Tab%2525252525252525252525252525252525252525252525252520diclofenac

# Diclofenac Tablet ## Overview Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, and inflammation. ## Primary Indications * Pain and inflammation associated with osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. * Mild to moderate pain, including dysmenorrhea. ## Adult Dosing * **Osteoarthritis, Rheumatoid Arthritis, Ankylosing Spondylitis:** * Immediate-release (IR) tablets: 150 mg to 200 mg per day divided into 2 to 4 doses. * Extended-release (ER) tablets: 100 mg once daily or 200 mg once daily. * Maximum IR daily dose: 225 mg. * Maximum ER daily dose: 200 mg. * **Dysmenorrhea:** * IR tablets: 50 mg three times daily as needed. * Alternatively, 100 mg initially, followed by 50 mg doses if needed. * Maximum daily dose: 200 mg. * **Acute Pain:** * IR tablets: 50 mg every 8 hours as needed. * Maximum daily dose: 150 mg. Dosing may need to be individualized based on patient response and tolerance. Specific dosing regimens may vary based on local protocol. ## Pediatric Dosing * **Pain and Inflammation (Rheumatoid Arthritis):** * Children 1 to 12 years: 1 mg/kg/day to 3 mg/kg/day divided into 2 to 4 doses. * Maximum daily dose: 200 mg. * **Juvenile Idiopathic Arthritis (JIA):** * Children 1 to 12 years: 1 mg/kg/day to 3 mg/kg/day divided into 2 to 4 doses. * Maximum daily dose: 200 mg. Use in pediatric patients should be under the guidance of a specialist. ## Dose Adjustments * **Hepatic Impairment:** Use with caution. Start at the lower end of the dosing range. Avoid in severe hepatic impairment. * **Renal Impairment:** Use with caution. Start at the lower end of the dosing range. Monitor renal function. Avoid in severe renal impairment. * **Elderly:** Increased risk of adverse effects. Consider lower doses and increased monitoring. ## Contraindications * Hypersensitivity to diclofenac, aspirin, or other NSAIDs. * History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. * Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery. * Active gastrointestinal (GI) bleeding or ulceration. * Inflammatory bowel disease (active). ## Adverse Effects * **Common:** Dyspepsia, abdominal pain, nausea, diarrhea, constipation, headache, dizziness, rash. * **Serious:** Cardiovascular thrombotic events (myocardial infarction, stroke), GI bleeding, ulceration, perforation, renal impairment, hepatic impairment, hypertension, hypersensitivity reactions, fluid retention, edema. ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Corticosteroids:** Increased risk of GI bleeding and ulceration. * **SSRIs/SNRIs:** Increased risk of bleeding, particularly GI bleeding. * **ACE Inhibitors/ARBs:** Reduced antihypertensive effect, increased risk of renal impairment. * **Diuretics:** Reduced diuretic effect, increased risk of renal impairment. * **Lithium:** Increased serum lithium levels. * **Methotrexate:** Increased risk of methotrexate toxicity. ## Monitoring * **Gastrointestinal:** Signs and symptoms of GI bleeding or ulceration. * **Cardiovascular:** Blood pressure, signs of heart failure. * **Renal:** Renal function (serum creatinine, BUN), especially in patients with risk factors. * **Hepatic:** Liver function tests (LFTs), especially in patients with pre-existing liver disease or those on long-term therapy. * **Hematologic:** Complete blood count (CBC) for signs of anemia or bleeding. ## Clinical Pearls * Use the lowest effective dose for the shortest duration necessary to minimize risks. * Consider co-administration with a proton pump inhibitor (PPI) or misoprostol in patients at increased risk of GI complications. * Caution in patients with pre-existing cardiovascular disease, hypertension, or risk factors for these conditions. * NSAIDs can mask signs of infection. * Monitor for signs of anaphylaxis. *** **Disclaimer:** This information is for educational purposes only and does not substitute for professional medical advice. Always consult with a qualified healthcare provider and refer to the most current prescribing information for diclofenac before making any treatment decisions.