Diclofenac

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An oral nonsteroid antiinflammatory agent (NSAID).

Information about Diclofenac

Diclofenac is a commonly used nonsteroidal antiinflammatory drug (NSAID) used for the therapy of chronic forms of arthritis and mild-to-moderate acute pain. 

Liver safety of Diclofenac

Therapy with diclofenac in full doses is frequently associated with mild serum aminotransferase elevations and, in rare instances, can lead to serious clinically apparent, acute or chronic liver disease.

Mechanism of action of Diclofenac

Diclofenac (dye kloe' fen ak) is a phenylacetic acid derivative and belongs to the acetic acid class of NSAIDs that includes indomethacin, etodolac, ketorolac, nabumetone, tolmetin and sulindac.  Like other NSAIDs, diclofenac acts as by inhibiting cellular cyclooxygenases (Cox-1 and Cox-2), which results in a decrease in production of pro-inflammatory prostaglandin, prostacyclin and thromboxane products, important mediators of inflammation and pain.  Diclofenac has analgesic as well as antipyretic and antiinflammatory activities. 

FDA approval information for Diclofenac

Diclofenac was first approved in the United States in 1988 and currently over 5 million prescriptions are filled yearly.  Current indications include mild-to-moderate forms of joint pain, caused by osteoarthritis, rheumatoid arthritis and ankylosing spondylitis as well as relief of symptoms of dysmenorrhea and mild-to-moderate pain. 

Dosage and administration for Diclofenac

Diclofenac is available in multiple generic and brand formulations, either alone or in combination with other analgesics or gastointestinal mucosal protective agents (such as misoprostol).  Diclofenac is not available over-the-counter in the United States, but it is in many other countries where indications include joint and muscle pain from trauma, bursitis, tendonitis, headache and dysmenorrhea.  As a result, diclofenac is one of the most frequently used NSAIDs worldwide.  Common commercial names for agents containing diclofenac include:  Arthrotec, Cataflam, Duravolten, Novo-Difenac, Nu-Diclo, Voltaren and Zorvoflex.  Diclofenac is available in multiple dose formulations, including 25, 50 and 75 mg tablets or capsules.  The recommended dose for chronic arthritis in adults is 50 mg orally three times daily; lower and intermittent doses are used for pain. 

Side effects of Diclofenac

Like most NSAIDs, diclofenac is generally well tolerated, but side effects can include headache, dizziness, somnolence, rash, nausea, diarrhea, dyspepsia, abdominal pain, heartburn, gastrointestinal bleeding, peripheral edema and hypersensitivity reactions.

Topical form

Diclofenac is also available in several topical forms.  Ophthalmic solutions (0.1%) are available for relief of pain or decrease in inflammation after cataract or corneal surgery.  Dermatological gels are used for treatment of actinic keratoses.  Diclofenac dermatologic patches are available for treatment of acute pain from minor strains, sprains and contusions.  Diclofenac gels and creams have also been used for topical therapy of osteoarthritis for specific joints that are amenable to topical treatment.  Topical formulations are available generically and under brand names such as Flector patch, Pennsaid, Solaraze, Surpass and Voltaren gel.

Nonsteroidal Antiinflammatory Drugs (NSAIDs)

Acetaminophen, Celecoxib, Diclofenac, Diflunisal, Etodolac, Fenoprofen, Flurbiprofen, Ibuprofen, Indomethacin, Ketoprofen, Ketorolac, Mefenamic Acid, Meloxicam, Nabumetone, Naproxen, Nimesulide, Oxaprozin, Phenylbutazone, Piroxicam, Rofecoxib, Sulindac, Tolmetin

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