Index
It belongs to a group of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). It works by reducing hormones that cause inflammation and pain in the body.
Similarly, dolten ophthalmic (for the eye) is available, used to relieve itchy eyes caused by seasonal allergies.
Dolton ophthalmic is also used to reduce swelling, pain, burning, or stinging after cataract surgery or corneal refractive surgery.
Indications
The patient should carefully consider the potential benefits and risks of molten and other treatment options before using the drug.
The lowest effective dose should be used for the shortest time possible and consistent with the patient’s treatment goals.
For sharp odor in adult patients
Dolton is indicated for the short-term treatment (5 days or less) of acute or moderately severe pain requiring opioid-level analgesia, usually in a postoperative setting.
The total combined duration of use of molten by injection and molten by mouth should not exceed five days of use.
If it exceeds five days, there is the possibility of increasing the frequency and severity of adverse reactions associated with the recommended doses.
Patients should be switched to alternative pain relievers as soon as possible, but treatment with molten should not exceed the recommended days.
Dolton injection has been used in conjunction with morphine and meperidine and has shown an opioid-sparing effect.
How should it be used?
Dolton should be used as directed by a physician. You need to check the drug label for exact dosing instructions.
The molten comes with an additional information sheet for the patient called a medication guide; the person should read it carefully and consult with a doctor about any doubts.
It is used orally and as an injectable form for the short-term relief (3 to 5 days) of moderately severe pain.
It is also used as eye drops to prevent and treat pain and swelling in the eye after eye surgery.
The drug is also given through the nose. Before using each bottle for the first time, it must be prepared. This the patient must:
- Remove the clear plastic cover and the blue plastic safety clip.
- Keep the bottle at arm’s length.
- With your index and middle fingers on the top of the bottle and your thumb on the bottom, press down evenly and release the pump five times.
- The bottle is now ready to use.
To use this nasal spray which gently blows the nose, the patient must:
- Sit up straight or stand up and lean your head slightly forward.
- Place the tip of the spray container on your nose.
- Make sure to point the container away from the center of your nose.
- Breathe gently through the nostril and squeeze the spray can.
- If the dose requires two jets, the process should be repeated for the other nostril.
- Replace the clear plastic cover after each use.
It is essential to know that molten is not for treating mild to moderate or chronic pain (e.g., headache).
Contact with the eyes should be avoided. If this happens, the patient should rinse with water. If eye irritation occurs and persists for more than one hour, it is necessary to contact a doctor.
Each bottle contains a day’s supply of molten. It is recommended to discard each bottle within 24 hours of opening it, even if it still includes any unused medicine.
If the patient misses a dose and takes it regularly, they should take it as soon as possible.
If it is almost time for the next dose, the missed dose should be discarded and returned to your regular dosing schedule. You should not take two doses at the same time.
Description
Each ml of molten injection contains the following excipients:
- Sodium chloride 4.35 mg.
- Alcohol (equivalent to absolute alcohol).
- Water for injections.
Dosage
The tablet presentation is recommended for short-term use only, that is, up to 7 days, and is not recommended for chronic use.
Adults
- It is recommended to take 10 mg every 4 to 6 hours. Doses greater than 40 mg per day are not recommended.
- The total combined daily dose for patients receiving a formulation change should not exceed 90 mg (60 mg for patients with renal impairment and less than 50 kg).
- In the previous case, the oral components should not exceed 40 mg on the day the formulation change is made.
- Patients should be converted to oral therapy as soon as possible.
Elderly
- The dose should be 60 mg; a longer dose interval is recommended, for example, 6 to 8 hours.
- The lower limit of the dosage range is recommended for patients over 65 years of age.
Dolton injection can be used in single or multiple doses to treat acute or moderately severe pain requiring opium-level analgesia, usually in the postoperative setting.
Hypovolaemia must be corrected before administration of molten. Patients should switch to alternative pain relievers as soon as possible.
Two formulas are presented when administering molten injection (IV and IM). The molten IV should be given no less than 15 seconds, and the endow IM should be given slowly and deep into the muscle.
The analgesic effect begins in approximately 30 minutes with a maximum effect in 1 to 2 hours after dosing. The duration of the analgesic effect is usually 4 to 6 hours.
It is essential to know the recommended dose of each formula according to the patient.
Treatment of molten IM:
- In the elderly (65 years or older) with renal impairment and body weight less than 50 kg, the recommended dose is 30 mg.
- For the elderly under 65 years, the single dose of 60 mg.
Treatment of molten IV:
- In older adults 65 years of age or older, with renal impairment and with a body weight less than 50 kg, the recommended dose is 15 mg.
- For the elderly, under 65 years the recommended single dose is 30 mg.
For multiple-dose treatment in elderly 65 years or older, with renal impairment and with bodyweight 50 kg, the recommended dose is 15 mg every 6 hours (should not exceed 60 mg).
Patients under 65 years of age should receive 30 mg every 6 hours. The maximum daily dose should not exceed 120 mg.
The dose or frequency of molten injection should not be increased for breakthrough pain.
For children, the safety and efficacy of Dolten have not been studied in children under 16 years of age.
Interactions
Dolton slightly reduces the plasma protein binding of warfarin.
In vitro studies indicate that at the therapeutic concentration of salicylate, the molten binding is reduced from approximately 99.2 to 97.5%.
This represents a potential two-fold increase in unbound plasma molten levels.
Dolton has been reported to reduce the diuretic response to furosemide in normovolemic individuals by approximately 20%.
Concomitant administration of dolten and probenecid results in decreased clearance of dolten and a significant increase in plasma levels of Dolton.
An increase in plasma lithium concentration has been reported due to the inhibition of renal lithium clearance.
There have been some reports of elevated plasma lithium levels with molten.
There are reports of possible interaction of molten and non-depolarizing muscle relaxants, leading to apnea.
Concomitant use of molten and angiotensin-converting enzyme inhibitors may increase the risk of renal failure, particularly in volume-depleted patients.
Very few seizures have been reported with concomitant use of dolten and antiepileptic drugs.
There have been hallucinations when dolten is used concomitantly with psychoactive drugs.
In laboratory tests, molten inhibits platelet aggregation and may prolong bleeding time.
Some foods reduce the speed of action but not the degree of absorption.
Side effects
Adverse reaction rates increase with higher doses of dolten. Professionals should be on the lookout for severe complications of treatment, such as:
- Gastrointestinal ulceration.
- Hemorrhage.
- Postoperative bleeding.
- Acute kidney failure.
- Anaphylactic and anaphylactoid reactions.
- Liver failure.
These NSAID-related complications can be severe in certain patients, mainly when the drug is misused, for whom molten is indicated.
In patients taking molten or other NSAIDs in clinical trials, the most commonly reported side effects in about 1% to 10% of patients are:
Body in general
- Fever.
- Infections
- Sepsis.
- Pallor.
Cardiovascular
- Congestive heart failure
- Palpitations
- Tachycardia.
- Syncope.
Dermatological
- Alopecia.
- Photosensitivity.
- Urticaria.
Gastrointestinal
- Anorexia.
- Dry mouth.
- Belching
- Esophagitis.
- However excessive.
- Gastritis.
- Glosses.
- Hematemesis.
- Hepatitis.
- Increased appetite
- Jaundice.
- Rectal bleeding.
Hematic and Lymphatic
- Equipoise.
- Eosinophilia.
- Epistaxis.
- Leucopenia.
- Thrombocytopenia
Metabolic and Nutritional
- Weight change.
Nervous system
- Abnormal dreams
- Abnormal thoughts
- Anxiety.
- Asthenia.
- Confusion.
- Depression.
- Euphoria.
- Hallucinations
- Hyperkinesia.
- Inability to concentrate
- Insomnia.
- Nervousness.
- Paraesthesia
- Drowsiness.
- Stupor.
- Tremors
- Vertigo.
Female reproductive system
- Infertility
Respiratory system
- Asthma.
- To.
- Dyspnoea.
- Pulmonary edema.
- Rhinitis.
Senses
- Abnormal taste
- Abnormal vision
- Blurry vision.
- Hearing loss.
Urogenital
- Cystitis.
- Dysuria.
- Hematuria.
- Increased urinary frequency.
- Interstitial nephritis.
- Oliguria o polyuria.
- Proteinuria.
- Urinary retention.
Other reactions rarely observed by some patients are:
Body in general
- Angioedema.
- Death.
- Hypersensitivity reactions such as anaphylaxis.
- Anaphylactoid reaction.
- Laryngeal edema.
- Edema of the tongue.
- Myalgia.
Cardiovascular
- Arrhythmia.
- Bradycardia.
- Chest pain.
- Redness
- Hypotension
- Myocardial infarction.
- Vasculitis.
Dermatological
- Exfoliative dermatitis.
- Erythema multiforme.
- Lyell’s syndrome.
- Toxic epidermal necrolysis.
Gastrointestinal
- Acute pancreatitis.
- Liver failure.
- Ulcerative stomatitis.
- Exacerbation of inflammatory bowel disease (ulcerative colitis, Crohn’s disease).
Hematic and Lymphatic
- Agranulocytosis.
- Aplastic anemia.
- Hemolytic anemia.
- Lymphadenopathy
- Pancytopenia
- Postoperative bleeding from the wound (rarely requiring blood transfusion).
Metabolic and nutritional
- Hyperglycemia
- Hyperkalemia.
- Hyponatremia.
Nervous system
- Aseptic meningitis.
- Seizures
- Coma.
- Psychosis.
- Respiratory system
- Broncoespasmo.
- Respiratory depression
- Pneumonia.
Senses
- Conjunctivitis.
Urogenital
- Flank pain with or without hematuria and azotemia.
- Hemolytic uremic syndrome.
An observational, non-randomized, post-marketing study involved approximately 10,000 patients receiving molten.
The study demonstrated that the risk of clinically severe gastrointestinal bleeding depended on the administered dose.
This was particularly true in elderly patients who received an average daily dose of more than 60 mg per day of molten.
Contraindications
Dolton is contraindicated in patients:
- With previously demonstrated hypersensitivity to molten.
- With active peptic ulcer.
- With recent gastrointestinal bleeding or perforation.
- With a history of peptic ulcer or gastrointestinal bleeding.
- After taking aspirin or other NSAIDs, those have experienced asthma, hives, or allergic-type reactions.
- With advanced renal failure or patients at risk of renal failure due to volume depletion.
- Pregnant women since its inhibitory effect on prostaglandin synthesis can affect fetal circulation and inhibit uterine muscles, thus increasing the risk of uterine bleeding.
- With suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis, and those at high risk of bleeding as it inhibits platelet function.
- I am currently receiving aspirin or NSAIDs due to the cumulative risks of inducing severe adverse events related to NSAIDs.
In its form of treatment, molten is contraindicated:
- As a prophylactic pain reliever before any major surgery.
- For the treatment of perioperative pain in coronary artery bypass grafting.
- Concomitant use of Dolten SL Tromethamine and probenecid.
- Concomitant use of Dolten SL Tromethamine and pentoxifylline.
- Dolton SL Tromethamine injection for neuraxial (epidural or intrathecal) administration due to its alcohol content.
