Dolo-Neurobion comprises 50mg Diclofenac, 50mg Pyridoxine (vitamin B6), 50mg Thiamin (vitamin B1), and 1mg vitamin B12. The B vitamins in the medication serve as coenzymes, facilitating the production of essential substances for metabolism.

They contribute to the metabolism of central and peripheral nerve cells, upholding the structure and function of the nervous system. Simultaneously, the B group vitamins exhibit a synergistic effect when combined with the analgesic properties of Diclofenac in managing mixed pain.

Vitamins B1, B6, and B12 play pivotal roles in nervous system metabolism. This B vitamin combination fosters the regeneration of impaired nerve fibers, thereby promoting improved rehabilitation and neuromuscular distribution.

The amalgamation of B vitamins and Diclofenac has been employed since 1962 to treat pain involving both nociceptive and neuropathic components. Research indicates a noteworthy synergistic effect between these B vitamins and the pain-relieving properties of Diclofenac.

Contraindications to Dolo Neurobion use encompass hypersensitivity to its active ingredients and excipients, a history of bronchospasm, rhinitis, asthma, or urticaria following non-steroidal anti-inflammatory drug treatment.

It is not recommended for individuals with acute peptic ulcer, gastrointestinal bleeding, acute cerebral hemorrhage, major bleeding, severe renal impairment, severe hepatic impairment, confirmed congestive heart failure (grade II - IV), peripheral artery disease, severe ischemic heart disease, severe cerebrovascular disease, pregnant women, and children under 12 years old due to the elevated Diclofenac content.

How to use and dose Dolo Neurobion

Administration

Orally. Dolo Neurobion tablets should be ingested whole without chewing, accompanied by a glass of water, preferably after meals.

Dosage

  • Adults: Take 1 tablet per administration, three times a day. The maximum recommended daily dose is 3 tablets.
  • Elderly: No dosage adjustment is necessary.
  • Overweight individuals: No dosage adjustment is required.
  • Patients with mild to moderate renal or hepatic impairment: No dosage adjustment is necessary.
  • Children under 12 years: Not recommended.

The treatment duration for acute mixed pain ranges from 3 to 10 days. It is advisable to administer the medication for the shortest duration possible. Patients with persistent or chronic mixed pain may undergo extended treatment, contingent on the physician's discretion.

Overdose

No cases of overdose with thiamin or vitamin B12 have been reported. Prolonged use of high pyridoxine doses may result in sensory neuropathy and related syndromes, with gradual improvement upon discontinuation and the possibility of full recovery.

In instances of acute Diclofenac poisoning in patients taking Dolo Neurobion, symptomatic and supportive treatment is warranted. Gastric lavage and activated charcoal are recommended measures. Supportive interventions are essential to mitigate the risk of renal failure, hypotension, convulsions, respiratory depression, and gastrointestinal irritation. Additionally, active patient monitoring is crucial for timely intervention.

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Missed Dose

If a dose of Dolo Neurobion is forgotten, the patient should take it as soon as possible. If the next scheduled dose is approaching, the missed dose should be skipped, and the regular dosing schedule resumed.

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Pros and Cons of dolo neurobion

Pros of Dolo Neurobion

  • Analgesic Effect
  • Nervous System Support
  • Regeneration of Nerve Fibers
  • Long-standing Use

Cons of Dolo Neurobion

  • Potential Side Effects
  • Drug Interactions
  • Caution in Special Populations

Differences Between dolo neurobion and vienva

Dolo Neurobion

Dolo Neurobion is commonly used for the treatment of mixed pain, which includes both nociceptive (inflammatory) and neuropathic (nerve-related) components. It is often prescribed for conditions like joint pain, rheumatism, neuritis, neuralgia, and postoperative pain.

Vienva

Vienva is primarily used for the prevention of pregnancy. It works by inhibiting ovulation, altering cervical mucus to impede sperm penetration, and affecting the endometrium to prevent implantation.

Alternative to dolo neurobion

Physical Therapy

For certain types of pain, especially musculoskeletal or neuropathic pain, physical therapy may be recommended as an alternative or complementary treatment.

Dolo Neurobion side effects

While using Dolo Neurobion, patients may encounter various side effects, categorized by their frequency of occurrence:

Uncommon

  • Gingivitis
  • Stomatitis
  • Exacerbation of ulcerative colitis or Crohn's disease
  • Glossitis
  • Esophageal damage
  • Constipation

Rare

  • Hypersensitivity reactions (edema, anaphylaxis, hypotension)
  • Insomnia
  • Disorientation
  • Psychomotor excitability
  • Visual disturbances
  • Memory disturbances
  • Sensitivity disturbances
  • Paresthesia
  • Tinnitus
  • Peptic ulcer
  • Gastrointestinal bleeding
  • Gastrointestinal perforation
  • Taste disturbance
  • Hematuria
  • Acute renal failure
  • Proteinuria

Very rare

  • Leukopenia
  • Thrombocytopenia
  • Agranulocytosis
  • Aplastic anemia
  • Hemolytic anemia
  • Vesicular rash
  • Eczema
  • Stevens-Johnson syndrome
  • Erythema multiforme
  • Exfoliative dermatitis scabs
  • Toxic epidermal necrolysis
  • Alopecia
  • Purpura
  • Photosensitivity reactions

Frequency not known

  • Hypersensitivity reactions (tachycardia, sweating, itchy skin, urticaria)
  • Confusion
  • Dizziness
  • Headache
  • Fatigue
  • Fluid retention
  • Hypertension
  • Edema
  • Stroke
  • Myocardial infarction (especially in individuals taking high doses of Diclofenac exceeding 100mg/day for an extended period)
  • Abdominal pain
  • Nausea
  • Vomiting
  • Dyspepsia
  • Flatulence
  • Diarrhea
  • Anorexia
  • Ischemic colitis localized
  • Hepatocellular damage
  • Increased levels of liver enzymes (ALT, AST)
  • Hepatitis
  • Chromaturia (reddish urine, appearing within the first 8 hours after taking the drug, usually resolving within 48 hours)

Should patients experience any side effects while using Dolo Neurobion, it is advised to discontinue the medication immediately and seek prompt medical attention by notifying their doctor or visiting the nearest hospital for timely diagnosis and treatment.

Be careful when using Dolo Neurobion

Patients need to be mindful of several important considerations before and while taking Dolo Neurobion:

  1. Gastrointestinal Risks: Diclofenac, a component of Dolo Neurobion, may lead to ulcers, bleeding, and stomach-intestinal perforation without warning signs during treatment. The risk is higher in the elderly, those taking higher doses, or for extended periods. Caution is advised, especially when using Dolo Neurobion alongside drugs that increase ulceration or bleeding risk, such as corticosteroids and anticoagulants.
  2. Cardiovascular Caution: Diclofenac in Dolo Neurobion can cause fluid retention or edema in individuals with cardiovascular disease. There's an increased risk of arterial thrombosis (myocardial infarction, stroke), especially with doses exceeding 100 mg/day and prolonged use. Monitoring is recommended in patients with cardiovascular risk factors, and Dolo Neurobion should be used after careful consideration.
  3. Nephrotoxicity Risk: Dehydrated patients using Dolo Neurobion with the diclofenac component are at an increased risk of nephrotoxicity. Therefore, dehydration should be avoided, and special caution is recommended in patients with mild or moderate renal impairment.
  4. Hepatic Impairment: Dolo Neurobion should be used cautiously in patients with mild or moderate hepatic impairment.
  5. Skin Reactions: Serious skin reactions may occur, especially at the initiation of Dolo Neurobion treatment. Therefore, Diclofenac should only be used in patients with acute intermittent porphyria or systemic lupus erythematosus after careful consideration of the benefits and risks.
  6. Pyridoxine Long-Term Use: Prolonged use of pyridoxine (6-12 months) in moderate doses may increase the risk of neuropathy. Regular health monitoring is advised during long-term use.
  7. Lactose Content: Dolo Neurobion contains lactose and is not recommended for use in patients with galactose intolerance, glucose-galactose malabsorption, or lactase deficiency.
  8. Side Effects and Activities: Side effects such as dizziness, fatigue, and visual disturbances may occur after taking Dolo Neurobion. Therefore, patients experiencing these effects should avoid driving or operating machinery.
  9. Impact on Fertility: Diclofenac use can impair fertility in women. It is not recommended for women attempting pregnancy, facing difficulties conceiving, or undergoing infertility tests.
  10. Pregnancy and Nursing: Dolo Neurobion should not be used in pregnant women, as it can cause harm to the embryo. In nursing women, usage is only recommended if necessary, reviewed, and approved by a doctor.

Dolo Neurobion drug interactions

Dolo Neurobion has various drug interactions that patients should be aware of:

  1. L-dopa Interaction: Concurrent use with pyridoxine may reduce the effectiveness of L-dopa.
  2. Pyridoxine Antagonists: Pyridoxine antagonists such as cycloserin, penicillamine, isoniazid, and hydralazine may diminish the effectiveness of pyridoxine.
  3. Loop Diuretics Interaction: Long-term use of loop diuretics (e.g., furosemide) can increase the elimination rate, leading to reduced thiamine levels.
  4. Increased Risk of Ulcers and Gastrointestinal Bleeding: Concomitant use of Dolo Neurobion with glucocorticoids, other non-steroidal anti-inflammatory drugs, serotonin reuptake inhibitors, or platelet aggregation inhibitors may heighten the risk of ulcers and gastrointestinal bleeding.
  5. Platelet Aggregation Inhibitors and Anticoagulants: Diclofenac may enhance the effectiveness of medications inhibiting platelet aggregation, such as anticoagulants like warfarin.
  6. Increased Serum Concentrations: Diclofenac may increase serum concentrations of phenytoin, lithium, digoxin, potassium-sparing diuretics, methotrexate, etc.
  7. Toxicity to Kidneys: Diclofenac may increase the toxicity of cyclosporin to the kidneys.
  8. Decreased Effectiveness of Antihypertensives or Diuretics: Diclofenac may reduce the effectiveness of antihypertensive medications or diuretics.
  9. Prolonged Elimination: Drugs containing probenecid or sulfinpyrazone may prolong the elimination of Diclofenac.

Conclusion

Dolo Neurobion, a medication comprising Diclofenac and a combination of B vitamins, serves as a valuable therapeutic option for individuals experiencing mixed pain. However, patients must remain vigilant regarding potential side effects and drug interactions outlined in the provided information. The medication's effectiveness hinges on strict adherence to prescribed doses and careful consideration of individual health conditions. Patients are strongly advised to communicate openly with their healthcare providers, promptly reporting any adverse effects or concerns.

Moreover, a comprehensive understanding of Dolo Neurobion's implications during pregnancy, interactions with other medications, and the importance of following medical guidance is crucial for optimizing its benefits and ensuring patient safety. As with any pharmaceutical intervention, informed and responsible usage is paramount to achieving positive health outcomes. For ongoing health and wellness information, patients are encouraged to stay updated through reputable sources like the Vinmec International General Hospital website.

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