When choosing anti-inflammatory drugs for therapy for various pathologies of the musculoskeletal system, the question may arise of choosing between the drugs Movalis or Diclofenac: which helps better and is preferable to use. To find out the answers to these questions, it is necessary to study the pharmacological characteristics of medications and review the results of clinical studies to compare these medications.
Treatment of pathologies of the musculoskeletal system
Anti-inflammatory drugs are basic in the treatment of a large number of diseases of the musculoskeletal system, including degenerative pathologies. Non-steroidal drugs, which include Movalis and Diclofenac, have a pronounced therapeutic effect, but also have side effects . The main undesirable effect when using these drugs is a negative effect on the organs of the digestive system. Therefore, non-steroidal anti-inflammatory drugs are not prescribed for more than 10 days.
Compound similarities
Non-steroidal drugs with anti-inflammatory activity (NSAID group) are used as active components in the drugs under consideration. The additional composition of the drugs is also identical. So, in tablets in both cases the auxiliary content is presented:
- lactose monohydrate;
- microcellulose;
- magnesium stearate;
- silicon dioxide.
In addition to these compounds, Movalis contains the dihydrate form of sodium citrate and povidone. Diclofenac contains starch and has an enteric film coating consisting of methacrylate, macrogol, talc, titanium dioxide and E172 dye.
Therapeutic effect of Diclofenac and Movalis
Diclofenac and Movalis are commonly prescribed medications that have a similar spectrum of actions, including anti-inflammatory, analgesic and antipyretic. But still, the effects of these drugs are different.
Diclofenac is a non-selective cyclooxygenase inhibitor, which is responsible for the greater number of possible negative reactions. Movalis is a selective inhibitor of cyclooxygenase type 2, and therefore there is no negative effect on the gastrointestinal tract when used. This is the main, but not the only difference in the action of drugs .
The pharmacological characteristics of each drug will help to identify the similarities and differences between the effects of Diclofenac and Movalis.
Pharmacological characteristics of the drug Diclofenac
Diclofenac has the following effects:
- anti-inflammatory;
- antipyretic;
- antiaggregation;
- analgesic;
- antirheumatic.
All these actions are possible due to inhibition of the enzyme cyclooxygenase. Because of this, the biochemical reactions of the arachidonic cascade become impossible, which causes a disruption in the synthesis of prostaglandins, leukotrienes, thromboxane and prostacyclin. The release of enzymes from lysosomes is blocked, and the aggregation of blood platelets is suppressed.
When the medication is used internally, complete resorption occurs; food intake can provoke a decrease in the rate of absorption, but does not have a depressing effect on its usefulness. Achieving the maximum concentration of a bioactive substance in plasma may differ depending on the dosage form:
- when taken orally in a short-acting tablet form, Cmax is achieved after 1-2 hours;
- when taken orally in a tablet form of prolonged action - after 5 hours;
- for intramuscular administration - after 10-20 minutes;
- for rectal administration - after half an hour.
Diclofenac binds to plasma proteins almost completely (99%). The bioactive substance enters the synovial fluid and tissues, where the increase in concentration will be somewhat slower. When applied topically, Diclofenac reaches the site of pathology through the skin.
About a third of the drug is excreted in the feces in a metabolized form, the remaining two-thirds undergo biotransformation in liver cells and are excreted in the urine.
Diclofenac has a more pronounced anti-inflammatory effect than acetylsalicylic acid, ibuprofen, butadione, and indomethacin.
Diclofenac helps relieve pain in the joints at rest and during movement, eliminates stiffness in the joints in the morning, their swelling, and the effect of the drug is aimed at improving the functionality of the joints. For post-traumatic and postoperative inflammation, the drug relieves pain and reduces swelling of the affected area. In the case of course use of Diclofenac for polyarthritis, the concentration of the active substance in articular and periarticular tissues is higher than in plasma.
The medicine is prescribed for the treatment of various diseases:
- inflammatory joint pathologies (gout, rheumatoid arthritis, rheumatoid arthritis, ankylosing spondylitis);
- degenerative-dystrophic pathologies (osteochondrosis, osteoarthritis);
- neuralgia, myalgia, sciatica, lumbago;
- pathological conditions of periarticular tissues (bursitis, tendovaginitis, rheumatic lesions of muscle tissue);
- post-traumatic and postoperative pain syndromes;
- adnexitis;
- migraine attacks;
- hepatic and renal colic;
- infectious and inflammatory pathologies of the respiratory system.
In forms for topical use, Diclofenac is prescribed for the correction of injuries to muscle tissue, tendons, ligaments and joints, and local forms of rheumatism. In the form of eye drops, the drug is used for the treatment of non-infectious conjunctivitis and for some operations on the organs of vision.
Contraindications to the use of Diclofenac:
- stomach ulcer;
- disorders of hematopoietic processes;
- exacerbation of intestinal inflammation;
- “aspirin” asthma;
- child's age up to 6 years;
- the period of bearing a child (especially the last trimester).
The prescription of this medication is limited for diagnosed disorders of the functionality of the kidneys and liver, heart failure, porphyria, lactation and during professional activities with a high concentration of attention.
Adverse reactions to Diclofenac:
- digestive disorders (vomiting, nausea, constipation, diarrhea, flatulence);
- NSAID gastropathy (erythema, erosion, ulcers in the antrum of the stomach);
- erosions, ulcers in the intestines;
- bleeding;
- pancreatitis;
- liver dysfunction (drug-induced hepatitis);
- impaired renal function (nephritis, rarely - failure);
- headaches and dizziness, irritability, excessive fatigue;
- local manifestations of allergies: exanthema, erythema, erosion, ulcers;
- systemic anaphylaxis;
- disorders of the hematopoietic organs (anemia, leukopenia, thrombocytopenia);
- increased blood pressure;
- convulsive conditions;
- in the case of intramuscular injection - the formation of abscesses, necrotic changes in adipose tissue;
- in the case of rectal administration - mucous-bloody discharge from the rectum, painful defecation.
To minimize the risk of side effects, when using Diclofenac, you should regularly donate blood for a general analysis to determine the formula and for a biochemical analysis to assess the functional state of the liver and a stool test for occult blood.
Useful video
Watch this video about the mechanism of action, indications and contraindications for the use of the drug Movalis:
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Pharmacological characteristics of the drug Movalis
Spectrum of pharmacological effects of Movalis:
- anti-inflammatory;
- antipyretic;
- analgesic.
Structurally, Movalis is a derivative of enolic acid. The mechanism of action of the drug is based on the selective inhibition of type 2 cyclooxygenase. Due to the selectivity of the effect on various forms of the enzyme, the severity of undesirable reactions from the digestive system is reduced.
When administered intramuscularly, absorption of the active substance occurs completely. The maximum concentration of meloxicam in plasma is one hour after entering the body.
The bioavailability of the drug when taken orally in tablet form reaches 89%. Maximum concentration in plasma when taken orally occurs after 5-6 hours. The intake of food does not impair the absorption of the drug.
When using rectal suppositories, the maximum concentration of the bioactive substance in plasma occurs after 5 hours. Therefore, suppositories are bioequivalent to the tablet form of the drug. Movalis is able to enter the synovial fluid, the local concentration is about 50% of the content in plasma.
The drug is excreted from the body in feces and urine in a metabolized form; less than 5% is excreted in unchanged form.
Movalis is prescribed in the following cases:
- for rheumatoid arthritis;
- with ankylosing spondylitis;
- for osteoarthritis and other degenerative pathologies.
Contraindications for use:
- hypersensitivity to the bioactive substance and auxiliary components of the drug;
- a history of bronchial asthma, skin manifestations of hypersensitivity or angioedema while taking non-steroidal anti-inflammatory drugs;
- stomach ulcer;
- ulcerative colitis;
- impaired liver function;
- impaired kidney function;
- pathologies of the blood coagulation system;
- heart failure;
- periods of childbearing and breastfeeding;
- injection solution is not prescribed to children under 18 years of age;
- Rectal suppositories and tablet forms are not prescribed to children under 12 years of age.
List of adverse reactions:
- disruption of hematopoietic processes (manifest in the form of anemia, leukopenia, thrombocytopenia);
- anaphylactic reactions;
- headaches and dizziness, sleep disturbances, mood swings;
- esophagitis, gastritis, colitis, stomach and duodenal ulcers;
- impaired liver function, hepatitis;
- dermatitis, photosensitivity, erythema, rashes, itching;
- bronchial “aspirin” asthma;
- renal failure, nephritis;
- impaired vision function, conjunctivitis.
In the case of a course of Movalis, to minimize side effects, the functional state of the hematopoietic system, liver, and organs of the digestive system should be monitored.
Results of clinical studies of the effectiveness of Movalis and Diclofenac
To identify the preferred drug, studies were carried out on the effectiveness of Diclofenac and Movalis and compared therapeutic results and side effects. In 2001, N. A. Shostak and D. A. Shemetov published the results of a study of the effect of drugs on patients with osteochondrosis of the lumbosacral spine , complicated by severe pain .
The effectiveness of Diclofenac was studied in the treatment of 24 patients, Movalis - 30. The study revealed that Movalis and Diclofenac have a similar rate of achieving an analgesic effect and comparable overall effectiveness . However, the advantage of Movalis is its greater safety with regard to the likelihood of side effects from the digestive system.
Movalis is just as effective, but safer than Diclofenac, a non-steroidal anti-inflammatory drug, and therefore it can be recommended as a good drug for the treatment of patients with pathologies of the musculoskeletal system.
Can be used for the following joint diseases
- Arthritis
- Arthrosis
- Osteoarthritis
- Osteochondrosis
Treatment is not possible if you are hypersensitive to the substances contained in the medication. Movalis is prescribed extremely rarely for older people, as well as for those who have problems with the kidneys and heart. Before prescribing a medicine, the doctor must carefully study the patient's medical history.
Comparison of drug costs
The question of the price of medicines in a number of situations is decisive in the issue of choosing a drug. The approximate price for different forms of Diclofenac and Movalis is shown in the table.
| The drug and its form | approximate price |
| Diclofenac | |
| Pills | 20 pieces - 40-70 rubles |
| Solution for intramuscular injection | 30-70 rubles |
| Suppositories | 60-250 rubles |
| Ointments and gels | 30-150 rubles |
| Movalis | |
| Pills | 20 pieces - 650-800 rubles, 10 pieces - 500-600 rubles |
| Solution for intramuscular injection | 5 ampoules - 900 rubles, 3 ampoules - 650 rubles |
| Suppositories | 300-350 rubles |
Of course, the cost of various forms of Diclofenac is several times less than the cost of similar forms of Movalis, which is why it is purchased by patients more often. However, if the doctor prescribed Movalis, it means that in a specific clinical situation it is more appropriate to use this drug.
When answering the question: Movalis or Diclofenac - which is better, reviews should not be decisive in making a specific decision. Only a specialist who is treating the patient can choose the right medication. Self-prescription of a particular medication can aggravate the condition due to the development of side effects from many organ systems, so you should be especially careful and follow all medical recommendations.
