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Almiral WHAT IS AND WHAT IT IS USED
Diclofenac is an anti-inflammatory drug used for the relief of pain , inflammation and stiffness . Diclofenac works by reducing substances that cause inflammation and pain in the body. It belongs to a group of medicines called non-steroidal anti-inflammatory drugs ( HCPBC ) .
Almiral may be administered for acute pain in a variety of conditions including exacerbated osteoarthritis , rheumatoid arthritis , acute pain , back pain, gout aggravated , renal pain ( such as pain caused by kidney stones ), acute trauma and post operative pain .
Almir when administered by intravenous infusion , is used to treat and prevent post-surgical pain .
Your doctor will explain what treat you and tell you more.
2 . BEFORE YOU TAKE Almira
Almira not take if:
you are allergic to diclofenac , aspirin, ibuprofen or other NSAIDs , or to any of the excipients of Almira . Symptoms of hypersensitivity include swelling of the face and lips (angioedema) , breathing problems , runny nose , rash or any other allergic reaction ;
ill or have suffered from gastric or duodenal ulcer or bleeding in the digestive tract ( this may include bleeding vomiting or bowel movement , light or dark blood in stool, tarry stools)
have had a bleeding in the stomach or intestine , or perforation after the reception of the other NSPBC ;
suffering from acute hepatic or renal failure;
suffer from acute heart failure;
you suffer from asthma , urticaria or acute rhinitis and these conditions are enhanced with the use of aspirin , diclofenac or other NSAIDs ;
use other NSAIDs or tablets that reduce blood clotting ( anticoagulants such as heparin) ;
suffer from disorders accompanied by bleeding . You should not take this medicine if you suffer from cerebrovascular bleeding or had surgery with a high risk of hemorrhage ;
have reduced blood volume or dehydration ;
now you are pregnant, plan to become pregnant or breast-feeding .
Take special care with Almir :
if you take other medicines protivobolkovi ;
if you have severe kidney or liver disease ;
if you have experienced stomach pain / heartburn after taking protivobolkovi medicines;
if you have stomach or intestinal disorder such as Crohn's disease or ulcerative colitis;
if you suffer or have suffered from heart , kidney or liver disease , or are elderly ;
suffer from blood disorders ;
if you have heart problems , if you have had a stroke or think that you are at risk of these conditions (for example if you have high blood pressure, diabetes or high cholesterol or are a smoker) .
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines , including medicines obtained without a prescription , herbal products and supplements including:
Other non-steroidal anti-inflammatory drugs (NSAIDs). incl. Selective inhibitors of cyclooxygenase - 2 , aspirin or ibuprofen ;
anticoagulants (eg, warfarin) ;
lithium (used for the treatment of certain mental disorders ) or digoxin ( cardiac glycoside used to treat heart disease ) ;
selective inhibitors of serotonin reuptake ( paroxetine , fluoxetine ) used to treat depression ;
antiplatelet agents such as aspirin ;
antidiabetic agents ;
methotrexate (used to treat inflammatory disorders and cancer ) ;
steroids ( anti-inflammatory drugs ) ;
"water " pills (diuretics ) ;
cyclosporin or tacrolimus ( used for the treatment of inflammatory diseases , and after transplantation ) ;
quinolone antibacterial agents ;
ACE inhibitors and angiotensin II- receptor , and other drugs for the treatment of hypertension.
Drugs such ALMIRAL may be associated with a slightly increased risk of heart attack ( " MI " ) or stroke. Any risk is more likely with high doses and prolonged treatment. Do not exceed the recommended dose and duration of treatment.
If you have heart problems, previous stroke or think that you might be at risk of these conditions (for example if you have high blood pressure, diabetes or high cholesterol or are a smoker) you should discuss treatment with your doctor or pharmacist.
If you are taking any other medicines , including those that use without a prescription should also tell your doctor. He may change the dose of any of these drugs , or to discontinue other , since they can reduce the effect of Almir . Always follow your doctor's instructions .
Pregnancy and lactation
Almir should not be used during pregnancy unless clearly necessary . Should be used at the lowest effective dose.
The use of diclofenac in the recent months of pregnancy should be avoided .
Almir can make getting pregnant more difficult. You should tell your doctor if you become pregnant or have difficulty getting pregnant.
Application of Almira during lactation is not recommended due to insufficient data . Diclofenac is excreted in small amounts in breast milk.
Driving and using machines
If you feel dizzy after using Almira , do not drive , avoid operating machinery.
3 . HOW TO TAKE Almiral
Your doctor decides when and how to treat you . It depends on the severity of your symptoms . Ask your doctor for more information. Always follow the doctor's instructions . If you are not sure, ask your doctor or pharmacist.
Typically, the liquid from the vial was aspirated into a syringe and injected into the gluteal region ( intramuscularly) . If you are in hospital the contents of the ampoule can be diluted and injected slowly intravenously ( intravenous infusion).
The usual dose for intramuscular injection of 75 mg - 150 mg daily , given as 1 or in more severe cases - 2 ampoules intramuscularly by deep intramuscular injection . If you need 2 injections per day is recommended alternating left and right buttock.
In renal colic , the recommended dose is 1 ampoule intramuscularly ( 75 mg): next ampoule can be applied , if necessary , 30 minutes later .
For preparation of an intravenous infusion , 1 vial must be diluted with 100-500 ml of a solution of sodium chloride ( 0.9%) or glucose (5% ) . Both the solution must first be buffered with bicarbonate solution 0.5 ml of 8.4 % or 1 ml of 4.2 %. Should be used only clear solutions . The solution must be prepared under aseptic conditions. Infusions should be prepared immediately prior to injection and used immediately.
Two alternative dosing regimens are recommended for intravenous infusion ( this application is only suitable for a patient who is in a hospital setting ):
Treatment of moderate to severe post-operative pain . 75 mg infused continuously by infusion of 30 minutes to 2 hours. If necessary , the treatment can be repeated after 4-6 hours ;
for the prevention of post-operative pain is done loading dose of 25 mg - 50 mg of 15 minutes to 1 hour , followed by a continuous infusion of 5 mg / hour to the maximum daily dose .
Infusions should be administered over two days.
The total daily dose should not exceed 150 mg.
Hepatic or renal function and use in elderly patients :
Your doctor will use the lowest effective dose and monitor you as you may get interference on your kidney function.
Children / 1-2 years /
This formulation and quantity of the drug is not recommended for use in children .
If you forget to take Almir
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose , skip and continue with the schemes which dosing . Do not take two doses at once. The total daily dose should not exceed 150 mg.
If you take more than the amount of Almira
Do not take more than the recommended dose Almira . If you accidentally take more dose, contact your doctor immediately or pharmacist. Can go to the nearest hospital. Always take the container with you to be able to show the doctor what you have taken .
4 . POSSIBLE SIDE EFFECTS
As with all medicines , some people sometimes experience side effects during treatment with Almira . These are called side effects.
If you experience any of the following , stop taking Almira and immediately seek medical attention or call your doctor:
signs of stomach or intestinal bleeding ( black stools , bleeding in vomiting);
stomach pain, indigestion , heartburn, bloating , or nausea (feeling of weakness) , or vomiting ;
skin rash , itching or bruising, painful red spots , skin or rash ;
sudden attack of breathlessness or wheezing (bronchospasm ) ;
swelling of face, lips , hands, or fingers ;
yellowing of the skin or whites of the eyes ;
prolonged sore throat or fever (fever) ;
unexpected changes in the type and quantity of urine.
May occur more uncommon effects such as:
diarrhea , indigestion, loss of appetite, abdominal cramps ;
headache, dizziness , vertigo ( tinnitus ) ;
rashes or skin lesions ;
elevated levels of enzymes in the blood which are indicative of liver function.
Medicinal product may rarely cause :
bleeding from the gastrointestinal tract , peptic ulcer , with or without perforation or bleeding , sometimes fatal , especially in elderly patients ;
drowsiness , fatigue , hypotension ( low blood pressure manifest the following symptoms: lightheadedness , dizziness , headache ) ;
fluid retention, which includes symptoms such as swelling of the ankle ;
liver function abnormalities including hepatitis, with or without jaundice.
Very rare medicinal product may cause:
tremor , abnormal sensitivity , drowsiness , nightmares, mood swings, depression, anger , metal disturbances , confusion , hallucinations , anxiety , disorientation and memory loss , psychotic reactions , aseptic meningitis ( with symptoms such as fever , stiff neck , headache, nausea and vomiting);
constipation , inflammation of the tongue, oral ulcers , intestinal disorders (including inflammatory bowel disease ) ;
palpitations ( rapid or irregular heart beat), back pain , hypertension ( high blood pressure) , inflammation of the lungs ( pneumonia) or blood vessels ( vasculitis) , severe heart failure ;
blood disorders (including anemia) ;
acute renal failure, blood in the urine , inflammation of kidney tissue ( nephritis ) , liver inflammation ( hepatitis ) ;
visual impairment , hearing loss , impotence ;
bullous reactions ( skin reactions with blisters ), including so -called syndrome of Stevens-Johnson syndrome and Lyell and other skin rashes that may worsen after sun exposure, hair loss.
These reactions are usually mild and disappear after a few days. If severe or do not go for a long time you should contact your doctor .
Drugs such Almir may be associated with a slightly increased risk of heart attack ( " MI " ) or stroke.
Do not be alarmed by this list of possible responses. When you can not show any of them .
If any of the side effects gets serious, or you notice other effects not listed in this leaflet , please tell your doctor or pharmacist.
5 . HOW TO STORE Almiral
Keep out of reach of children.
Store in original container. Do not store in the refrigerator and do not freeze .
Do not use after the expiry date stated on the carton and the label of each vial .
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required . These measures will help to protect the environment.
6 . OTHER INFORMATION
What does Almiral
The active agent is diclofenac sodium.
Each glass vial containing 3 ml of a solution containing 75 mg of diclofenac sodium.
The other ingredients are benzyl alcohol, sodium formaldehyde sulfoxylate , propylene glycol, sodium metabisulfite , sodium hydroxide , water for injections.
Almir looks like and contents of the pack
Almira solution for injection is a clear, colorless to pale yellow solution in 3 ml vials , amber , Type I.
Almira injection is supplied in glass ampoules amber containing 3 ml diclofenac sodium 25 mg / ml, in packs of 10 ampoules.
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