Voveran: Targeted Pain Relief with Potent Anti-Inflammatory Action

Voveran

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Product dosage: 50mg
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Synonyms Solunacsupragesic

Voveran (diclofenac) is a well-established nonsteroidal anti-inflammatory drug (NSAID) prescribed for the management of acute and chronic pain conditions involving inflammation. As a potent inhibitor of cyclooxygenase (COX) enzymes, it effectively reduces the production of prostaglandins, key mediators of pain, fever, and swelling. Its clinical profile is characterized by a strong analgesic and anti-inflammatory efficacy, making it a cornerstone in the treatment of musculoskeletal and arthritic disorders. Available in various formulations including oral tablets, topical gels, and injectable solutions, Voveran offers tailored therapeutic options to meet diverse patient needs and clinical scenarios, providing significant improvement in pain scores and functional mobility.

Features

• Active Pharmaceutical Ingredient: Diclofenac sodium or diclofenac potassium.
• Pharmacological Class: Nonsteroidal Anti-Inflammatory Drug (NSAID); a non-selective COX-1 and COX-2 inhibitor.
• Available Formulations: Enteric-coated tablets, dispersible tablets, sustained-release tablets, topical gel (1%), transdermal patches, suppositories, and solution for intramuscular injection.
• Standard Strengths: Tablets commonly available in 25 mg, 50 mg, and 75 mg (sustained-release) strengths. Topical gel is typically 1% diclofenac sodium.
• Rapid Absorption: Diclofenac potassium formulations are designed for faster absorption, providing quicker onset of action for acute pain.
• High Protein Binding: Extensively bound to serum albumin (>99%), influencing its pharmacokinetics and potential drug interactions.

Benefits

• Effective Pain Reduction: Provides potent analgesia for moderate to severe pain, significantly lowering patient-reported pain scores across various conditions.
• Powerful Anti-Inflammatory Action: Directly targets the underlying inflammation causing pain and stiffness, particularly in arthritis and soft tissue injuries, leading to reduced swelling and improved joint function.
• Improved Mobility and Function: By alleviating pain and reducing inflammation, Voveran enables enhanced range of motion and daily activity performance, contributing to a better quality of life.
• Flexible Dosing and Formulations: The variety of available forms (oral, topical, injectable) allows for personalized treatment plans, optimizing efficacy while minimizing systemic exposure and side effects where appropriate.
• Rapid Onset with Certain Formulations: The potassium salt formulation offers a relatively quick onset of action, making it suitable for managing acute pain episodes.

Common use

Voveran is indicated for the treatment of pain and inflammation associated with a wide range of musculoskeletal and rheumatic conditions. Its primary uses include the symptomatic treatment of osteoarthritis and rheumatoid arthritis, where it helps manage chronic pain and stiffness. It is also highly effective in treating acute painful conditions such as ankylosing spondylitis, acute gout attacks, and post-operative pain. Furthermore, Voveran is commonly prescribed for acute musculoskeletal disorders like sprains, strains, and tendinitis (e.g., frozen shoulder, tennis elbow). The topical formulation is specifically used for the relief of pain in osteoarthritis of superficial joints, such as the knees and hands.

Dosage and direction

Dosage is strictly individualized based on the indication, formulation, and patient response. The smallest effective dose for the shortest possible duration should be used.

• Oral Tablets (Adults): For rheumatoid arthritis and osteoarthritis, the typical dosage is 100-150 mg per day, administered in 2 or 3 divided doses (e.g., 50 mg two or three times daily). Sustained-release tablets are usually given as a single 100 mg daily dose.
• Diclofenac Potassium (for pain): 50 mg three times daily is common for acute conditions. The maximum recommended daily dose for all oral forms is 150 mg.
• Topical Gel (1%): For osteoarthritis of joints amenable to topical treatment, apply 4 grams of gel to the affected area four times daily. The total dose should not exceed 32 grams per day for all affected joints.
• Administration: Enteric-coated tablets must be swallowed whole with a full glass of water, preferably with food or milk to minimize gastric upset. They should not be crushed, chewed, or broken. The gel should be applied to clean, intact skin and not with occlusive dressings.
• Elderly & Hepatic Impairment: A dose reduction is recommended. Initiate therapy at the lowest possible dose with close monitoring.

Precautions

• Cardiovascular Risk: NSAIDs, including Voveran, may increase the risk of serious and sometimes fatal cardiovascular thrombotic events, myocardial infarction, and stroke. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.
• Gastrointestinal Risk: NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk.
• Renal Function: Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury. Use with caution in patients with impaired renal function, heart failure, liver dysfunction, those taking diuretics or ACE inhibitors, and the elderly.
• Hepatic Function: Borderline elevations of liver tests may occur in up to 15% of patients. Meaningful elevations (e.g., 3 times the upper limit of normal) have been reported. Discontinue therapy if liver disease develops or if systemic manifestations occur.
• Pregnancy: Avoid use in late pregnancy (starting at 30 weeks gestation) as it may cause premature closure of the fetal ductus arteriosus.
• Monitoring: Baseline and periodic evaluation of hemoglobin, renal function (serum creatinine), and hepatic function (liver enzymes) is advised for patients on long-term therapy.

Contraindications

Voveran is contraindicated in patients with a known hypersensitivity (e.g., anaphylactic reactions, serious skin reactions) to diclofenac or any component of the drug product. It should not be used in patients who have experienced asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe anaphylactic reactions to NSAIDs are more common in such patients. Use is also contraindicated in the setting of coronary artery bypass graft (CABG) surgery. Furthermore, it is contraindicated in patients with active peptic ulcer disease or a history of recurrent ulcer/bleeding.

Possible side effect

Like all NSAIDs, Voveran can cause a range of adverse effects. Common side effects (affecting >1% of users) include gastrointestinal issues such as nausea, vomiting, dyspepsia, diarrhea, abdominal pain, and flatulence. Other frequently reported effects are headache, dizziness, and rash. Serious side effects requiring immediate medical attention are less common but include:

• GI: GI bleeding, perforation, and ulceration, sometimes fatal.
• Cardiovascular: Hypertension, heart failure, myocardial infarction, stroke.
• Hepatic: Severe hepatitis, jaundice, liver failure.
• Renal: Renal impairment, nephrotic syndrome, acute renal failure.
• Hematologic: Anemia, prolonged bleeding time, thrombocytopenia.
• Dermatologic: Serious skin reactions including exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN).
• Allergic: Anaphylactic and anaphylactoid reactions.

Drug interaction

Voveran has a significant potential for pharmacokinetic and pharmacodynamic interactions.

• Anticoagulants (e.g., Warfarin): NSAIDs may enhance the anticoagulant effect, increasing the risk of serious GI bleeding. Concurrent use is generally avoided.
• Other NSAIDs and Aspirin: Concomitant use increases the risk of GI toxicity (bleeding, ulceration) with little to no increase in efficacy.
• ACE Inhibitors, ARBs, and Diuretics: NSAIDs may diminish the antihypertensive effect of these drugs and promote sodium retention, increasing the risk of renal impairment, especially in dehydrated patients.
• Lithium: Voveran can decrease renal lithium clearance, leading to increased plasma lithium levels and potential lithium toxicity.
• Methotrexate: NSAIDs can reduce the renal clearance of methotrexate, potentially increasing its toxicity.
• Cyclosporine: Concurrent use may increase the nephrotoxic effect of cyclosporine.
• SSRIs and SNRIs: Concomitant use may increase the risk of gastrointestinal bleeding.

Missed dose

If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Patients should not take a double dose to make up for a missed one, as this increases the risk of adverse effects. Maintaining a consistent dosing schedule is important for stable pain control.

Overdose

Symptoms of overdose are typically extensions of the drug’s pharmacological adverse effects. These may include headache, nausea, vomiting, epigastric pain, gastrointestinal bleeding, drowsiness, dizziness, tinnitus, and lethargy. More severe overdose can lead to hypertension, acute renal failure, respiratory depression, coma, and convulsions. There is no specific antidote. Management is supportive and symptomatic, including gastric lavage and administration of activated charcoal within one hour of ingestion. Forced diuresis, hemodialysis, or hemoperfusion are unlikely to be beneficial due to the drug’s high protein binding.

Storage

Store Voveran tablets and capsules at room temperature (15-30°C or 59-86°F), in a tightly closed container, and protect from moisture and light. Keep the topical gel at room temperature and ensure the tube is tightly closed. All medications must be kept out of reach of children and pets. Do not use any formulation after the expiration date printed on the packaging.

Disclaimer

This information is for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is based on the typical properties of the drug and may not cover all possible uses, directions, precautions, or adverse effects.

Reviews

• Clinical Efficacy (4.5/5): “Voveran remains a first-line choice for many clinicians managing inflammatory arthritis. Its potency is well-documented in numerous clinical trials, showing significant improvement in pain and stiffness scores compared to placebo. The availability of multiple formulations adds to its versatility in clinical practice.”
• Tolerability Profile (3/5): “While highly effective, its use is tempered by a well-known side effect profile, particularly concerning the GI and cardiovascular systems. It is crucial to prescribe it for the appropriate patient population and for the shortest duration necessary. Topical formulations offer a favorable risk-benefit ratio for localized pain.”
• Patient Reported Outcomes (4/5): “Many patients with chronic arthritic conditions report substantial improvement in daily function and quality of life with Voveran. The rapid-acting potassium salt is particularly valued for acute flare-ups. However, GI discomfort is a common reason for discontinuation in a subset of patients.”