Adults

100 mg once daily, preferably after a meal. Max dose 100 mg/day for long-term use.

Elderly

Start with the lowest effective dose and monitor for adverse effects, especially gastrointestinal bleeding.

Renal_impairment

Use with caution; dose reduction may be required for severe impairment. Not recommended for severe renal disease (CrCl < 30 mL/min).

Onset

Onset of action is typically within 1-2 hours, with full anti-inflammatory effect taking several days.

Excretion

About 60% excreted in the urine as metabolites, and about 30% in the bile and feces.

Half life

Elimination half-life is approximately 1.5-2 hours for the active compound, but the sustained-release profile extends its effective duration significantly.

Absorption

Well absorbed from the gastrointestinal tract. Peak plasma concentrations are reached within 4-8 hours due to the sustained-release nature.

Metabolism

Extensively metabolized in the liver, primarily by hydroxylation and subsequent glucuronidation. Metabolites are pharmacologically less active.

Lithium

Increased plasma lithium levels, leading to toxicity.

Methotrexate

Increased methotrexate toxicity.

Diuretics and ACE inhibitors

Reduced antihypertensive effect and increased risk of renal impairment.

Anticoagulants (e.g., Warfarin)

Increased risk of bleeding.