Please check your internet connection and try again.
# Diclofenac Tablets
## Overview
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis.
## Primary Indications
* Pain relief (mild to moderate)
* Inflammation associated with conditions like osteoarthritis and rheumatoid arthritis
## Adult Dosing
* **Pain:** 25 mg every 6-8 hours as needed. Maximum daily dose: 100 mg.
* **Osteoarthritis:** 35 mg three times daily or 50 mg twice daily. Maximum daily dose: 150 mg.
* **Rheumatoid Arthritis:** 50 mg three times daily or 75 mg twice daily. Maximum daily dose: 150 mg.
* *Note: Dosing may vary based on specific formulation (e.g., immediate-release, delayed-release) and local protocol.*
## Pediatric Dosing
* Not generally recommended for children under 12 years of age without specific physician guidance. Limited established pediatric dosing.
## Dose Adjustments
* **Hepatic Impairment:** Use with caution. May require dose reduction. Monitor liver function.
* **Renal Impairment:** Use with caution. May require dose reduction, especially in severe impairment. Monitor renal function.
## 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 bleeding or ulceration.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, dizziness, headache.
* **Serious:** Cardiovascular thrombotic events (MI, stroke), gastrointestinal bleeding/perforation, renal failure, hepatic failure, severe skin reactions (SJS/TEN), anaphylaxis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
* **ACE inhibitors, ARBs, Diuretics:** Reduced antihypertensive effect, increased risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Liver function tests (LFTs) periodically, especially with long-term use.
* Renal function tests (BUN, creatinine) periodically, especially in at-risk patients.
* Signs and symptoms of GI bleeding or ulceration.
* Blood pressure.
* Signs and symptoms of cardiovascular events.
## Clinical Pearls
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Administer with food or milk to reduce GI upset.
* Consider gastroprotection (e.g., PPI) in patients with increased risk of GI events.
* NSAIDs carry a boxed warning for cardiovascular and GI risks.
***
*Disclaimer: This information is intended for healthcare professionals and should not replace consultation with current prescribing information, clinical guidelines, and individualized patient assessment.*
