Diclofena

GENERIC NAME: diclofenac

DRUG CLASS AND MECHANISM
Diclofenac belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs) that are used for the treatment of mild to moderate pain, fever, and inflammation. Other members of this class include ibuprofen (Motrin), indomethacin (Indocin), nabumetone (Relafen), naproxen (Aleve) and several others. NSAIDs work by reducing the production of prostaglandins, chemicals that cause pain, fever and inflammation. NSAIDs block the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower production of prostaglandins. As a consequence, inflammation, pain and fever are reduced. Since the response to different NSAIDs varies from patient to patient, it is not unusual for a doctor to try different NSAIDs for any given condition. The FDA approved diclofenac in July 1998.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS
Tablets (delayed release): 25, 50, and 75 mg. Tablets (immediate release): 50 mg. Tablets (extended release): 100mg

PRESCRIBED FOR
Diclofenac is used primarily for the treatment of inflammation and pain caused by conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. It is also effective in treating soft tissue inflammations due to tendinitis and bursitis, and treating dysmenorrhea (menstrual cramps).

DOSING
Diclofenac should be taken with food to reduce stomach upset. The recommended dose for most conditions is 100-200 mg daily. Dosing intervals depend on the diclofenac formulation used and the condition being treated.

DRUG INTERACTIONS
Diclofenac, like other NSAIDs is associated with several suspected or probable interactions that affect the action of other drugs. Some examples are discussed below.

Diclofenac may increase the blood levels of lithium (Eskalith) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.

Diclofenac may reduce the blood pressure lowering effects of blood pressure medications. This may occur because prostaglandins play a role in the regulation of blood pressure.

When diclofenac is used in combination with aminoglycoside antibiotics [for example, gentamicin (Garamycin)] the blood levels of the aminoglycoside may increase, presumably because the elimination of aminoglycosides from the body is reduced. This may lead to more aminoglycoside-related side effects.

Individuals taking oral blood thinners or anticoagulants [for example, warfarin (Coumadin)] should avoid diclofenac because diclofenac also thins the blood, and excessive blood thinning may lead to bleeding.

Combining NSAIDs with methotrexate (Rheumatrex, Trexall) may reduce the elimination of methotrexate from the body and result in increased side effects from methotrexate.

USES
This medication is a nonsteroidal anti-inflammatory drug that relieves pain and reduces inflammation (swelling). It is used to treat headaches, muscle aches, dental pain, menstrual cramps and athletic injuries. It is commonly used to treat pain, swelling and stiffness associated with arthritis.

HOW TO USE
Take this medication with food, milk, or antacids to prevent stomach upset. This medication is most effective in relieving menstrual pain if taken at the earliest sign of pain. Take this medication with 6 to 8 ounces (180-240ml) of water. Do not lie down for at least 30 minutes after taking this drug.

SIDE EFFECTS
Stomach upset is the most common side effect. Nausea, vomiting, bloating, gas, dizziness, drowsiness, blurred vision or loss of appetite may also occur. If any of these effects persist or worsen, notify your doctor. Inform your doctor promptly if you develop: ringing in ears/ loss of hearing, vision changes. If you notice any of the following unlikely but very serious side effects, stop taking this drug and consult your doctor or pharmacist immediately: black stools, persistent stomach/ abdominal pain, vomit that looks like coffee grounds. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS
Tell your doctor your medical history, especially of: liver or kidney disease, blood disorders, ulcers, heart disease, alcohol use, high blood pressure, eye disease, asthma, nasal polyps, any allergies - especially aspirin/NSAID allergy (e.g., ibuprofen, celecoxib). Use caution when performing tasks requiring alertness. Limit alcohol intake as it may intensify the drowsiness effect of this medication. This medicine may cause stomach bleeding. Daily use of alcohol, especially when combined with this medicine, may increase your risk for stomach bleeding. Check with your doctor or pharmacist for more information. Do not take aspirin without consulting your doctor. Check the ingredients of any nonprescription medication you may be taking since many cough-and-cold formulas contain aspirin. Infrequently, this medication may increase the skin's sensitivity to sunlight. If this happens to you, avoid prolonged sun exposure, wear protective clothing and use a sunscreen. Avoid sunlamps. Caution is advised when this drug is used in the elderly. Tell your doctor if you are pregnant before using this drug. Use of this drug in the last 6 months of pregnancy is not recommended. This drug is excreted into breast milk. Consult your doctor before breast-feeding.

OVERDOSE
If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include severe stomach pain, coffee ground-like vomit, dark stool, ringing in the ears, change in amount of urine, unusually fast or slow heartbeat, muscle weakness, slow or shallow breathing, confusion, severe headache or loss of consciousness.

MISSED DOSE
If you miss a dose, take it as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

STORAGE
Store at room temperature away from moisture and sunlight. Do not store in the bathroom.

Note : This product information is intended only for residents of the India. Taj Pharmaceuticals Limited, medicines help to treat and prevent a range of conditions—from the most common to the most challenging—for people around the world.