Diclofenac Sodium

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Generic Name of Diclofenac Sodium - Learn More

Diclofenac Sodium

Diclofenac Sodium Precaution - What You Need to Know

Diclofenac sodium is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief, inflammation reduction, and fever control. While effective, there are several important precautions to consider before using this medication. It should be used with caution in patients with a history of gastrointestinal (GI) disorders, such as ulcers, gastrointestinal bleeding, or inflammatory bowel disease, as NSAIDs can increase the risk of bleeding, perforation, and ulceration of the GI tract.

Patients with cardiovascular conditions, particularly those with a history of heart disease, hypertension, or stroke, should use diclofenac sodium cautiously, as it has been associated with an increased risk of heart attack and stroke. The drug can cause fluid retention, renal impairment, and hypertension, so monitoring of kidney function and blood pressure is recommended, especially in long-term users.

Diclofenac sodium should be avoided in individuals with severe hepatic impairment, as the drug is metabolized in the liver. It should also be used cautiously in patients with renal impairment, as the drug can cause or worsen kidney dysfunction.

Pregnant women should avoid diclofenac sodium, particularly in the third trimester, due to the risk of fetal harm, such as premature closure of the ductus arteriosus. It is also excreted in breast milk, and its use should be limited during breastfeeding.

Diclofenac Sodium Indication - Uses and Benefits

Diclofenac sodium is primarily prescribed for the relief of pain and inflammation associated with a variety of conditions, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and musculoskeletal injuries like sprains and strains. It is also commonly used to treat dysmenorrhea (painful menstruation), acute gout attacks, and mild to moderate post-surgical pain.

In addition to its use for inflammatory conditions, diclofenac sodium is also used to treat soft tissue injuries and conditions such as tendinitis, bursitis, and shoulder pain. It is often administered as a topical gel for localized pain relief in conditions such as osteoarthritis of the knee, offering a more targeted approach with a reduced risk of systemic side effects.

Off-label, diclofenac sodium may be used for other pain management needs, such as acute pain after dental procedures, or for more specific conditions like sciatica, although this use should be guided by a healthcare provider.

Diclofenac Sodium Contraindications - Important Warnings

Diclofenac sodium is contraindicated in patients with known hypersensitivity to the drug or other NSAIDs, as this may lead to severe allergic reactions, including anaphylaxis. It is also contraindicated in individuals with active gastrointestinal bleeding, peptic ulcers, or a history of recurrent GI problems such as ulcers or bleeding disorders, as NSAIDs can exacerbate these conditions.

The drug should not be used in patients with severe liver or renal impairment, as it may further compromise liver and kidney function, potentially leading to life-threatening conditions. Diclofenac sodium is contraindicated in the third trimester of pregnancy due to the risk of fetal harm, particularly affecting the cardiovascular system, such as premature closure of the ductus arteriosus.

In patients with a history of cardiovascular diseases, particularly those with a recent history of heart attack, stroke, or uncontrolled hypertension, the use of diclofenac should be avoided, or at least used with extreme caution due to its association with increased cardiovascular risks.

Diclofenac Sodium Side Effects - What to Expect

Common side effects of diclofenac sodium include gastrointestinal issues, such as indigestion, nausea, and stomach pain. More severe side effects can include gastrointestinal bleeding, ulcers, and perforation, especially with long-term use. These side effects can be minimized by using the drug at the lowest effective dose and for the shortest duration necessary.

Other common side effects include headache, dizziness, and skin rash. Prolonged use of diclofenac sodium may increase the risk of cardiovascular events, including heart attack, stroke, and hypertension. Patients with a history of heart disease or hypertension should be closely monitored for these risks.

Renal side effects can occur, including fluid retention and reduced kidney function, leading to edema and electrolyte imbalances, especially in individuals with pre-existing kidney conditions. Hepatic side effects, such as elevated liver enzymes and jaundice, can also occur, particularly with prolonged use.

Serious side effects, although rare, can include severe allergic reactions (anaphylaxis), significant liver damage, and blood disorders like thrombocytopenia or agranulocytosis. If any of these symptoms occur, immediate medical attention is necessary.

Diclofenac Sodium Pregnancy Category ID - Safety Information

3

Diclofenac Sodium Mode of Action - How It Works

Diclofenac sodium works by inhibiting the activity of cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2. These enzymes play a critical role in the production of prostaglandins, which are chemicals in the body that promote inflammation, pain, and fever. By inhibiting COX enzymes, diclofenac reduces the synthesis of prostaglandins, leading to decreased inflammation, pain, and fever.

COX-1 is involved in maintaining the integrity of the gastrointestinal tract and protecting the kidneys, while COX-2 is primarily involved in inflammation and pain. Diclofenac's inhibition of both enzymes contributes to its therapeutic effects but also increases the risk of side effects, particularly gastrointestinal irritation and bleeding.

The drug is absorbed well after oral administration, with peak plasma levels typically occurring within 1-2 hours. It is metabolized in the liver, with a half-life of approximately 1-2 hours. Diclofenac sodium is also available in topical formulations, allowing for targeted delivery to the site of pain with reduced systemic side effects.

Diclofenac Sodium Drug Interactions - What to Avoid

Diclofenac sodium has several drug interactions that can increase the risk of adverse effects. When taken with other NSAIDs, including over-the-counter medications like aspirin, the risk of gastrointestinal bleeding and ulcer formation is significantly heightened. This combination should be avoided, as should the concurrent use of other blood-thinning medications, such as warfarin or heparin, as this can increase the risk of bleeding.

Combining diclofenac with other medications that affect renal function, such as diuretics or ACE inhibitors, can increase the risk of kidney damage, particularly in elderly patients or those with pre-existing kidney disease. It is recommended to monitor renal function during the use of diclofenac in such patients.

When used with lithium or methotrexate, diclofenac sodium can increase the levels of these drugs in the blood, potentially leading to toxicity. It is important to monitor the levels of these medications closely when they are taken with diclofenac.

Alcohol can enhance the gastrointestinal side effects of diclofenac, such as irritation, bleeding, or ulcer formation, and should be limited during treatment with this drug.

Diclofenac Sodium Pregnancy Category Note - Key Information

Pregnancy category: C; avoid use in late pregnancy (may cause premature closure of ductus arteriosus); category D if >30 weeks after gestation

Diclofenac Sodium Adult Dose - Recommended Dosage

For the treatment of pain and inflammation in conditions like osteoarthritis or rheumatoid arthritis, the usual adult dose of diclofenac sodium is 50-75 mg two to three times per day, with a maximum daily dose of 150 mg. For acute pain or dysmenorrhea, higher doses may be used, with an initial dose of 100 mg, followed by 50-75 mg as needed.

For musculoskeletal injuries or post-operative pain, the recommended dose is typically 75 mg taken twice a day, depending on the severity of the pain. In cases of acute gout, an initial dose of 100 mg may be used, followed by 50 mg every 8 hours until the symptoms subside.

Diclofenac sodium should be taken with food to reduce the risk of gastrointestinal irritation. The dose should be adjusted based on the patient’s response to treatment, and the lowest effective dose should be used to minimize the risk of side effects.

Diclofenac Sodium Child Dose - Dosage for Children

Diclofenac sodium is generally not recommended for children under the age of 14 unless prescribed by a healthcare provider. For pediatric patients aged 14 years and older, the dosing for pain or inflammation conditions such as juvenile arthritis typically mirrors adult dosing, with an initial dose of 50 mg two to three times per day. However, the lowest effective dose should be used.

For short-term use in children, especially in cases of fever or mild pain, the drug should be used with caution, and the potential for adverse effects, particularly gastrointestinal or renal issues, should be considered. Pediatric patients should be monitored closely during treatment for any signs of side effects.

Diclofenac Sodium Renal Dose - Dosage for Kidney Conditions

In patients with mild to moderate renal impairment, no significant dose adjustments are typically required for diclofenac sodium, but the drug should be used with caution, and renal function should be monitored regularly. In patients with severe renal impairment (creatinine clearance below 30 mL/min), diclofenac sodium is contraindicated due to the risk of further kidney damage and fluid retention.

For individuals with pre-existing kidney disease or those at risk of renal dysfunction, periodic monitoring of renal function (including serum creatinine and urine output) is recommended during treatment with diclofenac. If signs of renal impairment emerge, the drug should be discontinued or replaced with an alternative treatment.