VOLTADVANCEGO*20CAPS 25MG

VoltadvanceGo 12.5 mg soft capsules
VoltadvanceGo 25 mg soft capsules
Diclofenac epolamine
Equivalent medicinal product

What it is and what it is used for
VoltadvanceGo contains the active ingredient diclofenac epolamine.

VoltadvanceGo is a medicine that belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). This medicine is a pain reliever that can also reduce inflammation and swelling.

VoltadvanceGo is used for short-term symptomatic relief in the following situations: mild to moderate pain (such as headaches, toothaches, menstrual pain, rheumatic pain, and muscle pain).

What you need to know before taking this medicine
Do NOT take VoltadvanceGo:
• if you are allergic to
- diclofenac epolamine or any of the other ingredients of this medicine (listed in section 6)
- diclofenac, acetylsalicylic acid or any other non-steroidal anti-inflammatory drug (NSAID)
• if you currently have a stomach or duodenal ulcer, bleeding or perforation
• if you have blood cell production disorders of unknown origin
• if you have a history of gastrointestinal bleeding or perforation, related to previous NSAID therapy
• if you have had two or more episodes of stomach or duodenal ulcer or gastrointestinal bleeding (including blood in vomit, bleeding during defecation, fresh blood in stools or black and tarry stools)
• if you suffer from overt heart disease and/or cerebral vascular disease, e.g. you have had a heart attack, a stroke, a mini-stroke (transient ischaemic attack - TIA) or an obstruction of blood vessels to the heart or brain or surgery to eliminate or avoid such obstructions
• if you think you are allergic to diclofenac, acetylsalicylic acid, ibuprofen or any other NSAID. Signs of a hypersensitivity reaction include swelling of the face, lips, tongue and/or throat with difficulty swallowing (angioedema), breathing problems (difficulty breathing, asthma), chest pain, acute rhinitis (runny nose), rash or any other allergic reaction.
• if you suffer or have suffered from blood circulation problems (peripheral artery disease)
• if you have severe kidney, liver or heart failure
• if you are more than six months pregnant (see also Pregnancy, breastfeeding and fertility)
• if you are under 14 years of age.

If any of the above situations apply to you, consult your doctor or pharmacist.

Warnings and precautions
Consult your doctor or pharmacist before taking VoltadvanceGo if:
• you suffer or have suffered from any stomach or intestinal disorder, including ulcerative colitis or Crohn's disease
• you are elderly
• you have kidney or liver problems
• you have a condition called porphyria
• you suffer from any blood disorder or bleeding
• you have ever had asthma
• you are breastfeeding
• you suffer from angina, blood clots, high blood pressure, high cholesterol or triglyceride levels
• you have diabetes
• you are a smoker
• you have recently undergone surgery
• you are at risk of dehydration (e.g. due to illness or diarrhoea)
• you have undergone or are about to undergo stomach or intestinal surgery before using VoltadvanceGo, as VoltadvanceGo may sometimes worsen wound healing in the intestine after surgery.
In these cases, VoltadvanceGo may not be the right medicine for you.

Other important information

Cardiovascular disease
Medicines such as VoltadvanceGo may be associated with a slightly increased risk of heart attack (myocardial infarction) or stroke. Any risk is more likely with high doses and prolonged treatment. Do not exceed the recommended dose or duration of treatment.

Stop treatment and inform your doctor if you develop a worsening headache during treatment with VoltadvanceGo because prolonged use of medicines to reduce headache can, in some cases, worsen it.

If signs or symptoms of heart or blood vessel problems occur, such as chest pain, shortness of breath, weakness or difficulty speaking, contact your doctor immediately.

As it is an anti-inflammatory medicine, the active ingredient in VoltadvanceGo may mask the signs and symptoms of an infection. If you feel unwell and need to see a doctor, do not forget to tell them that you are taking VoltadvanceGo.

Side effects can be minimised by using the lowest effective dose for the shortest duration necessary.

Children and adolescents Children and adolescents under 14 years of age should not take VoltadvanceGo (see also Do not take VoltadvanceGo).

Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.

Some side effects can be serious.

Stop taking VoltadvanceGo and tell your doctor immediately if you experience:
• acute pain in the upper abdomen, feeling unwell, nausea
• vomiting blood or black particles, black stools or blood in stools
• allergic reactions such as rash, itching, bruising, painful red areas, peeling or blistering
• wheezing or shortness of breath (bronchospasm), difficulty swallowing, collapse
• swelling of the face, lips, hands or fingers
• yellowing of the skin or eyes
• persistent sore throat or high temperature, unusual bleeding or bruising
• unexpected change in the amount of urine produced and/or its appearance
• mild cramps and tenderness in the abdomen, starting shortly after the beginning of treatment with VoltadvanceGo and followed by rectal bleeding or bloody diarrhoea, usually within 24 hours of the onset of abdominal pain (frequency not known, frequency cannot be estimated from the available data).

Inform your doctor immediately if you notice any of the following reactions:
• chest pain, which may be a sign of a potentially serious allergic reaction called Kounis syndrome.

Medicines such as VoltadvanceGo may be associated with an increased risk of heart attack (myocardial infarction) or stroke.

The following side effects have also been reported:
Common (may affect up to 1 in 10 people)
• Headache, dizziness, vertigo.
• Nausea, vomiting, diarrhoea, indigestion (dyspepsia), abdominal pain, flatulence, loss of appetite.
• Rash and itching.

Uncommon (may affect up to 1 in 100 people)
• Increase in liver enzyme values in the blood.

Rare (may affect up to 1 in 1,000 people)
• Hypersensitivity, anaphylactic and anaphylactoid reactions (severe allergic reactions, including blood pressure drop and shock).
• Allergic swelling including facial oedema (angioedema).
• Drowsiness.
• Feeling of constriction of the airways (asthma) including shortness of breath (dyspnoea).
• Inflammation of the stomach (gastritis), stomach or duodenal ulcer with or without bleeding or perforation (with possible inflammation of the peritoneum called peritonitis), gastrointestinal narrowing (stenosis).
• Hepatitis (inflammation of the liver), jaundice, liver disorders.
• Urticaria.
• Oedema (fluid retention in the body).

Very rare (may affect up to 1 in 10,000 people)
• Disorders of red and white blood cell formation.
• Disorientation, depression, insomnia, nightmares, irritability, psychotic reactions.
• Sensitivity disorders (paresthesia), memory impairment, seizures or spasms, anxiety, tremor, non-infectious meningitis, altered taste.
• Visual disturbance, blurred or double vision.
• Ringing in the ear (tinnitus), impaired hearing.
• Palpitations, chest pain, weakness of the heart muscle (heart failure).
• High blood pressure (hypertension), inflammation of blood vessels (vasculitis).
• Inflammation of the lungs (pneumonia).
• Inflammation of the colon (colitis), including bleeding and worsening of Crohn's disease or ulcerative colitis, constipation.
• Inflammation of the oral mucosa (stomatitis), inflammation of the tongue, oesophageal lesions (damage to the oesophagus), formation of membranous narrowing in the intestine (intestinal diaphragm disease), inflammation of the pancreas (pancreatitis).
• Liver failure, a very severe and sudden form of hepatitis (fulminant hepatitis), liver necrosis.
• Rash (including eczema and blisters), light sensitivity, appearance of red-brown spots on the skin (purpura), Henoch-Schonlein purpura, severe skin reactions such as rash with blistering (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis/Lyell's syndrome), hair loss.
• Acute kidney dysfunction (renal failure), blood in the urine (haematuria), protein in the urine (proteinuria), nephrotic syndrome (fluid retention in the body and high levels of protein passing into the urine), damage to kidney tissue (interstitial nephritis, papillary necrosis).

Reporting of side effects
If you get any side effects, including those not listed in this leaflet, talk to your doctor or pharmacist. You can also report side effects directly via the national reporting system at: https://www.aifa.gov.it/content/segnalazionireazioni-avverse.
By reporting side effects you can help provide more information on the safety of this medicine.