A plaster containing DHEP and heparin for mild to moderate contusions and sprains with haematoma: a double-blind randomized study

Abstract

The plaster formulation combining DHEP and heparin relieves pain and induces faster dissolution of superficial haematomas, and may therefore contribute to a more rapid and complete recovery.

Effects of Topical Diclofenac Plus Heparin (Dhep+H Plaster) on Somatic Pain Sensitivity in Healthy Subjects With a Latent Algogenic Condition of the Lower Limb

“…This effect was not paralleled by any tissue change at ultrasound evaluation of the treated area, as revealed by a lack of any significant variation in the subcutis and muscle thickness after treatment with respect to basal conditions. Given also the absence of any ultrasound sign of tissue lesion/edema/hemorrhage neither in basal conditions nor at the subsequent evaluations, the superiority of the DHEP+H formulation with respect to the DHEP formulation only is therefore to be explained by a mechanism different from that of an anti‐edematous action due to heparin . On the other hand, the heparin plaster had only limited effects, not significantly different from those of the placebo plaster, on pain thresholds in the evaluated subjects (mild increase in subcutis electrical thresholds only): this would thus exclude a major direct action of this ingredient on pain sensitivity.…”

“…Therefore, the superior effect of the combination DHEP+H plaster has, with a high probability, to be attributed to a facilitating action of heparin toward the effects of diclofenac. The presence of heparin could promote either a greater release of diclofenac from the plaster or its better diffusion in the affected tissues and finally enhance the action of this NSAID onto pain receptors locally, promoting their desensitization …”

“…Given also the absence of any ultrasound sign of tissue lesion/edema/hemorrhage neither in basal conditions nor at the subsequent evaluations, the superiority of the DHEP+H formulation with respect to the DHEP formulation only is therefore to be explained by a mechanism different from that of an anti-edematous action due to heparin. [24][25][26][27] On the other hand, the heparin plaster had only limited effects, not significantly different from those of the placebo plaster, on pain thresholds in the evaluated subjects (mild increase in subcutis electrical thresholds only): this would thus exclude a major direct action of this ingredient on pain sensitivity. Therefore, the superior effect of the combination DHEP+H plaster has, with a high probability, to be attributed to a facilitating action of heparin toward the effects of diclofenac.…”

“…The presence of heparin could promote either a greater release of diclofenac from the plaster or its better diffusion in the affected tissues and finally enhance the action of this NSAID onto pain receptors locally, promoting their desensitization. [24][25][26][27] The positive action of DHEP+H was furthermore achieved without systemic or local side effects.…”

Rationale and evidence for the incorporation of heparin into the diclofenac epolamine medicated plaster

“…A further non pivotal study investigated the time to complete hematoma dissolution and pain parameters in patients with mild-to-moderate muscle contusions and strains (Table 4) 51 .…”