Fleckerin belongs to the group of chondroprotectors and has analgesic, anti-inflammatory and antipyretic effect.
Available in hard gelatin capsules, one package contains 30 pieces of tablets.
Active substance Fleckerine diacerein refers to slow acting agents, the effect of which is visible only after 2-4 weeks from the beginning of admission and reaches clinical significance only after 1-1.5 months.
Article content
- Mechanism of action
- Pharmacokinetics of the drug
- When should I not take the medicine?
- Use in pediatrics and during pregnancy
- Taking capsules for kidney and liver disease
- Undesirable effects
- Treatment regimen
- Cases of overdose
- Drug compatibility
- Special instructions
- Storage and dispensing conditions
- From practical experience
- Alternative selection
Mechanism of action
The mechanism of action of the active substance of diacerein differs from the mechanism of action of NSAIDs. It does not inhibit the production of prostaglandins, 
therefore does not have gastroduodenal undesirable effects.
The anti-inflammatory effect of diacerein and its active metabolite is associated with inhibition of the synthesis of interleukin 1, a mediator that plays a significant role in the development of the inflammatory process and in the destruction of cartilage tissue in osteoarthritis.
In addition, they slow down the rate of formation of enzymes also involved in cartilage degeneration. At the same time, active substances increase the production of hyaluronic acid, collagen II, proteoglycans, chondrocytes, which help restore cartilaginous tissue and restore joint performance.
Pharmacokinetics of the drug
The rate of absorption of the drug is slowed down when applied simultaneously with food. At the same time, the active substance is 24% better absorbed into the full stomach.
In addition, lack of food in the stomach or a minimum amount increases the likelihood of side effects. Once in the body, diacerein is completely metabolized.
Bioavailability of its metabolites is 35-56%.The substance is excreted mainly in the urine. T1 / 2 is about 7-8 hours.
The drug has cumulative properties.
The drug is prescribed for essential and secondary osteoarthritis.
When should I take medicine?
Pharmaceutical Fleckcerin is contraindicated if the patient has:
- with increased sensitivity to the composition of the capsules;
- in case of an allergic reaction to anthraquinone in the anamnesis;
- intestinal obstruction;
- severe renal and hepatic insufficiency;
- when carrying a child;
- during breastfeeding;
- in children's practice to 18 years.
Since capsules contain lactulose as an auxiliary substance, they are also contraindicated:
- with congenital intolerance to galactose;
- for impaired absorption of glucose and galactose.
Use in pediatrics and during pregnancy
Pharmaceutical is not used in children's practice, as there is insufficient data on the safety of its use in persons under 18 years of age.
It is unknown whether the agent is embryotoxic, fetotoxic or teratogenic, so it is worth not to take it during pregnancy, especially since active metabolites penetrate the placenta.
The active substance is found in breast milk, so you need to either refuse from natural feeding or from treatment with this drug.
Taking capsules for kidney and liver disease
Even in severe liver disorders, dose adjustment is not required. But constant medical control over the liver function during treatment is necessary, since the active substance increases the activity of hepatic enzymes.
In severe kidney diseases, when the clearance is less than 30 ml / min, the daily dosage of the drug should not exceed 50 mg.
Adverse Effects
As a rule, in most cases the pharmaceutical is well tolerated. 
But sometimes the following side effects may occur when taking the drug:
- allergy : urticaria, itching, Quincke's edema, bronchospasm, anaphylaxis( requires drug cancellation and correction of therapy);
- loose stools, epigastric pains, nausea ( will pass within a month from the beginning of treatment, require a dose reduction until the patient's gastrointestinal tract adapts to the drug);
- weakness ;
- liver inflammation ( observed rarely, requires immediate withdrawal of funds);
- staining the urine in yellow or brown ( depending on the pH of the urine, it has no clinical significance, does not require a dose reduction or drug withdrawal).
Treatment Scheme
In the first 15-30 days, while adaptation of the digestive tract to the new drug is in progress, it should be drunk 1 capsule 1 time per dinner. After this time, the frequency of reception is increased to 2 times a day.
Patients with chronic renal failure receive a dose of 50 mg per day. Take it in the evening with a meal.
Capsules should be swallowed during meals, wholly, without chewing. The duration of therapy is selected individually, but it should not be less than six months.
At the beginning of treatment, since there is a later onset of the therapeutic effect, it is advisable to combine the reception of Fleczerin with non-steroidal anti-inflammatory drugs, such as Movalis.
Cases of overdose
When an overdose of the drug is observed, weakness and loose stools. In this case, reception of adsorbents( Neosmectin, Polyphepan) and solutions correcting the water-salt balance of the organism( minerals without gas, Regidron) is shown.
In the first few hours after poisoning is shown a gastric lavage with warm boiled water. There is no specific antidote.
Drug compatibility
Simultaneous reception with NSAIDs and non-narcotic analgesics enhances the therapeutic effect of each other.
Do not take in parallel capsules with antacid agents containing magnesium and aluminum hydroxide, laxatives and dietary fiber. All of them worsen the absorption of diacerein.
Appointment of the drug on the background of chemotherapy and taking antibiotics will lead to increased side effects and a decrease in the adsorption of the drug. Therefore, while taking any medications that suppress the microflora from taking the drug, it is worth noting.
Special instructions
There is no negative effect of the active substance on the ability to drive vehicles and work with dangerous machinery.
During treatment, since it may last for 1 year, it is necessary to take an overall urinalysis, an expanded blood test, and blood for biochemistry to determine hepatic enzymes once every 3 months.
Urine staining makes it difficult to perform a series of tests, for example, on determining the glucose level in urine.
Storage and dispensing from pharmacies
The drug is banned for non-prescription drugs. Store pharmaceuticals in a place inaccessible to children, protected from direct sunlight and a maximum temperature of 25 degrees.
From the practical experience of using
Reviews of doctors and ordinary people.
Knee joints are very painful. The rheumatologist has written out Flekserin, I drink it or him 3 months of effect a zero.
Rose, Kazan
I suffer from osteoarthritis. I went through one course of treatment with Fleczerin, I drank half a year, now I took a break. I feel good, no pain.
Svetlana, Moscow
The preparation Fleckerin produces the Kiev vitamin plant. Unlike the original drug or European analogs, it does not always help. To say unequivocally, with what it is connected it is impossible.
This can be either due to a poor quality feedstock or because of the auxiliary components that can change the pharmacokinetics of the preparation.
Maxim Aleksandrovich, rheumatologist
Alternative choice
Today pharmacies have the following Fleczerin analogs for the pharmaceutical group: 
- Movalis;
- Butadione;
- Nurofen;
- Structur.
Also available are the complete or structural analogs of the drug:
- Arthrodar;
- Arthroker;
- Diamax.
Before replacing one drug with another, consult a specialist. The drug is released strictly according to the prescription of the doctor and treatment is possible only for the doctor's prescription.
