Active substance: serratiopeptidase; diclofenac sodium. 1 tablet contains serratiopeptidase 10 mg, diclofenac sodium 50 mg. Excipients: Maize Starch, Light Magnesium Carbonate, Lactose Monohydrate, Sodium Starch Glycolate, MCC PH 102, Cross Carmellose Sodium, PVP K-30.
Lithium, digoxin. The drug may increase plasma concentrations of lithium and digoxin. Monitoring of plasma concentrations of lithium and digoxin is recommended. Diuretic and antihypertensive agents. When used concomitantly with diuretics of antihypertensive agents, such as beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, the drug, like other NSAIDs, may decrease their hypotensive effect. Therefore, combination of such drugs should be administered with caution, and blood pressure should be monitored in patients (especially in elderly patients). The patients should consume sufficient amount of water, and after the start and termination of concomitant treatment, renal function should be periodically monitored, in particular when using diuretics and ACE inhibitors due to the increased risk of nephrotoxicity. Concomitant use of potassium-sparing diuretics may increase serum potassium level; therefore, patients concomitantly using such drugs should control serum potassium level. Other NSAIDs and corticosteroids. Concomitant use of the drug with other HSAIDs of corticosteroids may increase the frequency of gastrointestinal adverse effects. It is recommended to avoid concomitant use of the drug with other NSAIDs, including COX-2 selective inhibitors, due to the lack of any evidence of possible benefit from the synergistic action. Anticoagulants and antiplatelet agents. Regular concomitant use of the drug with anticoagulants, especially with warfarin and other coumarins and antiplatelet agents, may increase the risk of bleedings. Therefore, in case of such combination of drugs, thorough and regular medical supervision is recommended. Selective serotonin reuptake inhibitors (SSRIs). Concomitant use of NSAIDs and SSRIs may increase the risk of gastrointestinal bleeding. Antidiabetic agents. Concomitant use of the drug and antidiabetic agents does not alter efficacy of the latter. However, there are isolated reports about hypoglycemia, as well as hyperglycemia, which necessitated dosage adjustment of hypoglycemic agents. Therefore, during Fanigan therapy blood glucose level should be monitored. Methotrexate. Caution should be exercised when using NSAIDs less than 24 hours before or after using methotrexate, as in such cases methotrexate concentration in blood, and its toxic effect may increase. Drugs stimulating the enzymes which metabolize medicinal products. The drugs stimulating the enzymes, such as rifampicin, carbamazepine, phenytoin, St. John's wort (Hypericum perforatum) etc. theoretically are able to decrease plasma concentrations of diclofenac. Colestipol and cholestyramine. Concomitant use of Fanigan and Colestipol or cholestyramine reduces absorption of diclofenac approximately by 30% and 60%, respectively. Cyclosporine. The effect of NSAIDs on prostaglandins synthesis in the kidneys may increase nephrotoxicity of cyclosporine; therefore, the drug dosage should be reduced when prescribing cyclosporine. Antibacterial agents - quinolone derivatives. There are isolated reports about convulsions in patients receiving concomitantly quinolone derivatives and NSAIDs.
Administration during pregnancy or breast-feeding.
Tell your doctor immediately if you become pregnant while taking this medication.
For safety of any drug during pregnancy or breastfeeding – please consult your doctor.
Conditions of supply.