ZULU-200 SR TABLETS

Indications

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Acute musculoskeletal pain
• Post-operative pain

Dosage

Children: Paediatric dosing should be guided by the BNF for Children, which provides specific recommendations based on age and weight.

Adults: The specific adult dosage should be determined based on clinical guidelines and individual patient needs, as the BNF provides detailed recommendations.

Mechanism of action

Acelofenac exerts its effects by selectively inhibiting the COX-1 and COX-2 enzymes. This inhibition leads to a decrease in the production of prostaglandins, thereby reducing inflammation, pain, and fever. By lowering prostaglandin synthesis, acelofenac effectively alleviates symptoms associated with various inflammatory conditions.

Pharmacodynamics

The pharmacodynamics of acelofenac is characterized by its anti-inflammatory, analgesic, and antipyretic effects. The drug has a relatively rapid onset of action, making it effective for acute pain management. Acelofenac's anti-inflammatory properties also contribute to its efficacy in chronic conditions such as osteoarthritis and rheumatoid arthritis, where it helps to reduce swelling and improve joint function.

Pharmacokinetics

Acelofenac is well absorbed from the gastrointestinal tract, with peak plasma concentrations typically achieved within 1 to 3 hours after oral administration. The drug undergoes extensive hepatic metabolism, primarily via the cytochrome P450 system, resulting in various metabolites. Its elimination half-life ranges from 2 to 5 hours, with renal excretion being the primary route of elimination for both the parent compound and its metabolites.

Contra-indications

• Active gastrointestinal bleeding
• Severe liver impairment
• Severe renal impairment
• Hypersensitivity to acelofenac or any of its excipients
• History of hypersensitivity reactions to other NSAIDs

Adverse effects

• Gastrointestinal disturbances (e.g., nausea, vomiting, diarrhea)
• Gastrointestinal ulceration or bleeding
• Renal impairment
• Increased blood pressure
• Headache
• Dizziness
• Skin rashes

Interactions

• Increased risk of gastrointestinal bleeding with concurrent use of other NSAIDs or anticoagulants
• May reduce the antihypertensive effect of ACE inhibitors and diuretics
• Potentially increased nephrotoxicity when used with other nephrotoxic agents

Precautions

• Use with caution in patients with a history of gastrointestinal disorders
• Monitor renal function in patients with existing renal impairment or in those taking diuretics
• Use with caution in elderly patients or those with comorbidities
• Assessment of cardiovascular status is recommended prior to initiation in at-risk patients

Pregnancy

Acelofenac is not recommended during pregnancy, particularly in the third trimester, due to potential risks to the fetus and complications during delivery.

Breast-feeding

Use with caution as it is not fully established whether acelofenac passes into human breast milk.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Tablets
• Capsules
• Topical formulations