Voltaren (Diclofenac 75mg/3ml) Ampoules

Voltaren Injection general information

What are Voltaren Ampoules used for?

Voltaren Ampoules 75mg/3ml are used to treat renal colic (kidney stones) and biliary colic (gall stones), to help reduce the severe pain caused by these conditions.  Colic is a term given to acute pain that comes and goes in waves; it can come on rapidly and then eases over a period of time and goes.  Colic is caused by waves of muscular contraction of the smooth muscle found in hollow organs of the body such as the intestines, gall bladder and urinary tract including the kidneys and ureter (tube carrying urine from the kidneys to the bladder). 

Renal colic is caused by kidney stones, which form when a component of urine comes out of solution, such as calcium salts (oxalate or phosphate) if there is too much calcium in the blood.  Uric acid kidney stones form if the urine becomes too concentrated due to insufficient fluid intake or excess loss of fluid, or due to high protein diet.  Symptoms include severe pain radiating down from the lower back area, nausea and vomiting, urinary infections, and blood in the urine.

Biliary colic is caused by gall stones, which are crystals or stone like deposits, that form in the gallbladder from bile, a digestive fluid that is made in the liver and stored in the gallbladder.  Bile is important for digestion particularly of fats and fat-soluble enzymes.  Gall stones can form for several reasons, including too much cholesterol in the diet, excess bilirubin, a breakdown product of red blood cells that is disposed of in bile, failure of the gallbladder to empty when full causing concentration of bile.  Symptoms include indigestion, jaundice (yellowing of the skin and whites of the eyes due to build-up of bilirubin), nausea and vomiting, and abdominal pain.

Voltaren Ampoules 75mg are also used to reduce pain due to severe migraine attack when other forms of Voltaren are not suitable, for example when swallowing is difficult due to nausea.  Voltaren Ampoules can help relieve symptoms of migraine attack including headache, nausea and sensitivity to light, but cannot be used to prevent migraine attack.

Voltaren Ampoules 75mg are also used for acute pain caused by inflammatory and degenerative rheumatic diseases such as exacerbations of osteoarthritis and rheumatoid arthritis, and acute back pain.  Also, for inflammation caused by trauma and following surgery to reduce pain, swelling and oedema (fluid collection) around the wound.  

How do Voltaren Ampoules work?

Voltaren Ampoules 75mg/3ml contain diclofenac in solution, a nonsteroidal anti-inflammatory drug (NSAID) that has antirheumatic, anti-inflammatory, analgesic and antipyretic (fever reducing) properties.  Diclofenac in Voltaren Ampoules works by inhibiting the action of the enzyme cyclooxygenase (COX), which is an essential enzyme in the pathway for prostaglandins (PG) synthesis.  Cyclooxygenase 2 (COX-2) is induced during the inflammation process and is responsible for the synthesis of inflammatory prostaglandins like PGE2, which causes pain, swelling and other symptoms of inflammation.  Cyclooxygenase 1 (COX-1) is needed for normal cellular processes, particularly protection of the gut by regulation of acid content.  If COX-1 is inhibited this can result in the gastrointestinal side effects caused by some non-specific NSAIDs.  Diclofenac in Voltaren Ampoules inhibits COX-2 with greater potency that COX-1 which reduces gastrointestinal side effects, while being effective in blocking the production of inflammatory prostaglandins to relieve the symptoms of inflammation, including pain, swelling.  Diclofenac in Voltaren Ampoules 75mg/3ml is rapidly absorbed into the circulation by injection and is effective within 20 minutes of the injection to reduce moderate to severe pain.  The bioavailability of diclofenac following injection is greater that other routes including oral and suppositories, as this avoids first pass metabolism in the liver, which can reduce the amount of active diclofenac available to reduce pain and inflammation.  at the required site of action.  

What do Voltaren Ampoules contain?

Voltaren Ampoules 75mg/3ml contain the active ingredient diclofenac sodium in solution, a NSAID used to treat acute pain and inflammation.  it also contains mannitol, sodium metabisulphite, (E223), benzyl alcohol, propylene glycol, water for Ampoules, sodium hydroxide, nitrogen pure.

Treating renal or biliary colic with Voltaren Ampoules

Voltaren Ampoules 75mg/3ml contain diclofenac solution for injection, a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat severe acute pain caused by renal colic (kidney stones) and biliary colic (gall stones).  Colic is acute pain that comes and goes in waves; it can come on rapidly and then ease over a period of time and goes.  It is caused by waves of muscular contraction of the smooth muscle found in hollow organs of the body such as the intestines, gall bladder and urinary tract including the kidneys and ureter (tube carrying urine from the kidneys to the bladder).  Renal colic is caused by kidney stones, which form when a component of urine comes out of solution, such as calcium salts like oxalate or phosphate, if there is too much calcium in the blood.  Uric acid kidney stones form if the urine becomes too concentrated due to insufficient fluid intake or excess loss of fluid, or due to high protein diet.  Symptoms include severe pain radiating down from the lower back area, nausea and vomiting, urinary infections, blood in the urine. Biliary colic is caused by gall stones, which are crystal or stone like deposits that form in the gallbladder from bile, a digestive fluid that is made in the liver and stored in the gallbladder.  Bile is important for digestion particularly of fats and fat-soluble enzymes.  Gall stones can form for several reasons, including too much cholesterol in the diet, excess bilirubin, a breakdown product of red blood cells that is disposed of in bile, failure of the gallbladder to empty when full, causing concentration of bile.  Symptoms include indigestion, jaundice (yellowing of the skin and whites of the eyes due to build-up of bilirubin), nausea and vomiting, abdominal pain.  Diclofenac in Voltaren Ampoules works by inhibiting the action of the enzyme cyclooxygenase (COX), which is an essential enzyme in the pathway for prostaglandins (PG) synthesis.  Cyclooxygenase 2 (COX-2) is induced during the inflammation process and is responsible for the synthesis of inflammatory prostaglandins like PGE2, which causes pain, swelling and other symptoms of inflammation.  Cyclooxygenase 1 (COX-1) is needed for normal cellular processes, particularly protection of the gut by regulation of acid content.  Diclofenac in Voltaren Ampoules inhibits COX-2 with greater potency that COX-1 causing less gastrointestinal side effects, while being effective in blocking the production of inflammatory prostaglandins to relieve the symptoms of inflammation, including pain, swelling.  Diclofenac in Voltaren Ampoules is rapidly absorbed into the circulation and is effective within 20 minutes of the injection to reduce moderate to severe pain. 

What are the side effects of Voltaren Ampoules?

The most commonly reported side effects when taking Voltaren Ampoules 75mg/3ml include headache, dizziness, vertigo, nausea, vomiting, diarrhoea, dyspepsia, abdominal pain, flatulence, decreased appetite, rash and irritation at the site of application. 

When should Voltaren Ampoules not be used?

You should not use Voltaren Ampoules 75mg/3ml if you:

• are allergic to diclofenac or any ingredients in Voltaren Ampoules
• are pregnant or are breastfeeding
• have kidney or liver disease
• have had a heart attack within the last 6-12 months
• have cardiovascular disease or severe heart failure
• have uncontrolled hypertension (high blood pressure)
• have asthma or aspirin-induced asthma or rhinitis (runny itchy nose)
• have active or a history of gastrointestinal bleeding or perforation due to an ulcer
• have a tendency to bleed easily
• are taking medicines that interact with Voltaren Ampoules including aspirin or other NSAIDs, anticoagulants like warfarin, corticosteroids and anti-platelet agents, digoxin for heart failure, lithium for mood disorders, ACE-inhibitors, diuretics like frusemide, beta blockers for high blood pressure, the anti-cancer drug methotrexate, the immunosuppressant cyclosporine, SSRI antidepressants, the antibacterial trimethoprim

What medications interact with Voltaren Ampoules?

Several medications interact with Voltaren Ampoules 75mg/3ml and should either not be taken while you are taking Voltaren Ampoules or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Voltaren Ampoules: aspirin or other NSAIDs, anticoagulants like warfarin, corticosteroids and anti-platelet agents, SSRI antidepressants, the antibacterial trimethoprim (raise potassium levels)
• Drugs that are affected by Voltaren Ampoules: digoxin for heart failure, lithium for mood disorders, ACE-inhibitors, diuretics like frusemide, beta blockers for high blood pressure, the anti-cancer drug methotrexate, the immunosuppressant cyclosporine

How should Voltaren Ampoules be given?

The contents of an ampoule of Voltaren Ampoules 75mg/3ml should be given by intramuscular injection and injected into the gluteal muscle of the buttocks.  The dose you take and how often should be as recommended by your doctor, which is usually one ampoule per day for no more than two days.  In cases of extreme pain this can be increased to two ampoules per day, separated by several hours, one Ampoule per buttock.  Voltaren Ampoules may also be combined with other forms of Voltaren, such as tablets or suppository, depending on your doctor’s recommendation.  If you are being treated for post-operative pain, Voltaren Ampoules may be administered intravenously.

How should Voltaren Ampoules be stored?

You should store your Voltaren Ampoules 75mg below 25°C in a cool dry place and protect from light.