiclovit caps.
30pcs 1280 rub. order

ZdravCity

Neurodiclovit capsules 30 pcs. Lannacher Heilmittel
RUR 368 order

Pharmacy Dialogue

Neurodiclovit capsules No. 30 Lannacher
380 rub. order

Pharmacy24

Neurodiclovit No. 30 capsules G.L Pharma GmbH, Austria
159 UAH.order