Bonacerin
Generic Name
Diacerein
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| bonacerin 750 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Bonacerin (Diacerein) is an anti-inflammatory, analgesic, and antipyretic agent used in the treatment of osteoarthritis. It has a slow onset of action and helps to reduce pain, inflammation, and slows down cartilage degradation.
Uses & Indications
Dosage
Adults
The usual recommended dose of Diacerein is 50 mg twice daily, taken with food. Treatment is typically initiated with 50 mg once daily for the first 2-4 weeks to assess gastrointestinal tolerance, then increased to 50 mg twice daily. A 750 mg tablet is a significantly higher dose than standard Diacerein formulations (which are typically 50 mg) and would require specific medical guidance for its appropriate dosing regimen, if such a formulation exists.
Elderly
No specific dose adjustment is generally required, but caution is advised in elderly patients, especially those with renal impairment. Initial low dose (50 mg once daily) may be considered.
Renal_impairment
In patients with severe renal impairment (creatinine clearance < 30 mL/min), the dose should be reduced by half (e.g., 50 mg once daily). No adjustment needed for mild to moderate impairment.
Hepatic_impairment
Contraindicated in severe hepatic impairment. Caution is advised in moderate hepatic impairment, and dosage adjustment may be necessary with close monitoring.
How to Take
Take orally with food (usually with morning and evening meals). This helps to increase absorption and reduce the incidence of gastrointestinal side effects.
Mechanism of Action
Diacerein inhibits the synthesis and activity of interleukin-1 beta (IL-1β), a pro-inflammatory cytokine and a major mediator of cartilage degradation in osteoarthritis. It also inhibits phagocytosis and migration of macrophages, and production of superoxide radicals.
Pharmacokinetics
Onset
Slow onset of action; therapeutic effects are usually observed after 2-4 weeks of treatment.
Excretion
Primarily excreted renally (about 30-60% as rhein and its conjugates).
Half life
The plasma half-life of rhein is approximately 4-8 hours.
Absorption
Well absorbed after oral administration, undergoes rapid deacetylation to its active metabolite, rhein. Bioavailability is about 35-56%.
Metabolism
Extensively metabolized in the liver to the active metabolite rhein, and then further metabolized to rhein glucuronide and rhein sulfate.
Peak plasma concentration
Rhein peak plasma concentration is reached 2-4 hours after oral administration.
Side Effects
Contraindications
- Hypersensitivity to Diacerein or any excipients
- Inflammatory bowel disease (ulcerative colitis, Crohn's disease)
- Severe hepatic impairment
- Severe renal impairment (CrCl < 30 mL/min) unless dose adjusted
- Pregnancy and lactation
- Children under 15 years of age
- Concomitant use with laxatives
Drug Interactions
Antacids
May reduce the absorption of Diacerein. Administer at least 2 hours apart.
Diuretics
May increase risk of dehydration in case of severe diarrhea.
Laxatives
Concomitant use is contraindicated due to increased risk of diarrhea.
Other GI irritants
Caution with other medications that can cause gastrointestinal irritation (e.g., NSAIDs).
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose typically involve severe diarrhea and other gastrointestinal disturbances. Management is symptomatic and supportive, including fluid and electrolyte replacement if severe diarrhea occurs.
Pregnancy & Lactation
Diacerein is contraindicated during pregnancy and lactation due to insufficient data on safety and potential for adverse effects on the fetus/infant. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved in Bangladesh (DGDA)
Patent Status
Patent expired for generic Diacerein
Clinical Trials
Numerous clinical trials have demonstrated the efficacy of Diacerein in reducing pain and improving function in patients with osteoarthritis, with a slow, symptomatic effect and potential chondroprotective properties.
Lab Monitoring
- Liver function tests (LFTs) should be monitored before starting treatment, and periodically thereafter, especially in patients with a history of liver disease, or if symptoms suggest liver injury.
- Renal function should be monitored in elderly patients or those with known renal impairment.
Doctor Notes
- Emphasize the slow onset of action and the importance of continuous treatment.
- Monitor liver function tests periodically, especially in patients with pre-existing liver disease or those on prolonged treatment.
- Counsel patients on potential gastrointestinal side effects, particularly diarrhea, and advise immediate reporting of severe symptoms.
- Contraindicated in severe hepatic impairment, IBD, pregnancy, and lactation.
- Ensure patients understand that this is not for acute pain relief but for long-term management of osteoarthritis.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Always take Diacerein with food to minimize gastrointestinal side effects.
- Report any persistent or severe diarrhea to your doctor immediately.
- Do not take laxatives concurrently with Diacerein.
- Your urine may turn dark yellow or brownish; this is harmless and expected.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Diacerein is not known to affect the ability to drive or operate machinery.
Lifestyle Advice
- Maintain a healthy weight to reduce stress on your joints.
- Engage in regular, low-impact exercise suitable for osteoarthritis.
- Follow a balanced diet.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.