Adult 75 mg or 100 mg daily. Max dose: 100 mg daily. Elderly & patient w/ low body wt Initially 75-100 mg daily. Chronic treatment & in mild cases 75 mg daily. Taken preferably in the evening if symptoms are most severe during the night or in the morning.
Should be taken with food: Swallow whole w/ liqd, do not chew/crush.
Contraindications
Hypersensitivity to diclofenac, aspirin or other NSAIDs. Patients w/ PUD/haemorrhage; history of GI bleeding or perforation related to previous NSAID therapy; active, or history of, recurrent peptic ulcer/haemorrhage. Patients w/ severe heart failure. Treatment of peri-operative pain in CABG surgery setting. Patients w/ asthma & allergic reaction eg, allergic rhinitis, urticaria, angioedema or skin rash precipitated by aspirin or other NSAIDs. Pregnancy.
Monitor renal & hepatic function, blood counts, & signs of hypersensitivity reactions during prolonged treatment. May trigger allergic reactions, including anaphylactic reactions. Reports of severe cutaneous reactions, including Stevens-Johnson syndrome & toxic epidermal necrolysis (Lyell's syndrome). Discontinue immediately if rash occurs. Caution in patients w/ cardiac impairment & coagulation disorders. Associated w/ serious liver injury in rare cases. Not recommended in patients w/ pre-existing CV or cerebrovascular disease, or presenting risk factors for CV disease. Associated w/ increased risk of serious CV adverse events (eg, MI, stroke or thrombotic events) particularly at higher doses. May lead to onset of new HTN or worsening of pre-existing HTN. Caution in patients w/ HTN. Closely monitor BP during treatment initiation & at regular intervals thereafter. Caution in patients w/ fluid retention or heart failure. Increased risk of serious GI adverse events, including bleeding/ulceration/perforation of the stomach or intestines. Discontinue immediately if GI bleeding or ulcerations occur. Concurrent use of aspirin & NSAIDs. Long-term NSAID administration has resulted in renal papillary necrosis & other renal injury. Not recommended in patients w/ advanced renal disease. May impair ability to drive or operate machinery. Patients w/ renal or hepatic impairment. Elderly. Not recommended for childn.
Increased plasma conc of digoxin & lithium. Cases of hypoglycaemic & hyperglycaemic reactions w/ oral antidiabetic agents. Increased serum K levels w/ K-sparing diuretics. Increased risk of GI side effects w/ corticosteroids, glucocorticoids or K supplements. May induce GI ulceration or bleeding w/ anticoagulant or thrombolytic therapy. Increased risk of GI side effects, including ulceration or haemorrhage, w/ concurrent use of ≥2 NSAIDs, including aspirin. May increase the risk of cyclosporine-induced nephrotoxicity. Increased risk of agranulocytosis or bone marrow depression w/ methotrexate.
M01AB05 - diclofenac ; Belongs to the class of acetic acid derivatives and related substances of non-steroidal antiinflammatory and antirheumatic products.
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