Diclofenac - Comprehensive Usage Guide: instructions, indications, composition, side effects

Active Ingredient: Diclofenac sodium (or potassium)

Excipients: May include lactose, maize starch, povidone, magnesium stearate, talc, colloidal anhydrous silica, hypromellose, titanium dioxide, and other inactive ingredients depending on the formulation.

Diclofenac is available in various pharmaceutical forms, including:

• Tablets: Available in various strengths, such as 25 mg, 50 mg, and 100 mg.
• Capsules: Available in various strengths, such as 25 mg and 50 mg.
• Suppositories: Available in various strengths, such as 50 mg and 100 mg.
• Injectable solution: Available in vials containing diclofenac sodium, typically in strengths such as 75 mg/3 mL or 75 mg/1 mL.

Diclofenac belongs to the pharmacological group of nonsteroidal anti-inflammatory drugs (NSAIDs), specifically phenylacetic acid derivatives (ATC code: M01A B05).

• Pharmacodynamics: Diclofenac exerts its anti-inflammatory, analgesic, and antipyretic effects by inhibiting the enzyme cyclooxygenase (COX), thereby reducing the synthesis of prostaglandins involved in inflammation, pain, and fever.
• Pharmacokinetics: Following oral administration, diclofenac is rapidly and well-absorbed from the gastrointestinal tract. It undergoes extensive metabolism in the liver and is primarily excreted through the urine and bile.

Diclofenac is indicated for the relief of:

• Pain and inflammation associated with various musculoskeletal conditions, including rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis.
• Acute gouty arthritis.
• Painful menstrual periods.
• Postoperative pain.
• Migraine attacks (in some formulations).

Diclofenac is contraindicated in individuals with a history of hypersensitivity to diclofenac or other NSAIDs, as well as those with active peptic ulcer disease, severe heart failure, and/or established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease.

Diclofenac may interact with other medications, including anticoagulants, antiplatelet drugs, selective serotonin reuptake inhibitors (SSRIs), angiotensin-converting enzyme (ACE) inhibitors, diuretics, and lithium, potentially increasing the risk of bleeding or adverse effects. Caution is advised when co-administering diclofenac with other drugs.

Diclofenac tablets or capsules should be taken orally with a full glass of water. The dosage and duration of therapy should be individualized based on the patient’s condition, response to treatment, and risk factors for adverse effects. It is recommended to take diclofenac with food or milk to reduce the risk of gastrointestinal irritation.

Diclofenac is not recommended during pregnancy or breastfeeding due to the potential risk of fetal harm and excretion in breast milk. Women of childbearing potential should use effective contraception during treatment with diclofenac.

Diclofenac may cause dizziness or drowsiness in some patients. Therefore, caution is advised when driving or operating machinery, especially during the initiation of therapy or following dosage adjustments.

The recommended dosage of diclofenac varies depending on the indication, severity of pain, and patient factors. Healthcare providers will determine the appropriate dose and treatment duration based on clinical judgment and guidelines.

In the event of an overdose, supportive measures should be initiated as needed. Diclofenac overdoses may lead to symptoms such as gastrointestinal irritation, nausea, vomiting, and renal impairment. Immediate medical attention is required in cases of overdose.

Common side effects of diclofenac may include gastrointestinal disturbances (e.g., dyspepsia, abdominal pain), headache, dizziness, and peripheral edema. Serious adverse effects such as cardiovascular events, hepatic toxicity, and renal impairment are rare but may occur, especially with prolonged use or at high doses.

Diclofenac tablets, capsules, and suppositories should be stored at room temperature (15-30°C) in a dry place, protected from light and moisture. Injectable solutions should be stored according to manufacturer recommendations. Keep out of reach of children. Check the expiration date on the packaging and discard any expired or unused medication.

These extended instructions provide comprehensive information on the composition, pharmacological properties, indications, contraindications, interactions, administration, side effects, storage, and usage of Diclofenac, aiding healthcare professionals and patients in safe and effective pain management. Always consult a healthcare provider for personalized medical advice.