Anti-inflammatory drugs during pregnancy. Features of the use of drugs during pregnancy. Which ones are banned

Prolonged pain creates a stressful situation for a woman. When you feel pain, your body releases stress hormones. But since a pregnant mother and her child are almost a single organism, stress is inevitably transmitted to the child.

Stress hormones have a stimulating effect on the muscles, including (and especially) the muscles of the uterus. In this regard, a pregnant woman with chronic pain may experience a miscarriage or premature birth.

This is one side of the coin. On the other hand, stopping the pain simply by taking painkillers and not going to the doctor is unacceptable.

Pain is a signal from the body that something is wrong. This signal must be received in time by a person in order to find true reason this symptom. Influencing directly on the cause, we can count on getting rid of pain, recovery.

Moreover, taking painkillers can mask, lubricate the clinic of many diseases, for example, acute appendicitis. As a result, time may be lost during which a woman could be helped and prevent the disease from progressing.

In other words, you need to be reasonable in taking any medication. That is, you do not need to self-medicate, and you can take painkillers without a doctor's recommendation only when there is no way to see a doctor here and now. For example, if you are waiting for an ambulance for a long time on a weekend or holiday. Or if there is no way to apply for acute pain when your teeth hurt.

Aspirin is contraindicated in pregnancy

To reduce the likelihood of an adverse effect on the fetus, the following rules must be observed:

1. Take medications only as prescribed by the therapist and with the consent of the obstetrician-gynecologist leading the pregnancy.
2. In case of existing chronic diseases, even before pregnancy, get advice on further therapy from a “profile” specialist.
3. Take medicines in the minimum dosage and in a short course.
4. Always read the instructions for use; if possible, keep it until the successful completion of pregnancy.
5. If any adverse events occur, immediately stop taking the drug, take an enterosorbent, and seek medical help.
6. Timely undergo scheduled screening studies and ultrasound for the timely detection of the negative effect of medications on the intrauterine development of the child.

1. in the event that you need to be urgently hospitalized in a hospital;
2. if painkillers can distort the true state of the pregnant woman.

With great caution, it is necessary to treat pain in the abdomen, especially if they are sharp or pulling, accompanied by bloody discharge. In such cases, you need to urgently contact the doctors.

With pain caused by hypertonicity of the uterus, when it feels like it is turning to stone, you need to do the same, since this is a dangerous condition.

Headaches often occur with late toxicosis. Cases when a headache is accompanied by visual impairment (blurring of objects, “flies before the eyes”) should be especially alert. This may signal a severe form of late toxicosis - eclampsia. Then urgent hospitalization and intensive care are necessary.

But a headache in a pregnant woman is not always a pathology - perhaps it's just a reaction to stress, fatigue, a change in the weather. With headaches during pregnancy, it is imperative to measure blood pressure. If it does not deviate from the norm, and there are no visual impairments, then you can take painkillers on your own. But if migraines have become a permanent phenomenon, then you need to see a doctor.

Those that can be used belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs).

• Perhaps the most common of these is paracetamol. Scientific studies have proven that it does not adversely affect the fetus. It can be used by a pregnant woman at any time if the woman does not have individual intolerance to him.
• In the second trimester of pregnancy, it is allowed to use medicines based on paracetamol - these are Efferalgan and Fervex, which are very effective for colds accompanied by sore throat, migraines. Analgin should be treated selectively. It is forbidden to use it in the first trimester and in the third - starting from the 34th week. It can be taken once and in the second trimester - with severe toothache, for example.
• Another drug available during pregnancy is Diclofenac (Voltaren). It also belongs to the NSAID group.
• The following drug is particularly effective. This is VOLTAREN-GEL, which relieves back pain in pregnant women, as well as pain in the joints and ligaments. This drug can be used in the first and second trimesters. And in the third - only under the supervision of a doctor.
• Ketonal is a drug that also belongs to NSAIDs. It can not be used in the 3rd trimester of pregnancy, but up to 32 weeks, as directed by a doctor, you can.
• During pregnancy, NO-ShPA is used very actively. This medication belongs to the group of antispasmodics. It has a relaxing effect on the smooth muscle tissue of various organs. It is especially good to use it for anomalies of the gastrointestinal tract, the genitourinary system, for pain spreading from the head to the shoulders and neck. It has contraindications for individual intolerance, angle-closure glaucoma and severe heart rhythm disturbances.
• Duspatalin - an analogue of NO-SHPY has the same effect.

The above painkillers during pregnancy have been used for many years without any negative consequences for the health of the mother and child and guarantee safety and effectiveness.

All painkillers can be divided into narcotic or non-narcotic analgesics. The former include morphine and codeine. They are used only for severe pain.

During pregnancy, non-narcotic analgesics are used:

1. Paracetamol. It is available at any pharmacy and is used throughout pregnancy. The products of its metabolism are toxic, but are present in low concentrations and are rapidly excreted.
2. Non-steroidal anti-inflammatory drugs - Ibuprofen and Indomethacin. They are contraindicated in the 1st trimester and are prescribed with caution in the 2nd trimester, since their use can provoke premature closure of the arterial duct, neonatal pulmonary hypertension, and oligohydramnios. The latter effect is sometimes used therapeutically for polyhydramnios. High doses of these medicines in the 3rd trimester of pregnancy can adversely affect the baby's kidney function.
3. Ointments and creams. Ointments based on Ketoprofen, Diclofenac, Ketorolac are applicable in the first two trimesters. In the third, herbal preparations are used, with the exception of ointments with bee and snake venom. Local remedies that warm and stimulate blood circulation are prohibited, especially those used in the abdomen, pelvis and chest, as they can cause an increase in blood pressure and uterine tone.

Of the painkillers, Paracetamol is considered the safest. Its safety for pregnant women and children is confirmed by the World Health Organization. It is contraindicated in women with kidney, liver and erosive diseases of the gastrointestinal tract. Paracetamol, in addition to the analgesic effect, also has an antipyretic effect. Paracetamol is recognized worldwide as the drug of choice for fever in young children. This also indicates a high confidence in the drug.

Analgin is contraindicated in pregnancy and lactation. In European countries, it has already been discontinued. We use it quite widely. Analgin is included in the so-called triad, or lytic mixture, which is used as an ambulance at a very high temperature, severe intoxication as a result of administration.

Pregnant women should generally forget about Aspirin as an anesthetic and antipyretic. The drug has many side effects, and therefore the possibility of relieving pain with it by pregnant women should not be considered at all. Aspirin is prescribed to patients with cardiovascular pathology in small doses at night as a blood-thinning agent. It is its blood-thinning effect for a pregnant woman that can lead to irreparable consequences.

Very common and effective analgesics Nimesulide (Nise, Nimesil), Ketorolac (Ketorol, Ketonov) are contraindicated for expectant mothers.

About the latter, even the World Health Organization stated that it does not harm the fetus. But it's an anti-inflammatory. It can help very well if there is some inflammatory process in the body, but if it is not there, then this is an extra burden. Then you need to choose something from the first two in the list. No-shpa is harmless for pregnant women, it is even prescribed for pain in the lower abdomen in the first trimester. But she is not one of the strong drugs.

If the above options are too weak, use Nurofen. It is allowed in the first and second trimester, in the third it is undesirable.

It also happens that the pain is simply unbearable: a fracture, neuralgia, toothache, and so on. In these cases, doctors sometimes prescribe analgin.

Analgin with prolonged use is dangerous and reduces hemoglobin due to blood thinning.

And in the most extreme cases, when the pills do not give an effect, injections are prescribed to the pregnant woman. Usually it is Spazmalgon and Baralgin. In the first trimester, they are categorically contraindicated.

Most of the drugs that are approved for use during pregnancy belong to the group of NSAIDs (non-steroidal anti-inflammatory drugs). One of the most popular NSAIDs is PARACETAMOL. Many scientific studies have been conducted that have proven the absence of a negative effect of this drug on the fetus and the course of pregnancy.

Preparations based on PARACETAMOL (Fervex, Efferalgan) are approved for use in the second trimester of pregnancy, they are especially effective for colds, which are accompanied by sore throats and headaches.

Another popular drug in our country is ANALGIN. Separately, we note that this drug has not been used in developed countries for a long time, but because of its cheap cost it is widely used in Russia and the CIS countries. ANALGIN is prohibited for use in the first trimester and from 34 weeks of pregnancy. However, in the second trimester, a single dose of this drug (for example, with severe toothache) is justified.

The next drug used in pregnant women is DICLOFENAC (VOLTAREN). This drug also belongs to the group of NSAIDs. DICLOFENAC has proven itself especially well in the form of VOLTAREN-GEL, which effectively relieves back pain during pregnancy, as well as pain in the joints and ligaments (in case of injuries or chronic diseases).

Another drug from NSAIDs is KETONAL, it is prohibited for use in the third trimester of pregnancy. But it can be used up to 32 weeks of gestation as directed by a doctor.

Another universal drug for pain of various origins, which is actively used during pregnancy, is NO-ShPA. This remedy belongs to the group of antispasmodics, it has a relaxing effect on smooth muscle tissue in various organs. This drug is especially effective in the pathology of the gastrointestinal tract, urinary system, as well as tension headaches (which spread to the neck and shoulders).

Adverse effects of drugs

In fact, this is often not possible. Pharmaceutical companies rarely conduct clinical trials of their drugs in pregnant women. Therefore, in fact, only a very small part of the medicines has proven safety.

Doctors get most of the information based on the experience of long-term use of a particular medication. If the drug has been widely used in pregnant women for many years, and does not harm the bearing of the child, a conclusion is made about its safety. In addition, information is obtained from studies of cases when pregnant women accidentally took a particular drug, as well as from animal studies.

The most common medications, which are necessary for pregnant women - vitamin-mineral complexes. It is better to choose special vitamins for pregnant women, for example, Elevit Pronatal. Herbal medicines should be avoided during pregnancy, as many of them increase smooth muscle tone and can cause a risk of spontaneous abortion or premature birth.

Allergy

Used drugs:

• diphenhydramine (Dimedrol in tablets and solution and gel for external use Psilo-balm);
• loratadine (Alerpriv, Clallergin, Claridol, Clarisens, Claritin, Clarifer, Lomilan, Loratadine).

Before using them in the early stages of gestation (in the 1st trimester), you should consult with your doctor.

Cold and flu

For a cold, cough, sore throat and runny nose, pregnant women can take the following medicines:

• paracetamol (Panadol, Efferalgan);
• saline nasal drops and sprays (Aqua Maris, Morenazal, Nazol Aqua);
• warm water-salt solutions for gargling.

In severe influenza, oseltamivir (Tamiflu) may be used.

Paracetamol is allowed to be used for headache, toothache.

Diarrhea and infectious diseases

If a pregnant woman has loose stools at normal body temperature, this usually serves as a symptom of intolerance to one of the components of the food. In this case, diarrhea is indicated:

• Filtrum-STI;
• Smecta;
• Neosmectin;
• Hilak Forte;
• Endosorb.

With an infectious origin of diarrhea, when it is accompanied by fever, abdominal pain, vomiting, the appearance of pathological impurities in the feces or watery stools, you should immediately consult a doctor. At infectious diseases antibiotics are prescribed only in cases where the expected benefit to the mother outweighs the possible risk of complications in the fetus. The safest are penicillins, cephalosporins, macrolides. Such a popular remedy for diarrhea, like chloramphenicol, is contraindicated for pregnant women.

Difficulty defecation is a common condition in pregnant women. To normalize the stool, you need to consume enough fiber and water. If necessary, oat bran can be added to the diet, which can be mixed with kefir and taken at night. Of the approved drugs for constipation, lactulose-based syrups can be indicated:

• Good luck;
• Duphalac;
• Lactulose;
• Livolyuk-PB;
• Normase;
• Portalac;
• Romfalac;
• Evikt.

Lactulose is practically not absorbed in the intestine, causing an increase and softening of the volume of feces. It does not reduce the absorption of vitamins and nutrients. Therefore, such drugs can be taken for a long time.

Haemorrhoids

Of the safe remedies for hemorrhoids, the lactulose preparations already listed above can be noted, because the normalization of the stool is one of the conditions for eliminating inflammation of the venous plexuses in the rectum.

For introduction into the rectum and relief of the symptoms of the disease, you can use rectal suppositories and / or ointments:

• Posterisan;
• Natalsid;
• Neo-Anuzole;
• Prostopin (in the absence of an allergy to honey).

These medicines can be used at any gestational age. Many other popular products, such as the entire Relief line, can be used with caution. Means with lidocaine are contraindicated for pregnant women.

Read more about this disease during pregnancy in our review.

Candidiasis

Pathology occurs due to the physiological suppression of local immune defenses and the activation of fungi of the genus Candida. Safe preparations for thrush for pregnant women (vaginal tablets, vaginal and rectal suppositories, ointments):

• Bifidumbacterin;
• Viferon;
• Candide (except 1st trimester);
• Fluomizin;
• Ecofucin.

Means for thrush for oral administration can be taken only in severe cases of the disease as prescribed by a doctor. The listed topical medications can be used without a prescription.

This symptom occurs with toxicosis at the beginning of pregnancy in many women. The following drugs can help with nausea:

• Filtrum-STI and other enterosorbents;
• Essentiale improves liver function.

Hofitol from nausea of ​​pregnant women can be used with caution, cerucal (metoclopramide) is contraindicated.

Swelling of the lower extremities can be a sign of fluid retention in the body. Often it accompanies preeclampsia of the 2nd half of pregnancy and requires treatment under medical supervision. Diuretics for edema are not recommended for pregnant women. Only in severe cases in a hospital setting, a short course of furosemide solution can be administered. Hypothiazid and veroshpiron are contraindicated.

With edema, the main treatment is aimed at improving blood circulation in the kidneys and relieving vasospasm. For this purpose, eufillin, platifillin and other safe drugs are prescribed.

Hypertension

Absolutely safe for the fetus, even at the very beginning of its development, methyldopa. It is the drug of choice for hypertension in pregnancy. Labetalol may also be used.

With caution, the appointment of metoprolol is allowed. With a hypertensive crisis or preeclampsia, the administration of sodium nitroprusside and furosemide is acceptable.

ACE inhibitors - enalapril, captopril, lisinopril and others are strictly prohibited. Therefore, to select a remedy for pressure, if hypertension was previously present or occurred only during pregnancy, it is necessary to contact a cardiologist.

Depression

Up to 20% of pregnant women suffer from depression in varying degrees. The benefits of treating this condition far outweigh the potential threats to the fetus. Serotonin reuptake inhibitors are commonly prescribed to treat depression.

Read more about postpartum depression here.

Vaccination

Vaccines produced using live viruses (against rubella, chicken pox) are contraindicated during the gestational period. Some of these drugs, such as cholera or hepatitis A vaccines, are only given to pregnant women if they are at significant risk of infection.

Influenza vaccination in the 2nd and 3rd trimesters is not only permitted, but recommended. In addition, the doctor may advise between 27 and 36 weeks to be vaccinated with DTP. This vaccine will protect the newborn from whooping cough. Most young children get this disease from surrounding adults with a dry cough, and for babies it can be deadly.

Medicines a woman takes during pregnancy can affect the developing fetus different ways:

1. Act directly on the fetus, causing congenital malformations or death.
2. Cause vasoconstriction of the placenta and reduce the supply of oxygen and nutrients to the fetus, resulting in insufficient growth and birth weight.
3. Lead to a strong contraction of the uterine muscles, disrupting the blood supply to the fetus or causing premature birth.
4. Indirectly affect the fetus, for example, by reducing the pressure in the mother.

Previously, all drugs prescribed to pregnant women belonged to one of 5 safety classes. Now this classification has been abandoned. For each drug, the degree and evidence of danger is indicated. Based on this information, the doctor decides whether to prescribe the medication individually, based on the possible risk to the fetus and benefit to the mother.

What medicines should not be taken:

• isotretinoin and other medicines for the treatment of skin diseases based on it;
• NSAIDs, especially in the 3rd trimester;
• diuretic drugs;
• ACE inhibitors;
• antibiotics from the group of aminoglycosides, tetracycline, levomycetin, sulfonamides;
• sleeping pills of synthetic origin;
• cytostatics, immunosuppressants, glucocorticoid hormones.

Their use is especially dangerous against the background of the existing pathology of pregnancy, too young or mature age of the mother, as well as in the 1st trimester, when there is intensive cell division and the formation of tissues and embryonic organs of the embryo.

In some cases, under the supervision of a doctor, you can take:

• antibiotics for bacterial infections;
• modern antidepressants;
• oxymetazoline-based nasal sprays can be used in exceptional cases for no more than 3 days, and only in 2-3 trimesters.

Drugs with absolute contraindications:

• ACE inhibitors prescribed to treat hypertension and heart failure may cause premature birth or malformations in the baby;
• vasoconstrictor drops based on pseudoephrine and phenylephrine, especially in the 1st trimester, can cause the formation of a defect digestive system or limit the blood supply to the placenta;
• aspirin and other NSAIDs, which increase the likelihood of preterm labor and oligohydramnios;
• methotrexate, used for psoriasis and rheumatoid arthritis, increases the risk of birth defects and miscarriage;
• valproic acid in epilepsy causes heart disease in the fetus, cleft lip, impaired intellectual development in the future.

Salicylates have been used for a very long time and quite effectively. The main drug known to all is acetylsalicylic acid or aspirin. Aspirin is not recommended during pregnancy, especially in the first three months of pregnancy, but at other times under the supervision of a doctor and, if necessary, is sometimes prescribed.

There are various studies, unfortunately, they are quite contradictory. Aspirin has been shown to increase the risk of miscarriage. When strictly necessary, doctors prescribe aspirin only in minimal doses and a limited course. There are various preparations containing aspirin at their core, so they must be treated with caution, and some of them are strictly contraindicated in pregnancy.

This group includes: askofen, asphene, quersalin, cofitsil, sedalgin, citramon, sodium salicylate, salicylamide, cefecon, methyl salicylate, acelysin, mesalazine. Of the listed funds, one should especially dwell on citramone, since this is enough effective drug especially for headaches. It is recommended to avoid taking it precisely because of the content of aspirin and caffeine in the composition, but in some cases the doctor may allow its use, especially in a single dose.

Non-steroidal anti-inflammatory gels and ointments for joints

Joint pain can be caused by injury or disease. But to endure attacks, regardless of the reason for the desire, no one has. Medicine cannot completely cure some joint diseases. The simplest solution is to use anti-inflammatory ointments. The most popular drugs for getting rid of inflammation and pain in the joints are non-steroidal anti-inflammatory drugs or NSAIDs.

Indications for use

Severe or chronic pain, if not treated at all or done with inadequate methods, can have an adverse effect on the body of the woman and the fetus. Even if we forget about the emotional connection and the fact that the child feels the mood of the mother, in any case, the fetus is completely dependent on the female body, receiving oxygen and oxygen for growth and development. nutrients.

If possible, non-pharmacological agents should be used, but if they do not work, the most effective painkillers appropriate for the severity of the condition are selected for the pregnant woman, taking into account known or suspected risks to the fetus.

Indications for use

Taking any painkillers during pregnancy is prohibited if the pregnant woman:

• serious violations of the kidneys or liver;
• bronchial asthma;
• ulcerative lesions of the gastrointestinal tract.

If you have diseases from this list, taking any painkillers is contraindicated for you.

Appear within a few hours after ingestion. If you find at least one in your home, immediately call an ambulance.

When pregnancy occurs, women are of the opinion that it is better not to take any drugs or try to take a minimum of drugs. But no one is immune from situations in which you need to take painkillers even during pregnancy.

Many may say that pain during pregnancy can be tolerated so as not to endanger the baby once again. I can object to this that it is dangerous to endure pain for a long time both for the mother herself and for the fetus.

What should a pregnant woman know about pain?

Prolonged pain creates a stressful situation for a woman. When you feel pain, your body releases stress hormones. But since a pregnant mother and her child are almost a single organism, stress is inevitably transmitted to the child.

Stress hormones have a stimulating effect on the muscles, including (and especially) the muscles of the uterus. In this regard, a pregnant woman with chronic pain may experience a miscarriage or premature birth.

This is one side of the coin. On the other hand, stopping the pain simply by taking painkillers and not going to the doctor is unacceptable.

Pain is a signal from the body that something is wrong. This signal must be perceived in time by a person in order to find the true cause of this symptom. Influencing directly on the cause, we can count on getting rid of pain, recovery.

Moreover, taking painkillers can mask, lubricate the clinic of many diseases, for example, acute appendicitis. As a result, time may be lost during which a woman could be helped and prevent the disease from progressing.

In other words, you need to be reasonable in taking any medication. That is, you do not need to self-medicate, and you can take painkillers without a doctor's recommendation only when there is no way to see a doctor here and now. For example, if you are waiting for an ambulance for a long time on a weekend or holiday. Or if there is no way to apply for acute pain when your teeth hurt.

Situations that may require pain medication

Toothache, earache, headache, pulling pain in the abdomen, pain in the lower back and joints, pain with sprains, bruises and fractures, burns, as well as acute appendicitis, renal colic - this is an incomplete list of possible causes of pain in pregnant women.

Toothache is a topic that is especially relevant for expectant mothers, since during pregnancy the female body experiences a lack of calcium and phosphorus.

By nature, everything is so arranged that the child can be guaranteed to receive all the microelements and vitamins he needs. The kid will still take everything that he is supposed to, even at the expense of the reserves of his mother's body. Therefore, the destruction of dental tissue, the addition of caries during pregnancy is not uncommon for women.

Ideally, of course, you need to sanitize the oral cavity before planning pregnancy. But even this step, unfortunately, does not provide one hundred percent protection against the occurrence of painful problems with teeth in future mother.

The first trimester is a dangerous period

In the first trimester, you always need to once again think about whether it is worth taking any medications, especially painkillers. It is during this period that the risk of a negative effect of drugs on the fetus is especially high, since in the first months of pregnancy the child develops rapidly, most of the vital systems and organs of the baby are formed, the development and formation of which can be negatively affected by any factor from the outside.

Also, in the first months of pregnancy, metabolic processes are intensively going on in the organisms of both the mother and the child, and the not yet fully formed placenta cannot adequately perform its barrier function. That is why most drugs, including painkillers, are contraindicated in the first three months of pregnancy.

Painkillers: which can be taken during pregnancy and which are strictly prohibited?

Of the painkillers, the safest is considered Paracetamol. Its safety for pregnant women and children is confirmed by the World Health Organization. It is contraindicated in women with kidney, liver and erosive diseases of the gastrointestinal tract. Paracetamol, in addition to the analgesic effect, also has an antipyretic effect. Paracetamol is recognized worldwide as the drug of choice for fever in young children. This also indicates a high confidence in the drug.

Paracetamol

A single dose of Paracetamol should not exceed 500 mg. The doctor observing your pregnancy will tell you the daily dose.

It is important to understand that even in such cold powders as Theraflu, Coldrex, Fervex is included Paracetamol. And if they were recommended to you to relieve the symptoms of a cold, then you no longer need the additional use of Paracetamol and other analgesics. Otherwise, additional intake of painkillers can lead to their overdose.

Ibuprofen

If it is impossible to take Paracetamol, the doctor may prescribe to a pregnant woman Ibuprofen. This drug may be available under different trade names such as Nurofen, Ibufen.

A drug Nurofen Plus pregnant women are contraindicated, since the drug contains additional components and a large dose of the main substance, it can have a negative effect on the fetus.

Ibuprofen is approved for use in pregnant women in the first and second trimesters of pregnancy. In the third trimester of pregnancy, it is forbidden to take it, since it significantly affects the amount of amniotic fluid in the direction of their reduction.

Analgin is contraindicated in pregnancy and lactation. In European countries, it has already been discontinued. We use it quite widely. Analgin is included in the so-called triad, or lytic mixture, which is used as an ambulance at a very high temperature, severe intoxication as a result of administration. The use of such a potent agent once in the provision of emergency care is allowed under the supervision of a physician. In other cases, resorting to Analgin is not worth it.

Diclofenac

Diclofenac It is also a potent analgesic. Pregnant women are better off using its analogue Voltaren. His appointment to future mothers is possible for health reasons in the first and second trimester. In other words, it can be used only when the health benefits of the mother outweigh the undesirable effects of the drug on the fetus.

In the third trimester, Valtaren should not be taken, as it can further provoke weakness in labor and disrupt blood flow in the mother-placenta-fetus system.

No-shpa or Papaverine

No-shpa or Papaverine belong to antispasmodics, that is, to drugs that eliminate spasm of smooth muscles. If the pain is associated with spasm (drawing pains in the lower abdomen with uterine tone, throbbing headache), then these drugs will cope with it. In all other cases, they will be useless. As prescribed by a doctor and under his direct supervision, No-shpa can be taken regardless of the duration of pregnancy.

Aspirin is contraindicated in pregnancy

Pro Aspirin pregnant women in general should be forgotten, as about an anesthetic and antipyretic. The drug has many side effects, and therefore the possibility of relieving pain with it by pregnant women should not be considered at all. Aspirin is prescribed to patients with cardiovascular pathology in small doses at night as a blood-thinning agent. It is its blood-thinning effect for a pregnant woman that can lead to irreparable consequences.

Very common and effective analgesics Nimesulide (Nise, Nimesil), Ketorolac (Ketorol, Ketones) future mothers are contraindicated.

What form of painkillers is preferable for expectant mothers?

Many analgesics are presented in several forms at once: tablets, capsules, suppositories, injections, ointments, gels and others. You involuntarily think: what is the advantage of this or that form of release, in which case which form of the drug is better suited?

Each form of release is intended for different cases according to the degree of urgency of assistance, according to the stage and severity of the process. The best form of release for your specific case will be prompted by the doctor prescribing pain medication for you.

I will dwell on some points that every pregnant woman should know. I will tell you about the speed of action of various forms of drugs, about whether a local drug is so safe, unlike the same drug, but taken orally.

Tablets and capsules begin to act approximately the same time after ingestion. Now they produce coated tablets that dissolve only in the intestines. So manufacturers want to reduce the irritating effect of drugs on the gastric mucosa. Thus, there is no significant difference between capsules and tablets.

When using candles in the treatment of your pain, be prepared for the fact that it will take a little longer to wait before the onset of the effect of the drug. But the action of candles will last longer than tablets. That is why suppositories are so often recommended to be taken at night so that the pain does not interrupt your rest.

Only a doctor has the right to prescribe injectable forms of drugs, and it is necessary to carry out treatment with injectable forms only directly under his supervision.

Injected intramuscularly or intravenously, the drug begins to act faster, and its bioavailability is higher. That is, the active substance of the drug enters the bloodstream with the help of injections much more. Due to these effects of injectable forms of analgesics, they are prescribed for the treatment of acute, urgent and severe cases of pain in various pathologies.

Ointments and gels, that is, topical painkillers, have a limited number of indications. More precisely, they can not cope with any pain syndrome.

The current opinion among non-specialists that the topical application of ointments does not give as many side effects as drugs taken in the form of tablets is fundamentally wrong.

The principle of action of any drug is based on its absorption into the blood and moving with it to the diseased organ. And if the active substance still enters the bloodstream, it means that with maternal blood it will enter the placenta, and from there directly to the fetus. Thus, the drug, circulating in the blood, can have its negative effect on the body of the mother and fetus, regardless of the form in which the substance entered the body.

In summary, I will say that if you are pregnant, then any use of drugs should be agreed with your doctor. Self-medication and self-administration of any medications during pregnancy is unacceptable. If a pregnant woman is worried about pain, the right tactic would be to find out its causes, and only then the issue of dealing with the consequences - the pain syndrome - is decided.

There is no doubt that various drugs can have a negative effect on the fetus. However, the degree of this influence is very diverse and depends on many factors, which will be presented in more detail below. Even medications that are widely used and approved during pregnancy can cause various complications in the fetus and newborn. When prescribing any treatment during pregnancy, it should be borne in mind that all drugs are prescribed only according to indications. In this case, it is necessary to choose drugs with proven tolerability, giving preference to any one drug, rather than combined treatment. No drug is completely safe and harmless. Sensitivity to individual drugs can be genetically predetermined. The use of medications can contribute to pregnancy complications such as: spontaneous miscarriage; premature birth; stillbirth; congenital anomalies; cerebral paralysis; mental retardation or behavioral disorders, etc. Medicines that do not cause organic damage to the fetus can contribute to the development of allergic reactions in it. In addition, the negative effects of drugs may only appear after the birth of a child or at a later date. Often, concomitant diseases during pregnancy have a harmful effect on the fetus, which requires the use of various drugs. Various drugs for a pregnant woman are also prescribed for the purpose of a specific therapeutic effect on the fetus. In these cases, first of all, the ratio of benefits and harms from taking certain drugs is assessed and they are prescribed only if the likelihood of a therapeutic effect for the mother outweighs the risk of developing an undesirable effect on the fetus. Usually, only those drugs are prescribed for which there is already experience of their widespread use in pregnancy. It is impossible to compile an exact list of safe drugs. One can only assume that there are more or less safe drugs, but their harmlessness will never be completely ruled out.

All drugs can be conditionally divided into five following groups

• 1 group. Medicines that, in controlled trials in pregnant women, did not show a risk to the fetus in the first 12 weeks of pregnancy and for which there is no evidence of a harmful effect on the fetus in late pregnancy (most multivitamin complexes, potassium chloride, iron preparations, triiodothyronine).
• 2 group. Drugs, in the experimental study of which no teratogenic effect was detected, or complications observed in animals were not found in children whose mothers took drugs included in this group (penicillin antibiotics, heparin, insulin, aspirin, metronidazole).
• 3rd group. When testing these drugs on animals, their teratogenic or embryotoxic effects were revealed. Controlled trials have not been conducted or the effect of the drug has not been studied (isoniazid, fluoroquinolones, gentamicin, antidepressants, antiparkinsonian drugs). These drugs should only be used if the potential benefit outweighs the potential risk.
• 4 group. The use of drugs in this group is associated with a certain risk to the fetus, but the benefits of their use outweigh the possible side effects (anticonvulsants, doxycycline, kanamycin, diclofenac).
• 5 group. The teratogenic effect of drugs in this group has been proven, their intake is contraindicated during pregnancy, as well as when planning a pregnancy (isotretionine, carbamazepine, streptomycin).

It is advisable for pregnant women to refrain from taking any drugs in the first trimester of pregnancy, unless the drugs are specifically prescribed by a doctor, and to avoid any drugs, except for drugs corresponding to the first group of the above.

In cases where any drugs were used on the eve of conception or in the earliest stages of pregnancy, then, first of all, the drug should be identified in terms of its possible damaging effect. If, for example, it is a likely teratogen, one should try to determine the relationship between the time of its exposure and the likely time of conception. If exposure to a known teratogen occurred during the first 8 weeks of pregnancy, then further investigation is needed to clarify the risk of possible fetal abnormalities. To do this, from 8 to 13 weeks, it is advisable to determine the level of free? -hCG subunit in the blood, from 8 to 11 weeks, perform a PAPP-A test, determine the thickness of the collar space (NT) using ultrasound at 11-13 weeks of pregnancy. The table below lists drugs that should be avoided in early pregnancy due to their harmful effects on the fetus.

Medications not to be taken in early pregnancy

The use of anticoagulants in the first trimester of pregnancy is associated with an unfavorable outcome of pregnancy in 35% of cases and is dangerous for the development of skeletal abnormalities in the fetus (especially at 6-9 weeks of fetal development). The use of sex steroid hormone preparations is associated with an increased risk of stillbirth, the birth of fetuses with pathology of the cardiovascular system (tetralogy of Fallot, vascular transposition), hypospadias and the development of neuroblastoma in children in adolescence. The use of oral contraceptives in early pregnancy increases the risk of chromosomal abnormalities and the risk of having children with Down syndrome by 2.8 times. The risk of developing neuroblastoma in children, especially in males, increases by 1.2 times. There may be a slight increase in the risk of miscarriage in pregnancies associated with continued use of oral contraceptives.

The use of vitamin A during critical periods of development of organs and systems can lead to the formation of multiple malformations in the fetus. None of the tranquilizers or sleeping pills is completely safe. Therefore, their use, especially in the first trimester, should be abandoned. In the second half of pregnancy, the means used, as a rule, no longer cause large anatomical defects. Some drugs, while not teratogenic, can still cause fetal side effects when taken during the third trimester of pregnancy. In the last weeks of pregnancy or during childbirth, drugs affect mainly the functions of individual organs or enzyme systems of the newborn and to a lesser extent affect the fetus. When used in high doses in the last weeks of pregnancy, acetylsalicylic acid can cause jaundice in the fetus. In addition, when taken in the last week before delivery, acetylsalicylic acid can cause a violation of the blood coagulation system during childbirth in the mother and provoke bleeding in the newborn. Aminoglycoside antibiotics can be used during pregnancy only for absolute indications, as they have a damaging effect on the hearing aid and kidneys of the fetus. Tetracyclines can cause hepatocellular necrosis in the mother and impaired bone and tooth development in the fetus. Levomycetin (chloramphenicol) can cause peripheral vascular collapse in an infant if given in inadequate doses. The gray hair syndrome observed in newborns due to maternal treatment with chloramphenicol causes a relative contraindication for the use of this drug in late pregnancy. Most sulfonamides should be completely avoided during the third trimester of pregnancy. Oral anticoagulants in the second half of pregnancy can also cause microcephaly and bleeding. Heparin does not cross the placenta and is relatively safe, although it sometimes causes reversible osteoporosis and often bone demineralization. Thiazide diuretics (diuretics) can cause neonatal thrombocytopenia, probably due to direct bone marrow toxicity, and should be avoided in late pregnancy. The table lists drugs that should not be used in the second half of pregnancy, or in some cases used with great caution.

When prescribing and choosing medication during pregnancy, one should take into account not only her positive sides but also the risk to mother and fetus.

Certain drugs may be used during pregnancy. When prescribing folic acid in a volume of 400 mcg in the first trimester, there is a decrease in the risk of developing neural tube defects in the fetus. The usual daily dose of folic acid to prevent anemia in pregnant women is 500 micrograms. The use of multivitamin preparations within 3 months before pregnancy significantly reduces the risk of giving birth to children with pathology of the heart, blood vessels and nervous system(Materna, Elevit, Vitrum-prenatal, Gendevit). However, a teratogenic effect can be observed not only with a deficiency, but also with an excess content of vitamins in the body. Thus, an excess of vitamin C can lead to chromosomal abnormalities. Large doses of vitamin D can help remove calcium from the bones of the fetal skeleton and reduce the production of parathyroid hormone. Therefore, in the absence of any diseases and complications during pregnancy, a well-balanced mother's diet is quite sufficient for its normal course, proper development and growth of the fetus, and there is no need to prescribe multivitamin complexes, especially in the first trimester of gestation. It is more useful to eat foods rich in vitamins and microelements, in accordance with the increased needs of the body.

For the prevention and treatment of anemia in pregnant women, preparations containing iron and folic acid are usually used (Fenyuls, Sorbifer Durules, Ferrum Lek, Maltofer, Ferro-foilgamma). The main requirement for such preparations is to provide a minimum daily dose of iron and folic acid (500 mcg). Modern hormonal progestogen drugs (Dufaston, Utrozhestan) do not have an androgenic and anabolic effect, do not have a virilizing effect on the fetus. The appointment of glucocorticoid therapy (methipred, dexamethasone, prednisolone) without indications of the presence of autoimmune connective tissue diseases or hyperandrogenism in a woman is not justified due to the high risk of suppression of fetal adrenal function, development of osteoporosis and generalization of infection. Antispasmodics (No-shpa, papaverine) are used in the first trimester of pregnancy. Magnesium preparations - Magne B6, Magnerot can be used for a long time until the threat of termination is eliminated and throughout pregnancy to compensate for magnesium deficiency. They should be taken with caution in case of arterial hypotension - mimetics (Partusisten, Ginipral, Salgim) penetrate the fetus and contribute to an increase in glucose levels, causing tachycardia. With their long-term use, newborns have manifestations similar to diabetic fetopathy. The safest antiemetic drugs are Cerucal, Reglan. However, because nausea and vomiting are more common in early pregnancy, it is important to limit the use of these antiemetics to a minimum.

The use of antihistamines (Suprastin, Pipolfen, Cimetidine, Ranitidine, Tavegil) in the first trimester of pregnancy, as a rule, is not associated with an increased risk of congenital malformations in the fetus. Antacids (Almagel, Maalox), used in the II and III trimesters of pregnancy, also do not adversely affect the fetus. Relatively safe laxatives for the fetus are Bisacodyl, senna leaves. However, frequent and systematic use of these drugs is not recommended.

The use of antibiotics during pregnancy should be regulated by strict medical indications and carried out under the supervision of a physician. Relatively safe for both mother and fetus are: penicillin, ampicillin, amoxicillin, cephalosporins (Cefazolin, Cefotaxime, Suprax), augmentin, vilprofen, erythromycin. Starting from the second trimester of pregnancy, antimicrobial agents for local treatment can be used: terzhinan, Klion-D, miramistin, plivosept, clotrimazole. Preparations of recombinant interferons (KIPferon, Viferon) are recommended to be used no earlier than from the second trimester of pregnancy. In some cases, it becomes necessary to correct maternal hyperthyroidism. In this case, it is possible to prescribe low doses of carbimazole, methimazole or propylthiouracil. However, such treatment may be accompanied by a risk of hypothyroidism and gout in the fetus (10%). With hypothyroidism, levothyroxine, potassium iodide are prescribed. If you have an insulin dependent diabetes pregnant women are prescribed insulin after consultation with a specialist and under the control of blood sugar levels. Heparin and low molecular weight heparins (Fraxiparin) do not cross the placenta and do not adversely affect the fetus. Long-term (more than 6 months) use of heparin at therapeutic doses during pregnancy predisposes to reversible osteoporosis and fractures. Fraxiparine has a number of advantages: the absence of hemorrhagic complications in the mother and newborns and clinical signs of osteoporosis. Diuretics are not classified as potentially teratogenic for the human fetus, but the fetotoxic effect of diuretics of various chemical groups is not excluded. With prolonged use by pregnant women of large doses of thiazides in newborns, hyponatremia and thrombocytopathy may develop. Under the influence of ethacrynic acid, there is a weakening and loss of hearing in a newborn. Furosemide has no negative effect on the fetus. Drugs that lower blood pressure (antihypertensive drugs) can adversely affect the fetus by increasing its susceptibility to the effects of hypoxia. In newborns from mothers taking antihypertensive drugs, blood pressure for a certain time is slightly lower than in healthy children.

Treatment of bronchial asthma using β-adrenergic drugs (Salbutamol) during pregnancy is not contraindicated. Side effects of drugs currently used for acute asthma (including steroids and cromolyn sodium) have not been proven. In cases where pregnancy has occurred after ovulation stimulation with clomiphene, the risk of chromosomal abnormalities in the fetus increases. When using antiallergic drugs, the development of anomalies of the cardiovascular system and the musculoskeletal system in the fetus is often noted.

Many people who first encountered the problem of joint pain find themselves helpless in front of it, because they do not know what to do and how to treat the disease.

However, today there are very effective anti-inflammatory drugs for arthrosis and arthritis, which can affect the underlying cause of the pathology and the condition of the joints in different ways.

I would like to immediately warn those patients who are in no hurry to seek help from a doctor, but prefer to diagnose and treat the disease on their own. Any self-medication can bring irreparable harm to the entire body.

You need to take only those medicines that the doctor has prescribed.

Nonsteroidal drugs for joint diseases

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are the most effective in arthrosis and arthritis of any origin. The main task of these drugs is to influence the focus of inflammation in the joints and eliminate pain.

Unlike corticosteroids ( hormonal drugs), NSAIDs do not contain hormones, which reduces the number of side effects on the body.

Reminder for patients taking NSAIDs

Despite their relative safety, most NSAIDs should not be taken in long-term courses. This is due to the fact that non-steroidal drugs have a wide range of contraindications and have all sorts of side effects. Taking NSAIDs is contraindicated in:

• most pathologies of the gastrointestinal tract;
• disorders of the kidneys and liver;
• problems with the heart and blood vessels.

Anti-inflammatory drugs should not be taken if the patient has previously been ill or currently has a history of the following diseases:

1. gastritis;
2. stomach ulcer or duodenal ulcer;
3. colitis.

It turns out that non-steroidal anti-inflammatory drugs negatively affect the mucous membranes, causing inflammation and even ulcers in them.

With great care, NSAIDs should be used for violations of the functionality of the kidneys and liver, since drugs in this group affect the renal circulation, thereby causing a delay in the body of sodium and water. As a result, blood pressure can rise and serious violations of the functionality of the liver and kidneys occur.

In some cases, patients experience individual reactions of hypersensitivity or absolute intolerance to anti-inflammatory drugs.

Therefore, even in the absence of the pathologies listed above, the use of nonsteroidal drugs should be treated with caution. Medicines should be started gradually and in small doses. Before starting treatment, the patient should carefully study the accompanying instructions for the drug and take the medicine only according to the indicated scheme.

To reduce the negative impact that nonsteroidal drugs have on the gastric mucosa, tablets should be taken with plenty of water. Other liquids (juices, compotes, milk) may affect the absorption of the drug.

If the therapeutic course requires the use of several NSAIDs, they must be taken at different times. This will not affect the treatment in any way, but it will help to avoid numerous side effects.

NSAIDs should not be taken during pregnancy. If absolutely necessary, a woman should consult a gynecologist.

What NSAIDs will the doctor prescribe for joint diseases?

All nonsteroidal drugs are conventionally divided into two large groups: inhibitors of COX-1 and COX-2 (cyclooxygenase).

Acetylsalicylic acid (Aspirin) - this drug was discovered the very first and, despite its "venerable age" (Aspirin is over a hundred years old), it continues to be popular to this day. Although at present there are synthesized and much more effective non-steroidal drugs for the treatment of osteoarthritis.

Although Aspirin provides good dynamics in the treatment of many diseases of various systems and organs, this drug is rather weak for getting rid of arthritis and arthrosis. Therefore, with joint diseases, doctors usually do not prescribe it. This requires more serious therapy.

Aspirin is taken with great care in diseases of the blood, since the drug slows down its clotting.

Diclofenac, which is produced by different manufacturers under different names (Naklofen, Ortofen, Voltaren, Diklak, Dicloberl, Clodifen, Olfen, Dolex, Diclonac P, Wurdon), has gained the greatest popularity in the treatment of joint diseases today. The drug is also quite "middle-aged" it was created back in the 60s of the last century. Available in the form of tablets, capsules and ointments.

This remedy successfully combines high anti-inflammatory and analgesic characteristics.

Another effective remedy for various articular pathologies is Ibuprofen. This drug is slightly inferior to Indomethacin and other modern drugs in terms of anti-inflammatory and anesthetic properties, but it is well tolerated by the body and has a minimum of side effects.

The medicine is also produced under other names:

• Long;
• No pain;
• Solpaflex;
• Burana;
• Brufen;
• Ibalgin;
• MIG-400;
• Bonifen;
• Nurofen;
• Faspik;
• Ibuprom;
• Advil;
• Reumafeni.

In its effect on inflammation, Indomethacin is considered the most powerful drug, and its analgesic effect is quite high. Indomethacin is produced in tablets and capsules of 25 mg, in the form of a gel and ointment, rectal suppositories.

Despite the fact that Indomethacin has a very decent list of side effects, it is considered very effective in arthrosis and arthritis of various origins. Another advantage of the drug is its affordable cost.

The price of tablets (depending on the quantity in the package) ranges from 15 to 50 rubles.

This non-steroidal anti-inflammatory drug is produced by various pharmaceutical companies under the following names:

1. Indovis EU.
2. Indocollier.
3. Metindol.
4. Indovazin.
5. Indotard.

In addition to those drugs listed above, Ketoprofen belongs to the group of non-selective drugs of the first type, that is, COX-1. Its effectiveness is close to that of Ibuprofen.

Ketoprofen is produced in several dosage forms: tablets, aerosol, gel, ointment, rectal suppositories, solution for injection and external use.

You can buy Ketoprofen in pharmacies under other names:

• Flexen.
• Flamax.
• Quick.
• Fastum.
• Artrosilene.
• Ketonal.
• Artrum.
• Febrofid.

New generation COX-2 inhibitors

This group of NSAIDs has a selective effect on the body. In view of these qualities of inhibitors on the part of the gastrointestinal tract, there are much fewer side effects, at the same time, drug tolerance is increased.

In addition, it is known that COX-1 inhibitors can adversely affect the state of cartilage. In other words, they simply destroy it. COX-2 inhibitors do not have such characteristics, therefore, with arthrosis, these drugs are considered the best.

However, they also have drawbacks, many of the funds in this group, without affecting the stomach, negatively affect the state of the cardiovascular system.

New generation COX-2 inhibitors include:

1. Etoricoxib (Arcoxia).
2. Celecoxib.
3. Nimesulide.
4. Meloxicam.

Celecoxib was originally developed by the pharmaceutical company Pfizer under the name Celebrex.

Celecoxib has a fairly powerful analgesic and anti-inflammatory effect in arthrosis and arthritis, while it has practically no side effects from the gastrointestinal tract. Release form - capsules of 100 and 200 mg.

Meloxicam is an active substance that is part of many drugs prescribed for arthrosis of the joints. The most famous among them is Movalis, the main advantage of which is that it can be taken for a long course, which cannot be said about Indomethacin and Diclofenac.

Movalis can be taken for months and even years. However, this should be done only on the recommendation of a doctor. Release form - tablets, ointment, rectal suppositories, solution for intramuscular injections. The oral form of Meloxicam (Movalis) is good because the action of the tablets lasts throughout the day. If you take a pill in the morning, its effect will last until the evening.

Nimesulide, in addition to having a good anti-inflammatory and analgesic effect, has antioxidant qualities and properties that protect cartilage and collagen fibers from damaging effects.

The release forms of this medicine are varied: tablets for oral use and for resorption, gel, granules for preparing a solution.

Nimesulide is produced under the following trade names: Nise, Mesulid, Aulin, Rimesid, Aktasulide, Nimegesik, Kokstral, Nimid, Prolid, Nimika, Flolid, Aponin.

Non-steroidal anti-inflammatory gels and ointments for joints

Joint pain can be caused by injury or disease. But to endure attacks, regardless of the reason for the desire, no one has. Medicine cannot completely cure some joint diseases. The simplest solution is to use anti-inflammatory ointments. The most popular drugs for getting rid of inflammation and pain in the joints are non-steroidal anti-inflammatory drugs or NSAIDs.

• What are NSAIDs and NSAIDs
• Application restrictions
• Diclofenac
• "Bystrumgel" or "Indovazin"?
• Gels "Nise" and "Ketonal"
• Funds for children
• "Diklovit" and "Nurofen"
• "Finalgel" and "Ketoprofen"
• Balm "Horsepower"
• NSAIDs with bee venom

What are NSAIDs and NSAIDs

These drugs relieve inflammation and reduce pain, are devoid of the negative effects of steroid drugs and are effective in acute and chronic forms of joint diseases.

But even such relatively safe medicines, non-steroidal anti-inflammatory drugs, NSAIDs are not without drawbacks. The most common problems are associated with the consequences of the use of NSAIDs on the digestive tract and kidneys.

With prolonged use of non-steroidal anti-inflammatory drugs, damage to the mucous membrane of the duodenum and stomach is possible with the formation of ulcers, bleeding. Frequent nausea, diarrhea. The risk increases with increasing dosage and duration of NSAID use.

Therefore, it is necessary to consult a doctor before starting the use of NSAIDs. The specialist selects an effective minimum dosage for the minimum time period.

Application restrictions

The kidneys also suffer from excessive enthusiasm for local treatment of the joints. The consequences appear as:

• delays in the withdrawal of fluid and salts;
• pressure increase.

Extremely rare, but not excluded are such phenomena as acute renal failure and nephritis.

During the gestation period, NSAIDs should not be used, especially in the last months. Headaches, dizziness, rash, heart failure, bronchospasm are not excluded.

With a reasonable dosage and the condition of using anti-inflammatory drugs for a limited time, they will not cause irreparable harm to health. On the contrary, ointments will relieve excruciating pain in the joints and improve the condition.

Diclofenac

Diclofenac ointment is recognized as the most effective non-steroidal agent. The drugs "Diklonak-P", "Ortofen" and "Voltaren Emulgel" act similarly. The agent is applied in a thin layer to the affected area, gently massaging into the problem area so as not to cause additional pain.

The product is quickly absorbed without greasy traces, penetrates well deep into the tissues and is approved for use by children. In the form of an ointment or gel, the drug is easy to apply to the skin. The tool is forbidden to freeze: the healing properties of NSAIDs are lost.

Use an anti-inflammatory agent only externally to relieve swelling and reduce pain in the joint. Apply such a medication only to uninjured areas.

• Do not apply to open wounds.
• You don't need to put on a bandage.
• Do not allow contact with mucous membranes and eyes.

Both dosage and duration of use of NSAIDs depend on the effectiveness of treatment. If there is no improvement even after a couple of weeks, a visit to the doctor is mandatory.

The drug is contraindicated in bronchial asthma, during pregnancy and breastfeeding, rhinitis and individual intolerance to the components of the drug. For problems with the gastrointestinal tract, an ulcer, the use of Diclofenac is not recommended. This anti-inflammatory drug is prohibited for the treatment of joint pain in children under 6 years of age. With poor blood clotting and chronic cardio insufficiency, you can start the course only with the permission of the doctor.

"Bystrumgel" or "Indovazin"?

"Bystrumgel" will relieve inflammation and the action will last quite a long time. But an anti-inflammatory nonsteroidal drug is prohibited in case of hypersensitivity to the components of the drug, for children under 6 years old, in the last stages of pregnancy. During the use of NSAIDs, redness, swelling, rashes, blisters and even burns are not excluded.

The gel without pressure is massaged into the skin several times a day in problem areas.

With intolerance to aspirin, the use of Indomethacin ointment is excluded. If there are no contraindications, such a remedy will quickly and effectively relieve pain, relieve inflammation of the joint. The drug can be applied under a bandage.

Unpleasant side effects in the form of urticaria, reddening of the skin, rash, swelling, burning of the skin, suffocation and dry cough are not excluded. To solve the problem, it is recommended to either change the drug, or consult a doctor.

"Indovazin" will relieve pain in the joints. Apply it to sore spots several times a day and massage the problem area. An anti-inflammatory agent can be applied at night in the form of a compress. The gel has no side effects.

Against edema, inflammation of the joints, pain, the Dolgit cream is effective. This remedy is especially effective for gout, arthritis, sciatica. The drug relieves morning stiffness and increases joint activity. It is forbidden to use NSAIDs for children under 14 years of age, during pregnancy, breastfeeding. You can not use the cream for skin diseases and hypersensitivity to the components of the drug.

It is permissible to apply the ointment within a month. But in the absence of noticeable improvements, a visit to the doctor is mandatory.

Gels "Nise" and "Ketonal"

There are few side effects of Nise Gel. A new generation non-steroidal agent effectively relieves joint pain and inflammation. But with diseases of the stomach, exacerbations of skin diseases, with peptic ulcers, the drug is contraindicated.

Rub this anti-inflammatory agent delicately, slowly, without pressure. Before application, problem areas are washed and wiped dry. The course of application of the gel is 10 days.

If other drugs do not work well enough, Ketonal gel is used. This remedy is powerful and works effectively against joint pain.

• In case of hypersensitivity to NSAID components, the gel cannot be used.
• The use of NSAIDs is also prohibited for adolescents under 15 years of age.
• You should not use Ketonal Gel for longer than 2 weeks without consulting a specialist.

There are two active substances in the composition of the non-steroidal ointment "Deep Relief". They mutually reinforce each other's action, relieving inflammation, swelling, pain. When applied, massage the gel to dryness, applying over the diseased joint.

Funds for children

Almost all anti-inflammatory creams and joint ointments are contraindicated for children and adolescents. But there are products with a milder effect, without side effects on the children's body. But before you start using these funds for a child, you should consult with a specialist. In this way, the negative consequences of treatment can be avoided.

Ointment "Traumeel S" is a homeopathic remedy based on plant extracts. It gently acts, improving the condition of the joints. Use for babies under 3 years is contraindicated.

On a plant basis and the drug "Alorom". But it is also designed for children over 3 years old. This drug will help against inflammation of the joints, relieve pain and remove swelling. The list goes on, but joint problems are unusual for children. Therefore, if you suspect a pathology, you should consult a doctor, and not self-medicate with the use of NSAIDs.

"Diklovit" and "Nurofen"

Cream "Diklovit" effectively relieves inflammation and reduces joint pain. The water-alcohol base provides additional pain relief.

The anti-inflammatory drug is applied externally with a thin layer over the affected area, gently massaging until completely absorbed. Only the doctor determines the exact dosage, duration of treatment. The course of joint treatment leaves a maximum of 2 weeks and is extended according to a medical prescription.

In case of intolerance to any substance from the NSAID group, the use of a non-steroidal gel or cream is prohibited. With caution, Diklovit ointment is used for cardio insufficiency and disorders of the liver and kidneys.

The side effect is manifested in the form of skin itching, allergies, swelling and redness. Excessive passion for the use of this drug provokes a rash, spasms of the bronchi, increased skin sensitivity to light.

Ointment "Nurofen" is indicated for problems with joints in adults and children over 12 years old. Apply this anti-inflammatory drug no more than 4 times a day with breaks of 4 hours. Rub the product until completely absorbed. If no improvement has occurred in 2 weeks, this cream is replaced with another drug.

Side effects with use are rare, but possible. They appear in the deterioration of appetite and the appearance of ulcers on the walls of the stomach with prolonged use of the cream.

Headaches, sleep disturbances, hyperexcitability are the consequences of exceeding the dosage of NSAIDs. With excessive enthusiasm for the anti-inflammatory drug, shortness of breath, the development of hypertension and heart rhythm disturbances are possible.

Skin rash, swelling, spasms are not excluded. Renal failure, cystitis, nephritis may occur. Anemia is also considered a side effect of joint treatment.

"Finalgel" and "Ketoprofen"

A contraindication to use and the cause of side effects remains the specific aroma of many effective non-steroidal drugs. This disadvantage is deprived of the anti-inflammatory drug "Finalgel". He relieves pain quickly. But such a tool is not universal. If NSAIDs are intolerant, you will have to look for another option for getting rid of joint disease. Under the supervision of a doctor, they use an ointment for pathologies of the lungs and nasal polyps.

Restrictions are possible with asthma and a tendency to allergies. A negative reaction of the immune system to the components of this cream is not excluded. Possible manifestations of a skin reaction in the form of a rash, peeling, dryness, redness. The list of negative consequences can go on and on. But with the manifestation of any symptom, it is necessary to change the drug and consult a specialist for help.

The main difference between "Ketoprofen" and other ointments is in the instantaneous effect of anesthesia. Healing and restoration of the joint begins only on the 3rd day of application.

Adverse negative reactions are practically excluded: this anti-inflammatory drug is completely eliminated from the body. After applying the gel, it is recommended to wash your hands. It is important to cover the treated areas from the sun's rays.

Balm "Horsepower"

Balsam "Horsepower" was created on the basis of natural ingredients. The composition of the product contains vitamin E, and mint oil, and lavender ether. Balm quickly relieves pain and is suitable for therapeutic massage.

Do not apply this drug to skin lesions, mucous membranes, sites of malignant tumors. Due to the irritating effect of the ointment, a negative reaction of sensitive skin is possible. Perhaps the appearance of a network of vessels, the formation of hematomas.

To eliminate unpleasant consequences, try the gel on a small area and leave for 12 hours. The universal tool starts working a quarter of an hour after application. It relaxes muscles, relieving pain and reducing joint inflammation. There are no restrictions on the duration of application: NPVS removes this condition.

NSAIDs with bee venom

A transparent gel with a lavender scent is Artosilen. The active substance is quickly absorbed. This drug acts as an analgesic and anti-inflammatory agent.

The action of the anti-inflammatory cream lasts for a day, but it is recommended to apply the drug twice a day to enhance the effect. The course of treatment is 10 days. To extend the use without negative consequences, a visit to the doctor is mandatory.

"Flexengel" has a similar effect. They can safely replace the drug NSAIDs: the composition is almost identical.

On the basis of bee venom, a non-steroidal drug "Apizartron" was developed. This remedy and anesthetizes, and relieves inflammation of the joint, and removes toxins from the focus of pathology.

The ointment is applied to the affected areas and massaged after redness or a feeling of warmth, slowly and intensively. After treatment, be sure to insulate problem areas. Treatment of PNVS will take from a week to a decade for acute pain. If the problem is chronic, the treatment time is increased.

It is forbidden to use this drug for oncology, mental illness and individual intolerance to the components of the ointment. Ointments based on bee venom "Ungavipen", "Apiveren" and "Virapen" act similarly.

There are many effective remedies for treating joints, relieving pain and reducing inflammation. But the choice of ointment on the "maybe" will not bring the desired results. To select an effective NSAID drug, you should seek the advice of a specialist.

Anti-inflammatory drugs for arthrosis and arthritis of the joints

What are the most effective anti-inflammatory drugs for joint diseases? What are their benefits, and is there any harm from them? How do these drugs affect the disease and condition of the joints, as well as the body as a whole? We will talk about this in this article.

Warning: self-medication can harm your body! Take only medicines prescribed by your doctor. Before using any medication, be sure to consult your doctor!

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most important groups of drugs for the treatment of diseases such as arthritis and osteoarthritis. The main function of these drugs is to reduce the level of inflammation in the joints, as well as reduce painful symptoms.

Unlike hormonal anti-inflammatory drugs (corticosteroids), NSAIDs do not contain hormones and have much fewer side effects on the body as a whole.

What is important for the patient to know before using NSAIDs

1. Despite the relative safety, most NSAIDs cannot be taken for long courses, since they have significant side effects and are contraindicated in many diseases of the gastrointestinal tract, liver, kidneys, and the cardiovascular system.

2. Anti-inflammatory drugs should not be used if the patient currently or in the past had diseases such as gastritis, peptic ulcer of the stomach and duodenum, colitis. Unfortunately, this group of drugs has an extremely negative effect on the mucous membranes, causing inflammation and even the formation of ulcers.

3. With great care, these drugs should be taken in diseases of the kidneys and liver. NSAIDs have a strong effect on renal blood flow, causing water and sodium retention, which can provoke not only an increase in blood pressure, but also serious disruption of the renal apparatus, as well as the liver.

4. Sometimes some people may experience individual reactions of intolerance or hypersensitivity to anti-inflammatory drugs, therefore, even in the absence of the above diseases, they should be taken very carefully and in small doses, gradually.

5. Before taking the remedy, read the entire instructions for it very carefully and act only in accordance with it.

6. In order to reduce the negative effect of NSAIDs on the gastric mucosa, take the tablets with as much liquid as possible - best of all with a whole glass of water. Try to use only water for drinking, because other liquids can interfere with the absorption of the medicine.

7. Be careful not to take two or even three different NSAIDs at the same time. The medicinal effect of this is unlikely to increase, but the number of side effects can easily multiply.

9. At the time of taking drugs from the NSAID group, it is recommended to refrain from drinking alcohol, since this greatly enhances the negative effect on the gastric mucosa.

10. And, finally, the most important advice: try not to self-medicate and take medicines for the treatment of joints, including these, only as directed and under the supervision of a doctor! This will avoid many complications when taking these medications and at the same time achieve the maximum therapeutic effect.

List of NSAIDs for joint diseases

All NSAIDs are divided into 2 large groups: inhibitors of cyclooxygenase type 1 and type 2, abbreviated as COX-1 and COX-2.

Aspirin or acetylsalicylic acid

This is not only the very first discovered drug from this group of drugs, but in general one of the oldest medical drugs: it continues to be used and prescribed, despite the fact that it has existed for more than a hundred years, and now there are many other synthesized and more effective drugs. It is with aspirin that the treatment of osteoarthritis often begins.

Despite the fact that this remedy is effective in many areas of medicine, it is usually weak for the treatment of arthrosis and arthritis, and, as a rule, it is quickly replaced with other medicines, or even treatment is started with other means.

Aspirin should be taken with caution in blood disorders, as it slows down blood clotting.

Diclofenac

Perhaps one of the most popular NSAIDs, created back in the 60s. Available in both tablet and ointment form. In this remedy for the treatment of arthrosis, both high analgesic activity and good anti-inflammatory properties are well combined.

Produced under the names Voltaren, Naklofen, Ortofen, Diklak, Diklonak P, Wurdon, Olfen, Dolex, Dicloberl, Klodifen and others.