Reflexen
Generic Name
Diclofenac Sodium
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| reflexen 25 mg tablet | ৳ 20.06 | ৳ 200.60 |
Description
Overview of the medicine
Reflexen 25 mg tablet contains Diclofenac Sodium, a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, and inflammation.
Uses & Indications
Dosage
Adults
Usually 25-50 mg, 2-3 times daily, maximum recommended daily dose is 150 mg. Should be taken with food.
Elderly
Lower doses may be required, and renal function should be carefully monitored due to increased risk of adverse effects.
Renal_impairment
Use with caution. Dosage reduction may be necessary. Avoid in severe renal impairment (CrCl <30 mL/min).
How to Take
Take the tablet orally, preferably with food or milk to minimize gastrointestinal upset. Swallow the tablet whole with a glass of water, do not chew or crush it.
Mechanism of Action
Diclofenac Sodium inhibits the activity of cyclooxygenase (COX-1 and COX-2) enzymes, which are responsible for the synthesis of prostaglandins, mediators of pain and inflammation.
Pharmacokinetics
Onset
Analgesic effect usually within 30-60 minutes.
Excretion
Approximately 60% excreted renally as metabolites, and about 30% excreted via bile and feces.
Half life
Approximately 1-2 hours (plasma elimination), but longer (6-11 hours) in synovial fluid.
Absorption
Rapidly and completely absorbed from the gastrointestinal tract. Peak plasma concentrations are typically achieved within 2-3 hours.
Metabolism
Primarily hepatic metabolism via cytochrome P450 (CYP2C9) to form inactive hydroxylated metabolites.
Side Effects
Contraindications
- Hypersensitivity to diclofenac or any other NSAID (e.g., aspirin-induced asthma, urticaria, or allergic-type reactions)
- Active gastrointestinal bleeding, peptic ulcer, or history of recurrent peptic ulcer/hemorrhage
- Severe renal or hepatic impairment
- Severe heart failure (NYHA Class IV)
- Third trimester of pregnancy
- Coronary artery bypass graft (CABG) surgery (peri-operative pain)
Drug Interactions
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Lithium, Methotrexate
Increased plasma levels of lithium and methotrexate, leading to toxicity.
Other NSAIDs or Aspirin
Increased risk of adverse effects, particularly gastrointestinal.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Increased risk of gastrointestinal bleeding.
Diuretics, ACE Inhibitors, Angiotensin Receptor Blockers
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 lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Management is primarily supportive and symptomatic. Gastric lavage or activated charcoal may be considered within the first hour of ingestion.
Pregnancy & Lactation
Avoid during the third trimester of pregnancy due to potential risk of premature closure of the fetal ductus arteriosus. Use with caution in the first and second trimesters only if the potential benefit outweighs the risk. Diclofenac passes into breast milk in small amounts; consult a doctor before use during lactation.
Side Effects
Contraindications
- Hypersensitivity to diclofenac or any other NSAID (e.g., aspirin-induced asthma, urticaria, or allergic-type reactions)
- Active gastrointestinal bleeding, peptic ulcer, or history of recurrent peptic ulcer/hemorrhage
- Severe renal or hepatic impairment
- Severe heart failure (NYHA Class IV)
- Third trimester of pregnancy
- Coronary artery bypass graft (CABG) surgery (peri-operative pain)
Drug Interactions
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Lithium, Methotrexate
Increased plasma levels of lithium and methotrexate, leading to toxicity.
Other NSAIDs or Aspirin
Increased risk of adverse effects, particularly gastrointestinal.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Increased risk of gastrointestinal bleeding.
Diuretics, ACE Inhibitors, Angiotensin Receptor Blockers
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 lethargy, drowsiness, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Management is primarily supportive and symptomatic. Gastric lavage or activated charcoal may be considered within the first hour of ingestion.
Pregnancy & Lactation
Avoid during the third trimester of pregnancy due to potential risk of premature closure of the fetal ductus arteriosus. Use with caution in the first and second trimesters only if the potential benefit outweighs the risk. Diclofenac passes into breast milk in small amounts; consult a doctor before use during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 2-3 years from the date of manufacture.
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Generic
WHO Essential Medicine
YesClinical Trials
Diclofenac has undergone extensive clinical trials since its introduction, establishing its efficacy and safety profile in various pain and inflammatory conditions. Ongoing research continues to explore its applications and long-term effects.
Lab Monitoring
- Regular monitoring of renal function (creatinine, BUN) for long-term use or in patients with renal impairment.
- Liver function tests (ALT, AST) periodically, especially in patients with pre-existing liver conditions or prolonged use.
- Complete blood count (CBC) for signs of anemia or other hematologic abnormalities during long-term therapy.
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration to minimize adverse effects.
- Assess patient's cardiovascular and gastrointestinal risk factors before initiating therapy and periodically thereafter.
- Consider co-prescription of a proton pump inhibitor (PPI) for patients at high risk of GI complications.
- Monitor renal function, liver enzymes, and blood pressure regularly, especially in elderly patients or those with pre-existing conditions.
Patient Guidelines
- Take Reflexen exactly as prescribed by your doctor and do not exceed the recommended dose.
- Take the tablet with food or milk to reduce stomach upset.
- Do not take with other NSAIDs without consulting your doctor.
- Report any signs of unusual bleeding, dark stools, severe stomach pain, or allergic reactions to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Reflexen may cause dizziness, drowsiness, or visual disturbances in some individuals. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid or limit alcohol consumption while taking Reflexen, as it may increase the risk of stomach irritation and bleeding.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
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