What is Diclofenac?
The connection between pain and inflammation is known since ancient times. Today, the most widespread pain relieving medicines are those having antiinflammatory and analgesic effect at the same time - nonsteroidal anti-inflammatory drugs (NSAIDs).
Diclofenac creation history
Acetylsalicylic acid (Aspirin), which was synthesized by young scientist Felix Hoffman at the end of the XIX century, was a prototype of modern NSAIDS. The chemical structure and properties of acetylsalicylic acid became landmarks, which were the basis for new medicines class creation. Relatively low efficiency and toxicity of acetylsalicylic acid in high dosages have served as a strong incentive for the development of new NSAIDs. In 1966 more than 200 analogs of the 0-aminoacetic acid were synthesized during an implementation of the program for development of an anti-inflammatory drug with improved biological properties. The most interesting results were shown by Diclofenac sodium.
Originally Diclofenac was applied mainly in the treatment of rheumatological diseases, where both components of the drug are important: the expressed anti-inflammatory and strong analgetic effect. However, the application area of Diclofenac has been significantly extended. Now Diclofenac is used in surgery, traumatology and sports medicine (musculoskeletal system injuries, damage of soft tissues (bruises, sprains), post-surgery anesthesia), in neurology (to treat glossodynia, tunnel syndromes, migraine), in gynecology to treat dysmenorrhea, adnexitis, in oncology as the initial analgesic drug.
Intramuscular administration of Diclofenac sodium is an effective method to relieve kidney and liver colic. Diclofenac in a form of eye drops is used in ophthalmology. Many physicians prescribe Diclofenac to reduce various pain syndromes.
What is Diclofenac used for?
Despite a wide range of NSAIDs on the market, Diclofenac remains one of the most popular drugs among NSAIDs.
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID), which has anti-inflammatory, analgesic and febrifugal effect. The drug reduces and relieves pains in a place of application (including joint pains at rest and in motion), reduces morning constraint and swelling of joints.
Diclofenac is used to treat:
- chronic polyarthritis;
- ankylosing spondylitis;
- neuritis and neuralgia, such as cervical syndrome, lumbago, sciatica;
- acute gout attacks;
- rheumatic injuries of soft tissues;
- painful hypostases or inflammations after injuries or surgery;
- not rheumatic inflammatory painful states;
Diclofenac gel is used to treat:
- inflammatory and degenerative diseases of joints (osteochondrosis, osteoarthrosis, periarthropathia);
- rheumatism of soft tissues;
- traumatic bruises;
- sprains of muscles and sinews;
- inflammatory hypostases of soft tissues;
- the arthralgia and myalgia caused by heavy exercise stress.
Injection solution is usually prescribed, when a fast positive effect is needed or when using of suppositories is impossible.
Use of Diclofenac in rheumatology
Diclofenac has been widely used in rheumatology since its creation. Its high analgesic action along with good tolerance was the important feature, which has allowed Diclofenac to displace other NSAIDs used before.
Diclofenac is efficient to reduce a duration of morning constraint, relieve pain (at rest and in motion), decrease swelling and puffiness of joints as well as to improve functional capacity of joints, which provides increased volume of movements. Diclofenac is a number one drug to treat the majority of rheumatological diseases. It is used to treat inflammatory and degenerative rheumatic diseases (arthritis, arthroses, etc).
Use of diclofenac in medical practice, orthopedics, traumatology, sports medicine
Musculoskeletal system disorders are most common in all-medical practice. Pathology of musculoskeletal system may vary, depending on etiology and pathogenesis. Pain may be caused by an injury, degenerative processes, inflammation, dysplasias, trophic changes (osteoporosis). Mechanisms of disease development can be inflammatory, mechanical, neurogenic, etc.
The expressed analgesic effect of Diclofenac in case of moderate and severe pain, inflammatory processes arising after surgeries and injuries, fast relief of spontaneous pain and pain in motion, reduction of inflammatory hypostasis on places of injury have made this drug one of the most used in medical practice, particularly in orthopedics, traumatology, sports medicine, neurology.
The release form of Diclofenac is important in terms of orthopedic and traumatic damages treatment. Possibility to combine topical and general forms of Diclofenac allows achieving maximum efficiency with minimum possible side effects. Topical Diclofenac release forms are most widely to treat extraarticular tissue disorders (tendovaginitides, bursitis, rheumatic injury of soft tissues), injuries of sinews, sheaves, muscles and joints. The general forms, such as pills, suppositories, injections solutions are used in case of massive damages of a body (combined injuries, to relieve pain after surgery, head injuries, fractures of large bones, etc.).
Use of Diclofenac sodium in neurology
Diclofenac is also widely used in neurologic practice to relieve pain. The drug is prescribed to treat acute pack pain, tunnel syndromes (carpal channel syndrome, cubital channel syndrome, etc), migraine.
The duration of treatment and the way of administration depend on the intensity of pain. You may use Diclofenac gel for 7-10 days in case of moderate pain, which is not limiting your motion ability. Use Diclofenac sodium injections for 3-7 day in case of acute pain limiting your motions. Use oral forms of Diclofenac after treatment with injections.
Use of Diclofenac sodium in gynecology
Ability to eliminate pain and to reduce expressiveness of blood loss at primary dysmenorrhea have allowed Diclofenac to be used in gynecologic practice.
Adjust your dosage individually in case of primary dysmenorrhea. Usually, Diclofenac sodium daily dosage is 50-150 mg. The initial dosage is usually around 50-100 mg a day. The dosage can be increased up to 150 mg a day in the following several menstrual cycles in case of necessity.
Start taking Diclofenac right after the emergence of the first symptoms. You can use Diclofenac for several days, depending on dynamics of clinical symptoms. The drug can also be used to treat small pelvic inflammatory diseases, including at adnexitis.
Avoid using Diclofenac if you have:
- unclear pathological blood changes;
- peptic ulcer of stomach and duodenum;
- destructive and inflammatory diseases of intestines in aggravation phase;
- hypersensitivity to acetylsalicylic acid or other NSAIDs;- hypersensitivity to Diclofenac and other components of a drug;
- rectum inflammation
Avoid using Diclofenac for children under 12 years (injections and suppositories) and under 6 years (pills and gel).
May I use Diclofenac during pregnancy and breastfeeding?
Avoid using Diclofenac during pregnancy. If you need to use the drug during the lactation period, you should postpone breastfeeding until the end of the treatment.
Use Diclofenac under strict supervision of your doctor after a careful assessment of advantage/risk ratio if you suffer from:
- inborn hemopoiesis disorder;
- system lupus erythematosus and other connective tissue disorders;
- suspected stomach or duodenal ulcer, or a stomach ulcer under suspicion;
- erosive cankers (ulcer colitis, Crohn's disease);
- kidneys and/or liver disorders history;
- heavy arterial hypertension and/or heart failure.
Senior people and patients directly right after the surgery should also use Diclofenac with caution under a strict medical control.
Use Diclofenac with caution and under medical supervision from your health care provider if you have bronchial asthma, allergic rhinitis, mucous membrane polyps of nasal cavity as well as chronic obstructive respiratory diseases and persistent infections of respiratory tracts. Careless drug use may lead to asthma attacks, angioedema or hives.
How should I use Diclofenac and in what dosages?
Undoubted advantage of the drug is the variety of Diclofenac release forms, including pills (immediate and extended release pills), solution for injections, suppositories as well as topical release forms, such as ointments, creams, gels, spray. This variety creates conveniences adjusting an individual dosage and drug administration method depending on a type of a disorder. Opportunity to combine different ways of administration allows reducing the risk of undesirable adverse reactions.
Diclofenac sodium tablets
You can buy Diclofenac tablets in various dosages. The dosage and a method of using the drug are established individually by a medical specialist taking into account a disease severity. The average recommended dosage for adults is 100-150 mg of Diclofenac a day. The maximum daily dose of Diclofenac is 200 mg. In case of relatively mild extent of a disease and also for long time therapy, use 75-100 mg of Diclofenac a day.
The daily dosage should be divided into several single dosages. If you need to relieve night pain or morning constraint, use Diclofenac suppositories before going to bed in addition to tablets. However, the daily dosage should still not exceed 150 mg a day. Reduce your daily dosage to a minimum supporting quantity of the drug upon reaching the desired effect.
Children from 6 till 15 years old should use only Diclofenac 25 mg tablets. The daily dosage is 0.5-2 mg on each kg of body weight. The drug is used in 2-3 intakes depending on disease severity.
Teenagers from 16 till 18 years old may use Diclofenac sodium 50 mg tablets. Take a tablet with a large amount of water during your meals. Do not divide or chew Diclofenac pills.
Extended-release Diclofenac tablets
Extended-release Diclofenac tablet is a special form of the drug. The effect caused by extended-release Diclofenac tablets comes later but remains longer. The special features of this drug form allow decreasing the number of daily intakes (1-2 times a day instead of 3-4 times a day), preserving stable high concentration of the drug in the inflammation center. Thus, it is better to use extended-release Diclofenac pills for a long time treatment (in case of chronic pain syndromes).
The recommended initial dosage for adults is Diclofenac 75 mg. Use the same dosage in rather mild cases of disease as well as for long time therapy. When disease symptoms are most expressed at night or in the morning, use Diclofenac extended-release tablets before going to bed at night.
Take Diclofenac tablets during your meals. Swallow tablets entirely, without chewing them. If you need to increase the dosage, take 1-2 Diclofenac 25 mg pills in addition. The maximum daily dosage is 200 mg.
Now the Swiss pharmaceutical company Sandoz produces two-layer tablets of 75 mg. Each tablet consists of two layers and includes 12,5 mg of diclofenac of sodium of immediate release and 62,5 mg of diclofenac of sodium of the slowed-down release, thus providing both quick starts of action and long-term effect.
Children and teenagers under 18 years old should not use Diclofenac retard.
Diclofenac sodium rectal suppositories
Diclofenac rectal suppositories release form has a number of advantages. Suppositories do not cause those complications, which are possible in case of parenteral drug administration (development of muscular necroses, infiltrates and suppurations on the injection place). It is reasonable to use suppositories if it is impossible to take oral drugs (for debilitated patients, in a case of gastrointestinal disorders, etc.). There is a direct damaging effect of Diclofenac on mucous stomach cells in case of oral use. The risk of digestive tract injury remains in case of other administration methods, but it is significantly lower. That is why it is better to use Diclofenac suppositories if you have stomach or duodenum disorders.
Suppositories are often used in combination therapy: you may use either injections, or pills during the day, and use suppository before going to bed at night. Such combination creates the best therapeutic effect thanks to more even and lasting maintenance of the drug in the blood. Thus, the total daily dosage of Diclofenac should not exceed 150 mg.
Children from 6 to 15 years old should use only Diclofenac sodium 25 mg suppositories. The daily dosage is 0,5-2 mg/kg of body weight (daily dosage should be divided into 2-3 single dosages).
Teenagers from 16 to 18 years old may use Diclofenac 50mg suppositories.
The suppository is inserted into the rectum as deep as possible. It is recommended to use suppositories after preliminary purgation. Do not break suppository apart, it should be remained intaсt, because such change of the drug's storage conditions may lead to disturbance of Diclofenac sodium distribution in a body.
Diclofenac sodium injection solution
Use Diclofenac injections when you need the fast analgesic effect. Injections are usually prescribed in case of acute pain (kidney or liver colic, acute pain as a result of soft tissues damage (bruise, sprain), acute back pain, pain after surgery.
Use 1 ampoule of Diclofenac a day. However, you may use 2 injections a day with several hours interval in case of necessity. Injections can be combined with other Diclofenac release forms.
Duration of parenteral use should not exceed two days. You may continue treatment with Diclofenac pill or rectal suppositories after 2 days of injections.
In a case of intramuscular use, the drug is administered deeply in upper outside quadrant of the buttock. Use no more than 2 ampoules (150 mg) of the drug a day.
Avoid combination of two or more NSAIDs, because their efficiency remains constant, whereas the risk of side effects increases.
Diclofenac gel for topical administration
An undesirable effect of NSAID medicines on a body is almost limited if they are used as local application. Such Diclofenac release form is a mix of active drug with a basis, which provides absorption under the skin. This way of treatment allows administering the drug directly in a lesion. Thus, the impact on other body parts and tissues is minimal.
Diclofenac gel is intended, first of all, for those who cannot take an oral form of Diclofenac because of contraindications. Diclofenac gel is used in case of soft tissues injuries (bruise, sprains, backache, osteoarthrosis) 2-3 times a day.
After the gel is rubbed into the skin, no more than 6% of active ingredient gets into the blood stream. Thus, the drug quantity in muscles in the application zone approximately exceeds its level in the remote muscular tissue by three times.
You can buy Diclofenac gel over the counter online or in your local pharmacy.
Avoid using Diclofenac gel for children under 6 years old.
Diclofenac as a part of the combined drugs for a pain relief.
There are also released forms (ointments, gels), where Diclofenac is present as a main component. The combination of several medicines with different mechanisms of action allows increasing treatment efficiency.
Diclofenac side effects
Diclofenac side effects depend on individual sensitivity to the drug, size of used dosage, and duration of treatment. Most common side effects include:
- pains in epigastrium;
- gastritis up to erosive with bleeding;
- medicinal hepatitis;
- interstitial nephrite;
- aseptic meningitis;
- anaphylactic reactions.
- burning pain in a place of injection, fatty tissue necrosis;
- water retention in a body;
Skin rash, burning pain, redness is possible after using Diclofenac gel.
Avoid getting Diclofenac gel on damaged skin surface, open wounds, eyes and mucous membranes.
Use Diclofenac in the following cases after consulting with your attending physician, if you suffer from peptic ulcer of stomach and duodenum; abnormal liver or kidneys function; expressed hemopoiesis system disorders; bronchial asthma, rhinitis, polyps of nose mucous membrane; history of allergic reactions.
Can Diclofenac gel be used for children?
Strict doctor control is required if you need to use Diclofenac gel for children under 6 years.
Influence of Diclofenac to drive a car and to control mechanisms
The ability to drive a car or other activity, which demands increased attention, may be disturbed, if you were using Diclofenac for a long time (as dizziness and feeling of fatigue are among possible side effects). These side effects may be amplified by use of alcohol.
Interaction with other drugs
Increasing of lithium in blood plasma is possible if Diclofenac is used together with various lithium drugs.
The effect of antihypertensive drugs and diuretics may be decreased if they are used together with Diclofenac.
Simultaneous use of acetylsalicylic acid with Diclofenac may decrease a concentration of Diclofenac in blood plasma and increase risk of possible side effects.
Diclofenac may strengthen toxic effect of cyclosporine on kidneys.
Diclofenac may cause hypo- or hyperglycemia. Therefore, you should control glucose concentration in blood at a simultaneous use of Diclofenac with hypoglycemic drugs.
You have regular checks of blood coagulation indicators if you use Diclofenac together with anticoagulant drugs.
Store Diclofenac in dry at temperature not higher than 25 C. Keep away of reach of children and pets.
Where to buy Diclofenac without prescription?
Online pharmacies around the web offer to buy Diclofenac online without a prescription. You choose to order Diclofenac generic or Diclofenac sodium brand. Diclofenac generic if cheap analog of brand medication and it is usually available with overnight delivery.