Diclofenac

Details About Generic Salt ::  Diclofenac 

Main Medicine Class:: Musculoskeletal Disorders , Pain   Sub Medicine Class ::  Analgesics , Anti inflammatory Drugs

3F. MISCELLANEOUS in 3. OCULAR
DICLOFENAC
COX INHIBITOR, NSAID | ANTI-INFLAMMATORY
also comes under 12E. Analgesics & Anti-inflammatory Drugs in 12. Musculoskeletal Disorders & Pain,  
PK: A: Rapid D: ~1.4 L/kg (Vd) M: Liver E: Urine, feces

Indications & Dose: ACTINIC KERATOSES TP Adult Gel: Apply 3% to lesion area twice daily for 2-3 months | ANKYLOSING SPONDYLITIS PO Adult Delayed release tablet: 100-125mg/day in 4-5 divided doses | INFLAMMATION/PAIN PO/RECTAL Child 6 months–18 yrs: 0.3–1mg/kg TID, max 50mg | Severe IM Adult 75mg BID | INTRA-OPERATIVE MIOSIS TP Adult Prevention: Solution (0.1%) is instilled 4 times during the 2h before surgery | MIGRAINE PO Adult Solution: 50mg (one packet as diclofenac potassium) as a single dose at the time of migraine onset | OSTEOARTHRITIS PO Adult IR/delayed release tablet: 100-150mg/day in 2-3 divided doses, ER tablet: 100mg/day | TP Adult Gel (1%): Lower extremities: Apply 4g to affected area QID, max16g/joint/day, Upper extremities: Apply 2g to affected area QID, max 8g/joint/day, Solution: Knee: Apply 40 drops to each knee QID | PAIN PO Adult IR tablet: 50mg TID, max150 mg/day or initially 50mg followed by 50mg TID, IR capsule: 25mg QID | Acute TP Adult Gel (1%): Apply to affected area TID/QID, Transdermal patch: Apply 1 patch BID to most painful areastrains, sprains, contusions | POSTOPERATIVE INFLAMMATION TP Adult After cataract surgery, solution (0.1%) is instilled QID for 4 wks starting 24h after surgery | POST-OPERATIVE PAIN IV Adult Treatment: Bolus inj 75mg over 30 -120 min, may be repeated once after 4-6h if needed. Prevention: Initially 25-50mg after surgery over 15-60 min followed by 5mg/h to max 150mg/day | POST-PHOTOREFRACTIVE KERATECTOMY PAIN TP Adult Solution (0.1%) instilled twice in the hour before surgery, then 1 drop twice at 5min intervals immediately after the procedure & then q2-5h while awake for up to 24h | PRIMARY DYSMENORRHEA PO Adult IR tablet: 50mg TID, max150 mg/day or initially 50mg followed by 50mg TID | RENAL COLIC IM Adult 75mg, repeated once after 30 minutes if necessary | RHEUMATOID ARTHRITIS PO Adult IR/delayed release tablet: 150-200mg/day in 3-4 divided doses, Delayed release tablet: 150-200mg/day in 2-4 divided doses, ER tablet: 100mg/day, max 200mg/day in 2 divided doses

Contra: Hypersensitivity, history of asthma/other allergic reactions after taking aspirin/NSAIDs, treatment of perioperative pain in CABG surgery, moderate-to-severe hepatic/renal impairment

Precautions: Severe CVD, renal/hepatic disease, asthma, porphyria, hypovolemia/dehydration, bleeding tendency, elderly

ADR: Serious: Hepatotoxicity, anaphylaxis, ARF, prolonged bleeding time, GI bleeding, GI perforation, nephritis, tinnitus, Others: dizziness, drowsiness, headache, diarrhea, abdominal pain, dyspepsia, PUD, dysuria, frequent urination, hematuria, proteinuria, eczema, photosensitivity, rash, dermatitis, dry skin, exfoliation, allergic reactions

DDI: Serious Ceftriaxone/Anticoagulants biliary excretion increases by drug, Amoxicillin clearance increases by drug, Ciclosporin increases drug levels, Lithium/Digoxin levels increases, Colestyramine markedly reduces the absorption of drug

Diet: With food

Monitor: CBC, LFT, BUN,urine output, occult blood loss

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