Voveran SR: Sustained Relief for Chronic Musculoskeletal Pain
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Synonyms | |||
Voveran SR (diclofenac sodium sustained release) is a nonsteroidal anti-inflammatory drug (NSAID) specifically engineered for the long-term management of moderate to severe pain and inflammation associated with chronic musculoskeletal and joint disorders. Its advanced sustained-release formulation ensures a steady plasma concentration, providing consistent therapeutic effect over a 24-hour period with a single daily dose. This makes it a cornerstone in treatment plans for conditions like osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, where continuous symptom control is paramount for improving patient mobility and quality of life. Prescription-only, it should be used under strict medical supervision to maximize efficacy and minimize risks.
Features
- Active ingredient: Diclofenac sodium (100 mg per tablet)
- Pharmaceutical form: Film-coated, sustained-release tablet
- Mechanism: Dual inhibition of cyclooxygenase (COX-1 and COX-2) enzymes
- Release profile: Designed for gradual API release over 12–24 hours
- Excipients: Includes hypromellose, lactose monohydrate, magnesium stearate, and silicon dioxide
- Packaging: Blister strips of 10 tablets, typically in boxes of 30 or 60
Benefits
- Provides around-the-clock analgesia and anti-inflammatory action from a single daily dose, enhancing compliance.
- Reduces stiffness, swelling, and tenderness in affected joints, improving functional capacity.
- Enables sustained suppression of prostaglandin synthesis, targeting the root cause of inflammation.
- Supports long-term management of chronic arthritic conditions, helping delay disease progression.
- Minimizes peak-trough plasma fluctuations, potentially reducing incidence of concentration-dependent adverse effects.
- Facilitates restorative sleep and daily activity by controlling nighttime and morning symptoms effectively.
Common use
Voveran SR is primarily indicated for the symptomatic treatment of chronic inflammatory and degenerative forms of rheumatism, including osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It is also used in the management of acute musculoskeletal disorders such as periarthritis (e.g., frozen shoulder), tendinitis, bursitis, and low back pain. Its sustained-release profile makes it unsuitable for acute, short-term pain relief (e.g., postoperative or dental pain), where immediate-release formulations are preferred. Use is generally reserved for adults and should be initiated at the lowest effective dose for the shortest duration necessary to control symptoms.
Dosage and direction
The recommended dosage for adults is one 100 mg sustained-release tablet once daily, taken whole with a sufficient amount of water (at least 150 mL). It should be swallowed during or after a meal to reduce gastrointestinal irritation. Tablets must not be chewed, crushed, or divided, as this disrupts the sustained-release mechanism and may lead to overdose. For elderly patients or those with mild hepatic or renal impairment, a lower dose (e.g., 75 mg if available) may be advised. Treatment duration should be regularly evaluated by a physician; long-term use requires periodic monitoring of renal, hepatic, and hematological parameters.
Precautions
Use with caution in patients with a history of gastrointestinal disorders (e.g., ulcers, bleeding), cardiovascular disease (e.g., hypertension, heart failure), or renal or hepatic impairment. Avoid concomitant use with other NSAIDs, including over-the-counter products like aspirin or ibuprofen. Patients should be advised to report any signs of GI bleeding (e.g., melena, hematemesis), skin reactions, edema, or unexplained weight gain. Regular blood pressure checks are recommended during therapy. Use during pregnancy, especially in the third trimester, is contraindicated due to risk of premature closure of the ductus arteriosus.
Contraindications
Hypersensitivity to diclofenac, other NSAIDs, or any excipients in the formulation. Patients with active peptic ulceration or gastrointestinal bleeding. Severe heart failure (NYHA Class IV), ischemic heart disease, peripheral arterial disease, or cerebrovascular disease. Severe hepatic impairment (Child-Pugh Class C) or severe renal impairment (eGFR <30 mL/min/1.73m²). Third trimester of pregnancy. History of asthma, urticaria, or allergic-type reactions induced by NSAIDs.
Possible side effects
Common (≥1/100 to <1/10):
- Gastrointestinal: Epigastric pain, nausea, dyspepsia, diarrhea, flatulence
- CNS: Headache, dizziness
- Dermatological: Pruritus, rash
Uncommon (≥1/1,000 to <1/100):
- GI ulceration or bleeding, elevated liver enzymes, edema, hypertension
Rare (≥1/10,000 to <1/1,000):
- Severe cutaneous adverse reactions (e.g., Stevens-Johnson syndrome), bronchospasm, acute renal injury, hepatitis
Very rare (<1/10,000):
- Anaphylactoid reactions, agranulocytosis, aplastic anemia, congestive heart failure
Drug interaction
- Anticoagulants (e.g., warfarin): Increased risk of bleeding.
- ACE inhibitors/ARBs: Reduced antihypertensive effect; risk of worsened renal function.
- Diuretics: Reduced efficacy; risk of acute kidney injury.
- Lithium: Increased lithium plasma levels and toxicity.
- Methotrexate: Increased methotrexate toxicity.
- Cyclosporine: Increased nephrotoxicity.
- SSRIs/SNRIs: Increased risk of GI bleeding.
- Other NSAIDs or corticosteroids: Additive GI toxicity.
Missed dose
If a dose is missed, it should be taken as soon as remembered, unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not take a double dose to make up for a missed one, as this increases the risk of adverse effects.
Overdose
Symptoms may include headache, nausea, vomiting, epigastric pain, GI bleeding, drowsiness, tinnitus, or rarely, seizures, acute renal failure, or respiratory depression. There is no specific antidote. Management is supportive and symptomatic: gastric lavage or activated charcoal may be considered if presented within 1 hour of ingestion. Hemodialysis is not effective due to high protein binding. Monitor and support vital functions, especially renal and respiratory systems.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep in the original blister pack until use to maintain stability. Keep out of reach of children. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis, treatment decisions, and personalized dosing. Do not initiate, adjust, or discontinue medication without medical supervision. The prescribing physician should be aware of the patient’s full medical history and concurrent medications.
Reviews
Clinical studies and meta-analyses consistently demonstrate the efficacy of diclofenac sustained-release formulations in reducing pain and improving physical function in osteoarthritis and rheumatoid arthritis over placebo. In a 12-week randomized controlled trial, Voveran SR 100 mg once daily showed significant improvement in WOMAC pain and stiffness scores compared to baseline (p<0.01). Tolerability profile is consistent with the NSAID class; GI events were the most frequently reported adverse effects. Long-term observational data support its use in chronic settings, though caution is advised in at-risk populations.
– Based on aggregated clinical trial data and therapeutic guidelines.