NSAIDs

Diclofenac

Dosage

Adult: PO Pain and inflammation As Na: 75-150 mg/day. Max: 150 mg/day.

Migraine As K: Initial: 50 mg taken at 1st sign of attack, repeat 2 hr later if needed and subsequently 4-6 hrly if needed. Max: 200 mg/day. IV Post-op pain 75 mg infusion, may repeat 4-6 hr later if needed.

Prophylaxis of post-op pain As Na: 25-50 mg via infusion after surgery followed by 5 mg/hr. Max: 150 mg/day. IM Pain and inflammation 75 mg once daily, may increase to 75 mg twice daily in severe conditions.

Renal colic As Na: 75 mg, may repeat 30 mins later if needed. Max: 150 mg/day.

Rectal Post-op pain 75-150 mg/day in divided doses. Max: 150 mg/day (inclusive of other routes of administration).

Ophth Post-op ocular inflammation As 0.1% soln: As Na: Instill 4 times/day starting 24 hr after surgery, for up to 28 days. Prevention of intra-operative miosis As 0.1% soln: As Na: Instill 4 times w/in 2 hr before surgery. Post-photorefractive keratectomy pain As 0.1% soln: As Na: Instill twice in the hr before surgery, then 1 drop twice at 5-min intervals immediately after surgery, then 2-5 hrly while awake for up to 24 hr. Allergic conjunctivitis As 0.1% soln: As Na: Instill 1 drop up to 4 times/day. Pain and discomfort after radial keratectomy As 0.1% soln: As Na: Instill 1 drop before surgery followed by 1 drop immediately after surgery, then 1 drop 4 times/day up to 2 days. Inflammation after argon laser trabeculoplasty As 0.1% soln: As Na: Instill 1 drop 4 times/day during the 2 hr before procedure followed by 1 drop 4 times/day up to 7 days after procedure. Inflammation and discomfort after strabismus surgery As 0.1% soln: As Na: Instill 1 drop 4 times/day for the 1st wk, 3 times/day for 2nd wk, twice daily for 3rd wk and as needed for 4th wk. Pain after accidental trauma As 0.1% soln: As Na: Instill 1 drop 4 times/day up to 2 days.

Topical Local relief of pain and inflammation As 1% gel: As Na: Apply 3-4 times/day. Osteoarthritis As 1.6% soln: As Na: Apply 4 times/day. Actinic keratosis As 3% gel: As Na: Apply twice daily for 60-90 days.

Oral

Sprains

Adult: As sodium: 75-150 mg daily in divided doses. Max: 150 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Oral

Strains

Adult: As sodium: 75-150 mg daily in divided doses. Max: 150 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Oral

Tendinitis

Adult: As sodium: 75-150 mg daily in divided doses. Max: 150 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Oral

Pain and inflammation associated with musculoskeletal and joint disorders

Adult: As sodium: 75-150 mg daily in divided doses. Max: 150 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Oral

Bursitis

Adult: As sodium: 75-150 mg daily in divided doses. Max: 150 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Oral

Acute gout

Adult: As sodium: 75-150 mg daily in divided doses. Max: 150 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Oral

Dysmenorrhoea

Adult: As sodium: 75-150 mg daily in divided doses. Max: 150 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Oral

Migraine

Adult: As potassium: Initially, 50 mg taken at the 1st sign of an attack, an additional dose of 50 mg may be taken after 2 hr if symptoms persist. If needed, further doses of 50 mg may be taken every 4-6 hr. Max: 200 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Intravenous

Postoperative pain

Adult: As sodium: 75 mg infusion in 5% glucose or 0.9% sodium chloride given over 30-120 minutes, may repeat after 4-6 hr if necessary.

Hepatic impairment: Dose adjustment may be needed.

Intramuscular

Bursitis

Adult: As sodium: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions.

Hepatic impairment: Dose adjustment may be needed.

Intramuscular

Sprains

Adult: As sodium: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions.

Hepatic impairment: Dose adjustment may be needed.

Intramuscular

Strains

Adult: As sodium: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions.

Hepatic impairment: Dose adjustment may be needed.

Intramuscular

Tendinitis

Adult: As sodium: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions.

Hepatic impairment: Dose adjustment may be needed.

Intramuscular

Pain and inflammation associated with musculoskeletal and joint disorders

Adult: As sodium: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions.

Hepatic impairment: Dose adjustment may be needed.

Intramuscular

Acute gout

Adult: As sodium: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions.

Hepatic impairment: Dose adjustment may be needed.

Intramuscular

Dysmenorrhoea

Adult: As sodium: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions.

Hepatic impairment: Dose adjustment may be needed.

Intramuscular

Renal colic

Adult: As sodium: 75 mg, may repeat once after 30 minutes if needed. Max: 150 mg/day.

Hepatic impairment: Dose adjustment may be needed.

Intravenous

Prophylaxis of postoperative pain

Adult: As sodium: 25-50 mg infusion given after surgery over 15-60 minutes followed by 5 mg/hr. Max: 150 mg daily.

Hepatic impairment: Dose adjustment may be needed.

Ophthalmic

Postoperative ocular inflammation

Adult: As sodium (0.1% solution): Instill into the appropriate eye 4 times daily starting 24 hr after surgery for up to 28 days.

Ophthalmic

Prophylaxis of intra-operative miosis

Adult: As sodium (0.1% solution): Instill into the appropriate eye 4 times within 2 hr before surgery.

Ophthalmic

Post-photorefractive keratectomy pain

Adult: As sodium (0.1% solution): Instill into the eye twice in the hr before surgery, then 1 drop twice at 5-minute intervals immediately after surgery, then every 2-5 hr while awake for up to 24 hr.

Ophthalmic

Seasonal allergic conjunctivitis

Adult: As sodium (0.1% solution): Instill 1 drop into the affected eye(s) up to 4 times daily.

Ophthalmic

Pain and discomfort after radial keratotomy

Adult: As sodium (0.1% solution): Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.

Ophthalmic

Control of inflammation after argon laser trabeculoplasty

Adult: As sodium (0.1% solution): Instill 1 drop 4 times during the 2 hr before procedure followed by 1 drop 4 times daily, up to 7 days after procedure.

Ophthalmic

Inflammation and discomfort after strabismus surgery

Adult: As sodium (0.1% solution): Instill 1 drop 4 times daily for the 1st wk; then tid in the 2nd wk, bid in the 3rd wk, and as required for the 4th wk.

Ophthalmic

Pain after accidental trauma

Adult: As sodium (0.1% solution): Instill 1 drop 4 times daily for up to 2 days.

Topical/Cutaneous

Local symptomatic relief of pain and inflammation

Adult: As sodium (1% gel): Apply onto affected area 3-4 times daily.

Hepatic impairment: Dose adjustment may be needed.

Topical/Cutaneous

Osteoarthritis

Adult: As sodium (1.6% solution): Apply in small amounts (20-40 drops) onto affected area 4 times daily.

Hepatic impairment: Dose adjustment may be needed.

Topical/Cutaneous

Actinic keratoses

Adult: As sodium (3% gel): Apply bid for 60-90 days.

Hepatic impairment: Dose adjustment may be needed.

Rectal

Postoperative pain

Adult: 75-150 mg daily, in divided doses (25 mg, 50 mg and 100 mg suppositories only). Max: 150 mg/day (inclusive of diclofenac administered through other routes).

Child: 6-12 yr: 1-2 mg/kg/day in divided doses (12.5 mg and 25 mg suppositories only) for max of 4 days.

Hepatic impairment: Dose adjustment may be needed.

Administration Should be taken with food. (Take immediately after meals.)

Overdosage For action to be taken in the event of accidental overdose ... click to view diclofenac

Contraindications Active peptic ulcer; hypersensitivity to diclofenac or other NSAIDs. Treatment of perioperative pain in CABG surgery. 3rd trimester of pregnancy. Topical: Not to be applied onto damaged or nonintact skin.

Special Precautions History of GI ulceration; impaired cardiac, renal or hepatic function; hypertension; lactation. IV admin in patients with moderate or severe renal impairment; hypovolaemia or dehydration; asthma, porphyria. Monitor LFTs in patients on prolonged therapy. May prolong bleeding time; caution when used in patients with coagulation disorders or on anticoagulants. Prolonged therapy may increase risk of anaemia. 1st and 2nd trimester of pregnancy. Elderly, debilitated patients.

Adverse Drug Reactions GI disturbances; headache, dizziness, rash; GI bleeding, peptic ulceration; abnormalities of kidney function. Pain and tissue damage at Inj site (IM); local irritation (rectal); transient burning and stinging (ophthalmic).

Potentially Fatal: Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis.

Drug Interactions Not to be given IV to patients who are receiving other NSAIDs or anticoagulants including low dose heparin. Renal function may be worsened when used with ciclosporin or triamterene. Altered absorption when given with sucralfate, colestyramine or colestipol. Ophthalmic application of diclofenac may reduce the efficacy of ophthalmic acetylcholine and carbachol. Increased risk of GI ulceration and bleeding when used with corticosteroids, aspirin or anticoagulants.

Potentially Fatal: Increases blood levels of digoxin, lithium and methotrexate. Potentiate potassium-sparing diuretics.

Manufacturer Neon Labs

Contents diclofenac sodium.

JUSTIN INJ inj

25 mg x 1 mL x 3mlx10 (99 INR)

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