Please check your internet connection and try again.
# Diclofenac Tablet
## Overview
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation.
## Primary Indications
* Osteoarthritis
* Rheumatoid arthritis
* Ankylosing spondylitis
* Acute pain
* Dysmenorrhea
## Adult Dosing
* **Osteoarthritis, Rheumatoid Arthritis, Ankylosing Spondylitis:** 150 mg/day in 2-3 divided doses. Maximum 225 mg/day. Extended-release formulations: 100 mg once daily.
* **Acute Pain:** 25 mg every 6-8 hours as needed. Maximum 75 mg/day.
* **Dysmenorrhea:** 50 mg every 8 hours as needed. Maximum 200 mg/day.
## Pediatric Dosing
Limited data available. Some sources suggest:
* **Rheumatoid Arthritis:** 1-3 mg/kg/day in 2-4 divided doses. Maximum 75 mg/day.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in severe impairment, though specific guidelines are lacking.
* **Hepatic Impairment:** Use with caution. Start with lower doses and monitor liver function closely. Avoid in severe hepatic impairment.
## 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.
* Inflammatory bowel disease.
* Heart failure.
* Third trimester of pregnancy.
## Adverse Effects
* **Gastrointestinal:** Dyspepsia, nausea, abdominal pain, diarrhea, constipation, peptic ulceration, GI bleeding.
* **Cardiovascular:** Hypertension, edema, myocardial infarction, stroke (risk may increase with dose and duration).
* **Hepatic:** Elevated liver enzymes, hepatitis, jaundice.
* **Renal:** Renal insufficiency, interstitial nephritis.
* **Dermatologic:** Rash, pruritus.
* **Other:** Headache, dizziness, tinnitus.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of GI bleeding.
* **ACE inhibitors, ARBs, Beta-blockers:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Diuretics:** Reduced diuretic effect and increased risk of renal impairment.
* **Lithium, Methotrexate:** Increased serum levels and toxicity.
## Monitoring
* Renal function (serum creatinine, BUN).
* Liver function tests (AST, ALT).
* Blood pressure.
* Signs and symptoms of GI bleeding.
* Signs and symptoms of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary.
* Consider concomitant gastroprotective therapy (e.g., PPI) in patients at high risk for GI complications.
* NSAIDs carry a risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke.
* NSAIDs can cause serious skin adverse reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis.
***
*Please verify current prescribing information for the most up-to-date details before making clinical decisions.*
