Clofenac (Diclofenac): A Non-Steroidal Anti-inflammatory Drug (NSAID)

Clofenac contains Diclofenac Sodium, a potent non-steroidal anti-inflammatory drug (NSAID) with anti-rheumatic, anti-inflammatory, analgesic, and antipyretic properties. It is indicated for the relief of pain and inflammation in a wide range of conditions, including various forms of rheumatism, musculoskeletal injuries, post-operative pain, and gynecological disorders. It is also used in dentistry and ENT. Clofenac belongs to the therapeutic class of NSAIDs.

How Clofenac Works (Pharmacology)

Diclofenac's mechanism of action is to inhibit the production of prostaglandins:

• Inhibits Cyclooxygenase: It works by inhibiting the enzyme cyclooxygenase, which is a key part of the process for prostaglandin biosynthesis.
• Reduces Pain and Inflammation: Prostaglandins play a major role in causing inflammation, pain, and fever. By inhibiting their production, Diclofenac effectively reduces these symptoms.
• Uricosuric Effect: It also has a minor uricosuric effect, meaning it can help in the excretion of uric acid.
• Rapid Absorption: The drug is rapidly and completely absorbed from the gastrointestinal tract and is highly bound to plasma proteins.

Key Indications & Benefits

Clofenac is indicated for:

• Rheumatology: Inflammatory and degenerative forms of rheumatism, chronic arthritis, ankylosing spondylitis, and acute gout.
• Surgery and Traumatology: Sprains, bruises, dislocations, and post-operative pain.
• Obstetrics and Gynecology: Primary dysmenorrhea and inflammatory conditions like mastitis.
• Other indications: Renal and biliary colic, post-operative pain and inflammation in urogenital tract surgery, dentistry, and ENT.

Dosage & Administration

Clofenac is available in various forms (tablets, capsules, suppositories, injection, and gel), and the dosage varies depending on the form and the patient's age. It is often recommended to take oral forms with or after food. Always consult a registered physician for specific dosage instructions.

• Oral Tablets (Adults): 75-150 mg daily in 2-3 divided doses.
• Extended-release (SR) Tablets (Adults): One tablet daily.
• Children: 1-3 mg/kg of body weight daily in divided doses (not recommended for all indications).
• Elderly patients: The lowest effective dosage is recommended.
• Gel: 2-4 g applied to the affected area 3-4 times daily.

Important Considerations & Warnings

It is crucial to discuss your full medical history with your doctor before taking Clofenac.

Contraindications:

• Hypersensitivity to any of its ingredients.
• Active peptic ulcer.
• Patients in whom aspirin or other NSAIDs precipitate asthma attacks, urticaria, or acute rhinitis.
• The gel should not be used under occlusive dressings.

Side Effects:

• Generally well tolerated.
• Common: Epigastric pain, nausea, diarrhea, dizziness, headache.
• Rare: Peripheral edema, skin reactions (rash, eczema).
• Gel: May cause local irritation and reddening of the skin.

Pregnancy & Lactation:

• Pregnancy: It should be used during pregnancy only for compelling reasons, and the lowest effective dose should be used. It is not recommended during the first trimester. The gel is not recommended during pregnancy.
• Lactation: A very small amount may pass into breast milk, but undesirable effects on the infant are not expected.

Precautions & Warnings:

• Gastrointestinal Bleeding: In rare cases, peptic ulceration or gastrointestinal bleeding may occur.
• Elderly Patients: Should be kept under close observation.
• Topical Gel: Avoid contact with eyes or mucous membranes. Hands should be washed properly after application.

Drug Interactions:

• Lithium and Digoxin: May increase plasma concentrations of these drugs.
• Anticoagulants: May increase the risk of hemorrhage.
• Cyclosporin: Concomitant use may lead to nephrotoxicity.
• Methotrexate: Serious toxicity may occur if given within 24 hours of each other.
• Quinolone Antimicrobials: May increase the risk of convulsions.
• Other NSAIDs and Steroids: Co-administration may increase the frequency of unwanted effects.

Storage Conditions

Store in a cool and dry place, protected from light, below 30°C. Keep out of the reach of children.