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Troximetacin (Gel) Instructions for Use

Marketing Authorization Holder

Danson-BG (Bulgaria)

Manufactured By

Vetprom, AD (Bulgaria)

ATC Code

M01AB51 (Indomethacin in combination with other drugs)

Active Substances

Troxerutin (Rec.INN registered by WHO)

Indometacin (Rec.INN registered by WHO)

Dosage Form

Bottle OTC Icon Troximetacin Gel for external use 30 mg+20 mg/1 g: tubes 40 g or 50 g

Dosage Form, Packaging, and Composition

Gel for external use from yellow to yellow-brown in color, homogeneous, transparent.

1 g
Indomethacin 30 mg
Troxerutin 20 mg

Excipients: carbomer – 15 mg, disodium edetate – 0.5 mg, sodium benzoate – 2.5 mg, macrogol 400 – 522 mg, isopropanol – 150 mg, dimethyl sulfoxide – 150 mg, purified water – 110 mg.

40 g – aluminum tubes (1) – cardboard packs.
50 g – aluminum tubes (1) – cardboard packs

Clinical-Pharmacological Group

Drug with anti-inflammatory and angioprotective action for external use

Pharmacotherapeutic Group

Topical anti-inflammatory agent

Pharmacological Action

A combined drug containing Indomethacin and Troxerutin.

Indomethacin has a pronounced anti-inflammatory, analgesic, and anti-edematous action. This leads to pain relief, reduction of swelling, and shortening of the recovery time for damaged tissues. The main mechanism of action is associated with the suppression of prostaglandin synthesis through reversible blockade of COX-1 and COX-2.

Troxerutin (trihydroxyethylrutoside) is a bioflavonoid that has an angioprotective effect. It reduces capillary permeability and exhibits a venotonic action. It blocks the venodilatory action of histamine, bradykinin, and acetylcholine. It acts anti-inflammatory on perivenous tissue, reduces capillary fragility, and has some antiplatelet action. It reduces swelling, improves trophism in pathological changes associated with venous insufficiency.

Pharmacokinetics

The gel base used ensures the solubility and release of indomethacin and troxerutin.

The gel dosage form containing Indomethacin and Troxerutin is well absorbed from the skin surface and provides the therapeutic effect of the drug.

When applied to the skin, concentrations close to therapeutic levels are achieved in the subcutaneous tissue and periarticular tissues. The penetration of the active components of the drug into the systemic circulation is clinically insignificant.

Indications

As part of complex therapy for chronic venous insufficiency of the lower extremities (varicose veins) – to relieve edema, feeling of heaviness and pain in the legs; superficial thrombophlebitis, phlebitis; postphlebitic conditions; rheumatic soft tissue lesions (tenosynovitis, bursitis, fibrositis, periarthritis); postoperative edema, contusions, dislocations, sprains.

ICD codes

ICD-10 code Indication
I80 Phlebitis and thrombophlebitis
I83 Varicose veins of lower extremities
I87.0 Postthrombotic syndrome
I87.2 Venous insufficiency (chronic) (peripheral)
M65 Synovitis and tenosynovitis
M70 Soft tissue disorders related to use, overuse, and pressure
M71 Other bursopathies
M75.0 Adhesive capsulitis of shoulder
M79.0 Unspecified rheumatism
M79.7 Fibromyalgia (including fibromyositis, fibrosis)
R60 Edema, not elsewhere classified
T14.0 Superficial injury of unspecified body region (including abrasion, bruise, contusion, hematoma, bite of nonvenomous insect)
T14.3 Dislocation, sprain and strain of joint and ligament of unspecified body region
ICD-11 code Indication
BD70.0 Superficial thrombophlebitis of lower extremities
BD70.Z Superficial thrombophlebitis, unspecified
BD71.4 Deep vein thrombosis of lower extremity
BD74.1Z Varicose veins of lower extremities, unspecified
BD74.Z Chronic venous insufficiency of lower extremities, unspecified
BD7Z Diseases of veins, unspecified
EH92 Dermatoses provoked by friction or mechanical impact
EH92.1 Blister due to friction
FA27.2 Palindromic rheumatism
FB40.Z Tenosynovitis, unspecified
FB50.1 Bursitis associated with use, overuse or pressure
FB50.Z Bursitis, unspecified
FB51.3 Fibroblastic rheumatism
FB53.0 Adhesive capsulitis of shoulder
FB56 Specified soft tissue diseases, not elsewhere classified
MG29.Z Edema, unspecified
MG30.01 Chronic widespread pain
ND56.0 Superficial injury of unspecified body region
ND56.3 Dislocation, sprain or strain of unspecified body region

Dosage Regimen

The method of application and dosage regimen for a specific drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly adhere to the compliance of the dosage form of a specific drug with the indications for use and dosage regimen.

The drug is intended for external use only.

Apply a thin layer of gel to the affected skin area.

Use gentle, rubbing movements until fully absorbed.

Apply the gel three to four times daily.

The maximum duration of continuous treatment is 10 days.

Do not exceed the recommended application frequency or treatment duration.

Wash hands thoroughly before and after each application.

Avoid applying the gel to open wounds, abraded skin, or mucous membranes.

Do not use an occlusive dressing over the application site.

Discontinue use and consult a physician if symptoms persist or skin irritation occurs.

For chronic venous insufficiency, apply along the affected vein, typically from the ankle upward.

For rheumatic soft tissue conditions, apply directly over the painful or swollen area.

For post-traumatic injuries like contusions or sprains, apply to the site of injury.

Ensure the skin is intact and dry prior to application.

Do not allow the gel to contact the eyes or mouth.

Adverse Reactions

Drug tolerance is generally good.

Local reactions: possible appearance of hypersensitivity symptoms from the skin – contact dermatitis, itching, redness, rash, feeling of warmth and burning at the application site.

Contraindications

Impaired integrity of the skin; third trimester of pregnancy; lactation period; children under 14 years of age (no clinical experience of use); hypersensitivity to the components of the drug and NSAIDs.

With caution simultaneous use of the drug with other NSAIDs, bronchial asthma, allergic rhinitis, polyps of the nasal mucosa.

Use in Pregnancy and Lactation

The use of the drug is contraindicated in the third trimester of pregnancy and during lactation.

Pediatric Use

The use of the drug is contraindicated in children under 14 years of age (no clinical experience of use).

Special Precautions

The drug should not be applied to open wounds, mucous membranes, into the oral cavity, or into the eyes. If it gets into the eyes, on mucous membranes, or on open wound surfaces, local irritation may occur – lacrimation, redness, burning, pain. Necessary measures – rinsing the affected area with plenty of distilled water or physiological saline until complaints disappear or decrease.

After applying the drug, an occlusive dressing should not be applied.

Sodium benzoate, dimethyl sulfoxide, or propylene glycol contained in the drug as excipients may have an irritating effect on the skin.

Effect on ability to drive vehicles and mechanisms

The drug does not affect the ability to perform potentially hazardous activities requiring increased concentration and speed of psychomotor reactions (including driving vehicles, working with moving mechanisms).

Drug Interactions

The drug may enhance the effect of drugs causing photosensitization.

Storage Conditions

Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Over-the-Counter

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.

Medical Disclaimer

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