Diclofenac Sodium

Diclofenac Sodium

Class:Anti-rheumatics,Systemic Mydriatics,Cycloplegics.

Mechanism of action

Inhibits prostaglandin synthesis by decreasing the activity of the enzyme,cyclo-oxygenase,which result in decreased formation of prostaglandin precursors.

Pharmacokinetics

Protein binding:99 percent,Metabolism:in the liver to inactivate metabolites.Half life:2 hours.Time to peak serum concentration:within 2 hours.Elimination primarily in urine.

Indications

Inflammatory form of rheumatism,dysmenorrhea and adnexitis.migrain attacks.renal and biliary colic,As an adjuvant in severe infections of the ear,nose, and throat.Gel:post traumatic inflammation of the tendons,ligaments and joints.e.g due to sprains,strains or bruises.Localized forms of degenerative rheumatism,e.g osteoarthrosis of the peripheral joints and of the vertebral column.

Contraindications

Gastric or intestinal ulcer.known hypersensitivity to sodium metabisulfite(ampoules) or other excipients.known hypersensitivity to diclofenac of thiomersal.

Precautions

Symptoms or history of gastrointestinal disease,asthma,impaired hepatic,cardiac or renal function.NSAID may mask infections or temporarily inhibit platelet aggregation.Patients experiencing blurred vision after application of diclofenac eye drops should refrain from driving vehicles or use machinery antil their vision has cleared.Donot apply gel to diseased skin,open wounds or injuries.

Side effects

Occasional,gastrointestinal disorders,headaches,dizziness,vertigo,rash,elevation of serum transaminases,local reactions after IM injection.rare gastric or intestinal ulcer,gastrointestinal bleeding,abnormalities of renal function,hepatitis,hypersensitivity reactions.Isolated cases:pancreatitis,diaphragm-like intestinal strictures,aseptic meningitis,pneumonitis,cardiovascular disturbances.

Pregnancy

Pregnancy risk factor B (D in 3rd trimester).

Drug interactions

Lithium,digoxin,methotrexate,cyclosporine,diuretics,anticoagulants,oral antidiabetics and quinolones.

Dosage

Tablet:adults:75-150 mg/day in divided doses(dysmenorrheal and migraine attacks;up to 200 mg/day.Children over 12 months:0.5-3 mg/day.ampoule:IM or IV;1 or at the most 2 daily as initial therapy for not more than 2 days.ampoule must not be given as an IV bolus injection.Before IV infusion,dilute contents of 1 ampoule with 100-500 ml saline 0.9 percent or glucose 5 percent buffered with 0.5 ml sodium bicarbonate 8.4 percent or 1 ml of 4.2 percent,Ampoule IV: postoperative pain only.Gel:apply to the skin 3-4 times daily and rub in gently.

Brands

Tabs.Artifen 50 mg,Tabs.Dicloran 50 mg,Gel.Voltral