DICLOMOVE-SR 100MG TABLET

Indications

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Acute pain
• Dysmenorrhea
• Postoperative pain
• Gout
• Tendinitis
• Bursitis

Dosage

Children: Refer to the BNF for Children for specific paediatric dosing guidelines, as these vary depending on the child's age, weight

Adults: Refer to the appropriate clinical guidelines or pharmacological resources for specific adult dosage regimens, as they can vary based on the condition being treated.

Mechanism of action

Diclofenac exerts its pharmacological effects primarily through the inhibition of cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2. This inhibition leads to a reduction in the synthesis of prostaglandins, which are mediators of inflammation, pain, and fever. By decreasing prostaglandin levels, diclofenac alleviates pain and reduces inflammation.

Pharmacodynamics

The analgesic and anti-inflammatory effects of diclofenac are evident in its ability to decrease pain and swelling associated with various inflammatory conditions. Its onset of action typically occurs within a few hours, depending on the route of administration, and it can provide symptomatic relief for a range of conditions. Diclofenac also possesses antipyretic properties, contributing to its effectiveness in treating fever.

Pharmacokinetics

Diclofenac is absorbed rapidly and extensively after oral administration, with peak plasma concentrations occurring within 1 to 2 hours. It is highly protein-bound (approximately 99%) and undergoes extensive hepatic metabolism, primarily via cytochrome P450 enzymes. The elimination half-life of diclofenac is approximately 1 to 2 hours, with its metabolites excreted mainly in the urine. The drug's pharmacokinetics can be influenced by factors such as age, liver function, and the presence of other medications.

Contra-indications

• Active peptic ulceration
• Severe heart failure
• History of gastrointestinal bleeding or perforation related to previous NSAID therapy
• Hypersensitivity to diclofenac or any excipients in the formulation
• Severe hepatic impairment
• Severe renal impairment
• Pregnancy (third trimester)

Adverse effects

• Gastrointestinal disturbances (nausea, vomiting, diarrhea)
• Dyspepsia
• Abdominal pain
• Headache
• Dizziness
• Rash
• Increased liver enzymes
• Renal impairment
• Cardiovascular events (e.g., heart attack, stroke)

Interactions

• Other NSAIDs or salicylates (increased risk of gastrointestinal ulceration and bleeding)
• Anticoagulants (increased risk of bleeding)
• Lithium (may increase lithium levels)
• Methotrexate (may increase toxicity)
• Diuretics (NSAIDs may reduce the efficacy of diuretics)
• ACE inhibitors and angiotensin II receptor antagonists (may reduce their antihypertensive effect)

Precautions

• Use with caution in patients with a history of gastrointestinal disease
• Monitor renal function in patients with renal impairment
• Use with caution in patients with cardiovascular disease or risk factors
• Avoid in patients with known hypersensitivity to NSAIDs
• Monitor liver function tests in long-term use

Pregnancy

Avoid use during pregnancy, particularly in the third trimester, due to potential risks to the fetus.

Breast-feeding

Use with caution; limited data available. Diclofenac is excreted in breast milk but in small amounts.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Oral tablets (various strengths)
• Topical gel
• Suppositories
• Injection solution