Voltarile 25 Uses

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What is Voltarile 25?

Voltarile 25 is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and other symptoms of arthritis of the joints (eg, osteoarthritis), such as inflammation, swelling, stiffness, and joint pain. However, Voltarile 25 does not cure osteoarthritis and will help you only as long as you continue to use it.

Voltarile 25 topical 3% gel is also used to treat actinic keratosis, a skin problem that may become cancerous if not treated. The exact way that topical Voltarile 25 helps this condition is unknown.

Voltarile 25 topical solution is used to treat pain and swelling caused by osteoarthritis of the knees.

Voltarile 25 topical patch is used to treat acute pain caused by minor strains, sprains, and contusions (bruises).

Voltarile 25 is available only with your doctor's prescription.

Voltarile 25 indications

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Carefully consider the potential benefits and risks of Voltarile 25 delayed-release tablets and other treatment options before deciding to use Voltarile 25 delayed-release tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Voltarile 25 delayed-release tablets are indicated:

For relief of the signs and symptoms of osteoarthritis
For relief of the signs and symptoms of rheumatoid arthritis
For acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis

How should I use Voltarile 25?

Use Voltarile 25 as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Voltarile 25.

Uses of Voltarile 25 in details

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Use: Labeled Indications

Ankylosing spondylitis (delayed-release tablets only): Acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis.

Dysmenorrhea (immediate-release tablets only): Treatment of primary dysmenorrhea.

Migraine (powder for oral solution only): Acute treatment of migraine attacks with or without aura in adults.

Osteoarthritis (immediate-release, extended-release, and delayed-release tablets; capsules [Zorvolex]; and suppositories [Canadian product] only): Relief of signs and symptoms of osteoarthritis.

Pain

Capsules/immediate-release tablets only: Relief of mild to moderate acute pain.

Injection only: Management of mild to moderate pain and moderate to severe pain (alone or in combination with opioid analgesics) in adults.

Rheumatoid arthritis (immediate-release, extended-release, and delayed-release tablets; and suppositories [Canadian product] only): Relief of signs and symptoms of rheumatoid arthritis.

Off Label Uses

Gout, treatment (acute flares)

Data from a limited number of trials support the efficacy of Voltarile 25 in the treatment of acute gout flares.

Based on the 2012 American College of Rheumatology guidelines for management of gout, nonsteroidal anti-inflammatory drugs are effective and recommended agents in the treatment of acute gout flares.

Voltarile 25 description

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A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.

Voltarile 25 dosage

Carefully consider the potential benefits and risks of Voltarile 25 extended-release tablets, and other treatment options before deciding to use Voltarile 25 extended-release tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

After observing the response to initial therapy with Voltarile 25 extended-release tablets the dose and frequency should be adjusted to suit an individual patient’s needs.

For the relief of osteoarthritis, the recommended dosage is 100 mg daily.

For the relief of rheumatoid arthritis, the recommended dosage is 100 mg daily. In the rare patient where Voltarile 25 extended-release tablets 100 mg/day is unsatisfactory, the dose may be increased to 100 mg twice a day if the benefits outweigh the clinical risks of increased side effects.

Different formulations of Voltarile 25 (Voltarile 25 enteric-coated tablets; Voltarile 25 extended-release tablets; Voltarile 25 potassium immediate-release tablets) are not necessarily bioequivalent even if the milligram strength is the same.

Voltarile 25 interactions

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What other drugs will affect Voltarile 25?

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Aspirin: Concomitant administration of Voltarile 25 and aspirin is not recommended because Voltarile 25 is displaced from its binding sites during the concomitant administration of aspirin, resulting in lower plasma concentrations, peak plasma levels, and AUC values.

Anticoagulants: While studies have not shown Voltarile 25 to interact with anticoagulants of the warfarin type, caution should be exercised, nonetheless, since interactions have been seen with other NSAIDs. Because prostaglandins play an important role in hemostasis, and NSAIDs affect platelet function as well, concurrent therapy with all NSAIDs, including Voltarile 25, and warfarin requires close monitoring of patients to be certain that no change in their anticoagulant dosage is required.

Digoxin, Methotrexate, Cyclosporine: Voltarile 25, like other NSAIDs, may affect renal prostaglandins and increase the toxicity of certain drugs. Ingestion of Voltarile 25 may increase serum concentrations of digoxin and methotrexate and increase cyclosporineís nephrotoxicity. Patients who begin taking Voltarile 25 or who increase their Voltarile 25 dose or any other NSAID while taking digoxin, methotrexate, or cyclosporine may develop toxicity characteristics for these drugs. They should be observed closely, particularly if renal function is impaired. In the case of digoxin, serum levels should be monitored.

Lithium: Voltarile 25 decreases lithium renal clearance and increases lithium plasma levels. In patients taking Voltarile 25 and lithium concomitantly, lithium toxicity may develop.

Oral Hypoglycemics:

Voltarile 25 does not alter glucose metabolism in normal subjects nor does it alter the effects of oral hypoglycemic agents. There are rare reports, however, from marketing experiences, of changes in effects of insulin or oral hypoglycemic agents in the presence of Voltarile 25 that necessitated changes in the doses of such agents. Both hypo- and hyperglycemic effects have been reported. A direct causal relationship has not been established, but physicians should consider the possibility that Voltarile 25 may alter a diabetic patientís response to insulin or oral hypoglycemic agents.

Diuretics: Voltarile 25 and other NSAIDs can inhibit the activity of diuretics. Concomitant treatment with potassium-sparing diuretics may be associated with increased serum potassium levels.

Other Drugs: In small groups of patients (7-10/interaction study), the concomitant administration of azathioprine, gold, chloroquine, D-penicillamine, prednisolone, doxycycline, or digitoxin did not significantly affect the peak levels and AUC values of Voltarile 25. Phenobarbital toxicity has been reported to have occurred in a patient on chronic phenobarbital treatment following the initiation of Voltarile 25 therapy.

Protein Binding

In vitro, Voltarile 25 interferes minimally or not at all with the protein binding of salicylic acid (20% decrease in binding), tolbutamide, prednisolone (10% decrease in binding), or warfarin. Benzylpenicillin, ampicillin, oxacillin, chlortetracycline, doxycycline, cephalothin, erythromycin, and sulfamethoxazole have no influence in vitro on the protein binding of Voltarile 25 in human serum.

Drug/Laboratory Test Interactions

Effect on Blood Coagulation: Voltarile 25 increases platelet aggregation time but does not affect bleeding time, plasma thrombin clotting time, plasma fibrinogen, or factors V and VII to XII. Statistically significant changes in prothrombin and partial thromboplastin times have been reported in normal volunteers. The mean changes were observed to be less than 1 second in both instances, however, and are unlikely to be clinically important. Voltarile 25 is a prostaglandin synthetase inhibitor, however, and all drugs that inhibit prostaglandin synthesis interfere with platelet function to some degree; therefore, patients who may be adversely affected by such an action should be carefully observed.

Voltarile 25 side effects

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What are the possible side effects of Voltarile 25?

Ocular

Transient burning and stinging were reported in approximately 15% of patients across studies with the use of Voltarile 25 ophthalmic solution, 0.1%. In cataract surgery studies, keratitis was reported in up to 28% of patients using Voltarile 25 ophthalmic solution, 0.1%, although in many of these cases keratitis was initially noted prior to the initiation of treatment. Elevated intraocular pressure following cataract surgery was reported in approximately 15% of patients undergoing cataract surgery. Lacrimation complaints were reported in approximately 30% of case studies undergoing incisional refractive surgery. The following adverse reactions were reported in approximately 10% or less of the patients: abnormal vision, acute elevated IOP, blurred vision, conjunctivitis, corneal deposits, corneal edema, corneal opacity, corneal lesions, discharge, eyelid swelling, eye pain, injection (redness), iritis, irritation, itching, lacrimation disorder, and ocular allergy.

Systemic

The following adverse reactions were reported in 3% or less of the patients: abdominal pain, asthenia, chills, dizziness, facial edema, fever, headache, insomnia, nausea, pain, rhinitis, viral infection and vomiting.

Clinical Practice

The following reactions have been identified during postmarketing use of topical Voltarile 25 ophthalmic solution, 0.1% in clinical practice. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. The reactions, which have been chosen for inclusion due to either their seriousness, frequency of reporting, possible causal connection to topical Voltarile 25 ophthalmic solution, 0.1%, or a combination of these factors, include corneal erosion, corneal infiltrates, corneal perforation, corneal thinning, corneal ulceration and epithelilal breakdown.

TO REPORT SUSPECTED ADVERSE REACTIONS, contact Altaire Pharmaceuticals, Inc., at 1-800-258-2471 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Voltarile 25 contraindications

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What is the most important information I should know about Voltarile 25?

Voltarile 25 in all formulations, Cataflam, Voltaren, and Voltaren-XR, is contraindicated in patients with known hypersensitivity to Voltarile 25 and Voltarile 25-containing products. Voltarile 25 should not be given to patients who have experienced asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to Voltarile 25 have been reported in such patients.

Active ingredient matches for Voltarile 25:

Diclofenac sodium


List of Voltarile 25 substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Voparan 75 mg Injection (Swiss Pharma Pvt. Ltd.)$ 0.04
Vosun Gel 30 gm Ointment (Sungrace Pharma Pvt. Ltd.)$ 0.51
Vovenec 50 mg Tablet (Psyco Remedies.)$ 0.01
VOVERAN - D Capsule/ Tablet / 50mg / 10 units (Novartis)$ 0.33
VOVERAN TPM topical gel 1 % w/w x 30g (Novartis Pharma)$ 1.16
Vovin 50 mg Tablet (Mediwin Pharmaceuticals)$ 0.01
Vovin F 50+20 Tablet (Mediwin Pharmaceuticals)$ 0.02
Wisnac R 100+20 Capsule (Wisdom Pharma Pvt. Ltd)$ 0.05
Wisnac S 50+10 Tablet (Wisdom Pharma Pvt. Ltd)$ 0.05
X-DICO-AQ inj 75 mg x 1ml (DML)
XODAC INJ inj 75 mg x 3ml (ABL Lifecare)
Xyron 75 mg Injection (Oboi Laboratories (Ciron Drugs & Pharmaceuticals Pvt Ltd))$ 0.02
Zacnase 50+10 Tablet (Instant Remedies Private Limited)$ 0.06
Ziodic 75 mg Injection (Biocin Genetics & Pharma)$ 0.02
Ziodic 50+325 Tablet (Biocin Genetics & Pharma)$ 0.01
ZIODIC topical gel 30g (Biocin Genetics & Pharma)$ 0.66
ZOBID - D Dispersible Tablet / 25mg / 10 units (Nicholas Piramal (Sarabhai Piramal))$ 0.05
ZOBID - D Dispersible Tablet / 50mg / 10 units (Nicholas Piramal (Sarabhai Piramal))$ 0.24
Zobid SR 100 mg Tablet (Abbott Healthcare Pvt Ltd (AHPL))$ 0.05
Zonex P 50+500 Tablet (Divine Life Care Pvt Ltd)$ 0.02
ZONEX P 50MG/500MG TABLET 1 strip / 10 tablets each (Divine Life Care Pvt Ltd)$ 0.17
Zonex P 50 mg/500 mg Tablet (Divine Life Care Pvt Ltd)$ 0.02
Zontis 30 gm Gel (Octavius Pharma)$ 0.71

References

  1. DailyMed. "DICLOFENAC EPOLAMINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "diclofenac". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "diclofenac". http://www.drugbank.ca/drugs/DB00586 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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