Medicine Information

clofenac

Name: clofenac
Brand: clofenac

Suppository25 mgNSAIDs (Non-steroidal anti-inflammatory drugs)ATC: M01AB05

Generic Name

diclofenac-25-mg-suppository

Manufacturer

Various (e.g., Novartis, Square Pharmaceuticals)

Country

Global

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
clofenac 25 mg suppository	৳ 16.00	N/A

Description

Overview of the medicine

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, and fever. The 25 mg suppository is typically used for conditions requiring rapid action or when oral administration is not feasible.

Uses & Indications

Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis

Acute musculoskeletal pain (e.g., sprains, strains)

Post-operative pain and inflammation

Dysmenorrhea (menstrual pain)

Migraine attacks (as an adjunct)

Fever management in children (25 mg strength often used for pediatric or lower dose needs)

Dosage

Adults

Usually 25-50 mg, 1-3 times daily, rectally. Maximum 150 mg/day.

Elderly

Use lowest effective dose for the shortest duration possible. Monitor for adverse effects.

Renal_impairment

Use with caution. Dosage reduction may be necessary in severe impairment. Not recommended in severe renal failure.

How to Take

For rectal administration only. Insert gently into the rectum after removing the wrapper. Avoid breaking the suppository.

Mechanism of Action

Diclofenac inhibits cyclo-oxygenase (COX-1 and COX-2) enzymes, which are responsible for the synthesis of prostaglandins. Prostaglandins are mediators of inflammation, pain, and fever.

Pharmacokinetics

Onset

Within 30-60 minutes.

Excretion

Approximately 60% excreted in urine, mainly as metabolites; 30-40% excreted in bile/faeces.

Half life

Plasma elimination half-life is approximately 1-2 hours.

Absorption

Rapidly and completely absorbed from the rectal mucosa.

Metabolism

Extensively metabolized in the liver, primarily by CYP2C9, to inactive metabolites.

Side Effects

Contraindications

Hypersensitivity to diclofenac or other NSAIDs (e.g., aspirin-induced asthma)
Active gastrointestinal bleeding, ulceration, or perforation
Severe heart failure
Severe hepatic or renal impairment
Third trimester of pregnancy
History of proctitis or rectal bleeding

Drug Interactions

Methotrexate

Increased methotrexate toxicity.

Lithium/Digoxin

Increased plasma levels of lithium/digoxin.

Diuretics/ACE Inhibitors

Reduced hypotensive effect and increased risk of renal impairment.

Anticoagulants/Antiplatelets

Increased risk of bleeding.

Other NSAIDs/Corticosteroids

Increased risk of GI adverse effects.

Storage

Store below 30°C. Protect from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose may include headache, nausea, vomiting, epigastric pain, gastrointestinal bleeding, diarrhea, disorientation, excitation, coma, drowsiness, tinnitus, and convulsions. In cases of significant poisoning, acute renal failure and liver damage are possible. Management is symptomatic and supportive.

Pregnancy & Lactation

Avoid in the third trimester of pregnancy due to risk of premature closure of fetal ductus arteriosus and impaired renal function. Use with caution in first and second trimesters, only if potential benefit outweighs risk. Diclofenac passes into breast milk in small amounts; generally not recommended during lactation.

Side Effects

Contraindications

Hypersensitivity to diclofenac or other NSAIDs (e.g., aspirin-induced asthma)
Active gastrointestinal bleeding, ulceration, or perforation
Severe heart failure
Severe hepatic or renal impairment
Third trimester of pregnancy
History of proctitis or rectal bleeding

Drug Interactions

Methotrexate

Increased methotrexate toxicity.

Lithium/Digoxin

Increased plasma levels of lithium/digoxin.

Diuretics/ACE Inhibitors

Reduced hypotensive effect and increased risk of renal impairment.

Anticoagulants/Antiplatelets

Increased risk of bleeding.

Other NSAIDs/Corticosteroids

Increased risk of GI adverse effects.

Storage

Store below 30°C. Protect from light and moisture. Keep out of reach of children.

Overdose

Pregnancy & Lactation

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 suppositories per box50 suppositories per box

Shelf Life

Typically 2-3 years from manufacturing date.

Availability

Pharmacies, hospitals

Approval Status

Approved (internationally, varies by country)

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Numerous clinical trials have established the efficacy and safety of diclofenac for various pain and inflammatory conditions. Ongoing research explores new formulations and applications.

Lab Monitoring

Liver function tests (especially with long-term use)
Kidney function tests (serum creatinine, BUN)
Complete blood count (CBC) (monitor for anemia, bleeding)

Doctor Notes

Use the lowest effective dose for the shortest possible duration to minimize adverse effects.
Caution in patients with a history of GI issues, cardiovascular disease, or renal/hepatic impairment.
Monitor blood pressure, renal function, and liver enzymes in patients on long-term therapy.

Patient Guidelines

Wash hands before and after handling the suppository.
Remove the wrapper and insert the suppository gently into the rectum, pointed end first.
Lie down for a few minutes after insertion to help retain the suppository.
Do not break or cut the suppository.
Do not use if you have a history of rectal bleeding or irritation.

Missed Dose Advice

If a dose is missed, take it as soon as remembered. If it is close to the time for the next dose, skip the missed dose and continue with the regular schedule. Do not double the dose.

Driving Precautions

May cause dizziness or visual disturbances. Patients should be advised to exercise caution when driving or operating machinery if they experience these effects.

Lifestyle Advice

Avoid alcohol consumption, especially if you have a history of gastrointestinal problems, as it may increase the risk of side effects. Report any unusual symptoms to your doctor.