Medicine Information

Diclofen

Name: Diclofen
Brand: Diclofen
Rating: 4.5 (117 reviews)

Suppository25 mgNSAIDs (Non-Steroidal Anti-Inflammatory Drugs), Pain Management, Anti-rheumaticATC: M01AB05

Generic Name

Diclofenac 25 mg Suppository

Manufacturer

Example Pharmaceutical Co. Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
diclofen 25 mg suppository	৳ 12.09	N/A

Description

Overview of the medicine

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, and inflammation. The 25 mg suppository form is often used for rectal administration, particularly when oral administration is not feasible or for local effects.

Uses & Indications

Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis

Acute gout attacks

Post-operative pain and inflammation

Dysmenorrhea (menstrual pain)

Fever associated with inflammation

Dosage

Adults

Usually 25-50 mg, 1-3 times daily. Maximum daily dose should not exceed 150 mg. For rectal administration, one 25 mg suppository 1 to 3 times daily as directed by a physician.

Elderly

Use with caution and at the lowest effective dose due to increased risk of adverse effects, especially renal and gastrointestinal.

Renal_impairment

Initial dose reduction may be necessary. Monitor renal function closely. Avoid in severe renal impairment.

How to Take

For rectal administration only. Wash hands thoroughly before and after use. Remove the suppository from its wrapper and insert it gently into the rectum, pointed end first.

Mechanism of Action

Diclofenac inhibits prostaglandin synthesis by reversibly inhibiting cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. This leads to a reduction in inflammation, pain, and fever.

Pharmacokinetics

Onset

Analgesic effect begins within 30-60 minutes.

Excretion

Approximately 60% of the dose is excreted in the urine as metabolites, and about 30% in the bile and feces.

Half life

Plasma elimination half-life is approximately 1-2 hours, but therapeutic effects can last longer due to accumulation in synovial fluid.

Absorption

Rapidly absorbed from the rectal mucosa; peak plasma concentrations achieved within 30-60 minutes.

Metabolism

Primarily metabolized in the liver by hydroxylation and glucuronidation, mainly by CYP2C9, CYP2C19, and CYP3A4 enzymes.

Side Effects

Contraindications

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

Drug Interactions

Corticosteroids

Increased risk of gastrointestinal ulceration or bleeding.

Lithium, Methotrexate

Increased plasma levels of these drugs, leading to toxicity.

Anticoagulants (e.g., Warfarin)

Increased risk of bleeding.

SSRIs (Selective Serotonin Reuptake Inhibitors)

Increased risk of gastrointestinal bleeding.

Diuretics, ACE inhibitors, Angiotensin II receptor blockers (ARBs)

Reduced antihypertensive effect and increased risk of renal impairment.

Storage

Store in a cool, dry place 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 syncope. Acute renal failure and liver damage are possible. Management is symptomatic and supportive. Gastric emptying (e.g., activated charcoal) is not relevant for suppositories; however, general supportive care should be provided.

Pregnancy & Lactation

Pregnancy Category C (first and second trimesters), Category D (third trimester). Avoid in late pregnancy due to potential for premature closure of the ductus arteriosus and impaired renal function in the fetus. Use with caution during lactation; small amounts may pass into breast milk.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 suppositories per pack20 suppositories per pack

Shelf Life

Typically 2-3 years from manufacturing date.

Availability

Available in pharmacies and hospitals

Approval Status

Approved by major regulatory bodies

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have established the efficacy and safety of diclofenac in various pain and inflammatory conditions. Ongoing research continues to explore its long-term effects and comparative effectiveness.

Lab Monitoring

Complete Blood Count (CBC) with long-term use
Liver function tests (ALT, AST) periodically
Renal function tests (Creatinine, BUN) periodically

Doctor Notes

Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
Monitor for signs and symptoms of GI bleeding and cardiovascular events, especially in patients with risk factors.
Assess renal and hepatic function periodically in patients on long-term therapy.

Patient Guidelines

Use exactly as prescribed by your doctor.
Do not exceed the recommended dose or duration of treatment.
Report any unusual symptoms, especially severe stomach pain, black stools, or unusual bleeding/bruising, to your doctor immediately.
Avoid lying down for at least 15 minutes after inserting the suppository to ensure proper absorption.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for the 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

Diclofenac may cause dizziness or visual disturbances in some individuals. If you experience these effects, do not drive or operate machinery.

Lifestyle Advice

Avoid alcohol consumption, especially if you have a history of gastrointestinal problems, as it may increase the risk of stomach irritation and bleeding.
Maintain adequate hydration.