Reumanisal

Reumanisal Uses, Dosage, Side Effects, Food Interaction and all others data.

Reumanisal is a prodrug which is metabolized to rhein. It is currently approved in France for the treatment of osteoarthritis although the use of diacerein is restricted due to the side effects including severe diarrhea . Reumanisal is under investigation for the treatment of Insulin Resistance, Diabetes Mellitus (Type 2), and Diabetes-Related Complications.

Decreases inflammation and cartilage destruction and also corrects altered osteoblast acitivity .

Trade Name Reumanisal
Generic Diacerein
Diacerein Other Names Diacerein, DiacereĆ­na
Type
Formula C19H12O8
Weight Average: 368.297
Monoisotopic: 368.053217346
Protein binding

99% of rhein is bound to plasma proteins .

Groups Approved, Investigational
Therapeutic Class
Manufacturer
Available Country Greece
Last Updated: September 19, 2023 at 7:00 am
Reumanisal
Reumanisal

Uses

Reumanisal is an slow-onset anthraquinone IL-1 inhibitor used in the treatment of degenerative joint diseases like osteoarthritis.

For the treatment of osteoarthritis affecting the hip or knee .

Reumanisal is also used to associated treatment for these conditions: Osteoarthritis in the Hip Joint, Osteoarthritis of the Knee

How Reumanisal works

Reumanisal's active metabolite rhein Rhein reduces cartilage destruction by decreasing expression of matrix metalloproteinase (MMP)-1 and -3 as well as upregulating tissue inhibitor of matrix metalloproteinases which serve to reduce the activity of several MMPs . The anti-inflammatory action of rhein reduces the level of interleukin-1beta activity which plays a large role in reduction of extracellular matrix production, MMP activity, and continued inflammation . Rhein reduces abnormal osteoblast synthetic activity through an unknown mechanism .

Toxicity

Rhein Rhein has an oral LD50 of >5000mg/kg in mice. This is equivalent to a diacerein dose of >6476mg/kg.

Volume of Distribution

15-60L .

Elimination Route

Bioavailability of 50-60% . Entirely converted to the active metabolite rhein Rhein before reaching systemic circulation.

Half Life

4-10h .

Clearance

Total CL is 1.5L/h and renal CL is 0.1L/h .

Elimination Route

37% excreted in urine and 53% in feces as estimated in rats .

Innovators Monograph

You find simplified version here Reumanisal

FAQ

What is Reumanisal used for?

Reumanisal is a slow-acting medicine of the class anthraquinone used to treat joint diseases such as osteoarthritis.

How safe is Reumanisal?

Reumanisal is safe, apart from a substantially higher risk of diarrhoea, especially with longer-term use.Reumanisal has an acceptable safety profile, particularly in comparison with that of NSAIDs and paracetamol. The ESCEO positions Reumanisal as a first-line pharmacological background treatment of osteoarthritis.

How does Reumanisal work?

Reumanisal works by blocking the actions of interleukin-1 beta, a protein involved in the inflammation and destruction of cartilage that plays a role in the development of symptoms of degenerative joint diseases such as osteoarthritis.

What are the common side effects of Reumanisal?

Common side effects of Reumanisal are include:

  • Diarrhoea.
  • Stomach discomfort and pain.
  • Nausea.
  • Vomiting.
  • Yellowing of skin and eyes.
  • Urine discoloration.
  • Increase in liver enzyme levels.
  • Allergic skin reaction.

Is Reumanisal safe during pregnancy?

Reumanisal should not be administered during pregnancy.

Is Reumanisal safe during breastfeeding?

Reumanisal should not be administered during lactation.

Can I drink alcohol with Reumanisal?

Patients should be advised to limit their alcohol intake while on treatment with Reumanisal. 

Can I drive after taking Reumanisal?

Reumanisal may cause dizziness and drowsiness. So if you observe such symptoms, then do not drive.

When should be taken of Reumanisal?

The recommended starting dose is 50 mg once daily with evening meal for the first 2 to 4 weeks of treatment, after which the recommended daily dose is 50 mg twice daily. 

Can I take Reumanisal on an empty stomach?

The Reumanisal should be taken with food, one with breakfast and the other with evening meal.

How often can I take Reumanisal?

The recommended dose is 50 mg to be taken twice daily.

How long does Reumanisal take to work ?

Reumanisal starts showing its action in 2-3 hours. The duration of action of Reumanisal is 27 hours

How long can Reumanisal be taken?

The duration of action of Reumanisal is 27 hours.

Who should not take Reumanisal?

Reumanisal should not be used in any patient with liver disease or a history of liver disease, and doctors should be monitoring their patients for early signs of liver problems.

Is Reumanisal an antibiotic?

Reumanisal is a novel antibacterial agent; the antibacterial breakpoint could not be found in the literature or in standards.

What happen If I missed a dose of Reumanisal?

If you forget to take a dose of Reumanisal, make sure that you remember to take your next dose when it is due. Do not take two doses together to make up for a missed dose.

What happen if I overdose on Reumanisal?

Never take more than the prescribed dose. Seek emergency medical treatment or contact the doctor if you suspect that you might have taken an overdose of Reumanisal.

Can Reumanisal causes diarrhoea?

Reumanisal may cause diarrhoea or loose stools in the first few days of treatment. Contact your doctor if the diarrhoea does not stop within 3-4 days.

Who should not take Reumanisal?

Avoid taking Reumanisal if you are allergic to it. Seek medical attention if you notice any allergic reactions such as skin rash, hives (painful, itchy eruptions that sting), swelling (face, lips, tongue, etc.), breathing difficulty, etc. Reumanisal is excreted through the kidneys. 

If you have pre-existing kidney problems, this medicine may accumulate in your kidneys and further worsen your condition. Hence, this medicine is not recommended for use if you have kidney problems.

Can Reumanisal affects my heart ?

Reumanisal Improves Left Ventricular Remodeling and Cardiac Function by Reducing the Inflammatory Response after Myocardial Infarction.

Does Reumanisal cause kidney damage?

Reumanisal has shown to be safe and effective in patients with moderate to severe renal impairment, and dose adjustment is not required in these patients.

Can Reumanisal affects my liver?

Around 0.5% of patients on Reumanisal had some kind of liver reaction, with most cases being mild, reversible increases in serum transaminases.

*** Taking medicines without doctor's advice can cause long-term problems.
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