Please check your internet connection and try again.
# Diclofenac Tablet
## Overview
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used for pain and inflammation.
## Primary Indications
* Pain and inflammation associated with osteoarthritis
* Rheumatoid arthritis
* Ankylosing spondylitis
* Acute pain
## Adult Dosing
* **Osteoarthritis, Rheumatoid Arthritis, Ankylosing Spondylitis:** 50 mg three times daily or 75 mg twice daily.
* **Acute Pain:** 50 mg every 8 hours as needed.
* **Maximum Daily Dose:** 225 mg.
* **Controlled-release formulations:** Dosing varies by product; consult specific product labeling.
## Pediatric Dosing
Dosing has not been established for children.
## Dose Adjustments
* **Hepatic Impairment:** Use with caution. Mild to moderate impairment may require dose reduction. Avoid in severe hepatic impairment.
* **Renal Impairment:** Use with caution. Monitor renal function, especially in patients with pre-existing renal disease. Avoid in severe renal impairment.
* **Elderly:** Increased risk of adverse effects; consider lower doses and monitor closely.
## Contraindications
* Known 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
## Adverse Effects
* **Cardiovascular:** Increased risk of thrombotic events (myocardial infarction, stroke), hypertension.
* **Gastrointestinal:** Dyspepsia, nausea, abdominal pain, GI bleeding, ulceration, perforation.
* **Renal:** Renal impairment, acute kidney injury.
* **Hepatic:** Elevated liver enzymes, hepatitis, jaundice.
* **Dermatologic:** Rash, pruritus.
* **Other:** Headache, dizziness.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin:** May decrease diclofenac's cardioprotective effect; concurrent use generally not recommended.
* **Corticosteroids:** Increased risk of GI toxicity.
* **Diuretics, ACE inhibitors, ARBs:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate levels and toxicity.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
## Monitoring
* Signs and symptoms of GI bleeding or ulceration.
* Blood pressure.
* Renal function (serum creatinine, BUN).
* Liver function tests (ALT, AST).
* For patients on long-term therapy, consider periodic complete blood counts.
## Clinical Pearls
* Lowest effective dose for the shortest duration necessary to minimize risks.
* Administer with food or milk to reduce GI upset.
* Avoid concurrent use with other NSAIDs.
* Consider gastroprotective agents (e.g., PPIs) in patients at high risk for GI complications.
* NSAIDs carry a boxed warning regarding cardiovascular and GI risks.
***
*This information is for educational purposes only and does not substitute for professional medical advice. Always consult the most current prescribing information and your healthcare provider for any medical decisions.*
