Indications.

• Inflammatory and degenerative forms of rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, spondyloarthritis)
• pain syndromes from the spine;
• rheumatic diseases of extra-articular soft tissues
• acute attacks of gout
• post-traumatic and postoperative pain syndromes accompanied by inflammation and swelling, for example, after dental and orthopedic interventions
• gynecological diseases accompanied by pain and inflammation, such as primary dysmenorrhea or adnexitis;
• as an adjuvant for severe inflammatory diseases of the ENT organs, accompanied by severe pain, for example, pharyngotonsillitis, otitis media. In accordance with general therapeutic principles, the underlying disease should be treated with basic therapy. Fever as a symptom is not an indication for the use of the preparation.

Contraindications.

• acute stomach or intestinal ulcer; gastrointestinal bleeding or perforation;
• a history of bleeding or perforation of the gastrointestinal tract associated with previous treatment with nonsteroidal anti-inflammatory preparations (NSAIDs)
• active peptic ulcer/bleeding or history of recurrent peptic ulcer/bleeding (two or more separate episodes of diagnosed ulcer or bleeding)
• III trimester of pregnancy;
• inflammatory bowel diseases (such as Crohn's disease or ulcerative colitis);
• liver failure (Child-Pugh class C, cirrhosis or ascites)
• renal failure (creatinine clearance <15 ml/min/1.73 m2)
• congestive heart failure (NYHA II-IV);
• coronary heart disease in patients with angina pectoris who have had myocardial infarction
• cerebrovascular diseases in patients who have suffered a stroke or have episodes of transient ischemic attacks;
• peripheral artery disease
• treatment of PERIOPERATIVE pain during coronary artery bypass grafting (or use of a heart-lung machine)
• Like other NSAIDs, diclofenac is also contraindicated in patients who, in response to the use of ibuprofen, acetylsalicylic acid or other NSAIDs, experience attacks of bronchial asthma, angioedema, urticaria or acute rhinitis, nasal polyps and other allergic symptoms.

Method of administration and dose.