Clofenac Plus
- Brand:Square Pharmaceuticals Ltd.
- Product Code: Clofenac Plus (75 mg+20 mg)/2 ml
- Availability: In Stock
-
16.00Tk.
Indications
The injection contains
Diclofenac Sodium that is used to relief all grades of pain and inflammation in
a wide range of conditions including:
- Arthritic conditions such as
rheumatoid arthritis, osteoarthritis, juvenile chronic arthritis,
ankylosing spondylitis, acute gout.
- Acute musculoskeletal disorders
such as periarthritis (e.g., Frozen shoulder), tendinitis, tenosynovitis,
bursitis.
- Other painful conditions
resulting from trauma including, fracture, low back pain, sprains,
strains, dislocations, control of pain and inflammation in orthopaedic,
dental and other minor surgeries, postoperative pain, pain of renal colic
etc.
The injection also
contains Lidocaine which acts as a local anaesthetic. Therefore the possibility
of pain at the injection site, which is most likely to occur after
intramuscular injection, is minimized if the Diclofenac Sodium + Lidocaine
Hydrochloride injection is used in the above indications.
Pharmacology
Diclofenac Sodium is a potent nonsteroidal
antiinflammatory drug (NSAID) with marked analgesic and antipyretic properties.
It also has some uricosuric effects. The action of Diclofenac appeared to be
associated with the inhibition of prostaglandin synthesis. Diclofenac may
inhibit synthesis of prostaglandins by inhibiting cyclooxygenase, an enzyme
that catalyses the formation of prostaglandin precursors from arachidonic acid.
Peak plasma concentration is achieved within half an hour following injection.
Lidocaine is the most widely used local
anaesthetic drug. It acts more rapidly and is more stable than most other local
anaesthetics. It is a very useful surface anaesthetic. Like other local
anaesthetics, Lidocaine impairs the generation and conduction of nerve impulses
by slowing depolarization. The onset of anaesthesia of Lidocaine Hydrochloride
is more rapid and the duration is 1-2 hours.
Dosage & Administration
Each 2 ml ampoule
contains Diclofenac Sodium 75 mg and Lidocaine Hydrochloride 20 mg.
- Adults: One ampoule once (or in severe cases, twice) daily by
intramuscular injection.
- Renal colic: One ampoule once daily intramuscularly. A further
ampoule may be administered after 30 minutes, if necessary. The
recommended maximum daily dose of diclofenac is 150 mg, by any route. The
recommended maximum daily dose of lidocaine is 200 mg.
- Children: In juvenile chronic arthritis, 1-3 mg of
diclofenac/kg body wt. daily in divided doses.
- Elderly patients: In elderly or debilitated patients, the lowest
effective dosage is recommended, commensurate with age and physical
status.
* চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন'
Interaction
Lithium and Digoxin: Diclofenac may increase plasma
concentrations of Lithium and Digoxin.
Anticoagulants: There are isolated reports of an
increased risk of haemorrhage with the combined use of Diclofenac and
anticoagulant therapy, although clinical investigations do not appear to
indicate any influence on anticoagulant effect.
Antidiabetic
agents: Clinical studies have
shown that Diclofenac can be given together with oral antidiabetic agents
without influencing their clinical effect.
Cyclosporin: Cases of nephrotoxicity have been reported in
patients receiving Cyclosporin and Diclofenac concomitantly.
Methotrexate: Cases of serious toxicity have been reported
when Methotrexate and NSAIDs are given within 24 hours of each other.
Quinolone
antimicrobials: Convulsions may
occur due to an interaction between quinolones and NSAIDs. Therefore, caution
should be exercised when considering concomitant therapy of NSAIDs and
quinolones.
Other NSAIDs and
steroids: Co-administration of
Diclofenac with other systemic NSAIDs and steroids may increase the frequency
of unwanted effects. With Aspirin, the plasma levels of each are lowered,
although no clinical significance is known.
Diuretics: Various NSAIDs are liable to inhibit the
activity of diuretics. Concomitant treatment with potassium-sparing diuretics
may be associated with increased serum potassium levels. So, serum potassium
should be monitored.
Contraindications
It is contraindicated
for those patients who are hypersensitive to Diclofenac. In patients with
active or suspected peptic ulcer or gastrointestinal bleeding or for those
patients in whom attacks of asthma, urticaria or acute rhinitis are
precipitated by Aspirin or other NSAIDs possessing prostaglandin synthetase
inhibiting activity Diclofenac is also contraindicated. Because of the presence
of Lidocaine, this injection is also contraindicated for those patients
who are hypersensitive to local anaesthetics of the amide type, although the
incidence is very rare. In patients with Adams-Stokes syndrome or with severe
degrees of SA, AV, or intraventricular heart block in the absence of an
artificial pacemaker, and for those patients who are hypersensitive to any of
the excipients used in the formulation (Sodium Metabisulphite, Disodium
Edetate, Benzyl Alcohol, Sodium Hydroxide, Propylene Glycol), this injection is
also contraindicated.
Side Effects
Side effects to
Diclofenac Sodium and Lidocaine injection are usually mild and transient.
However if serious side effects occur the injection should be discontinued.
Gastrointestinal discomfort, nausea, diarrhea and occasionally bleeding may
occur. In very rare instances, injection site disorder may occur. In isolated
cases, abscesses and local necrosis may occur. The adverse effects due to
Lidocaine mainly involve the CNS, are usually of short duration, and are dose
related. The CNS reactions may be manifested by drowsiness, dizziness,
disorientation, confusion, lightheadedness etc.
Pregnancy & Lactation
Use in Pregnancy: It should not be prescribed during
pregnancy, unless there are compelling reasons for doing so. The lowest
effective dosage should be used. These types of drugs are not recommended
during the last trimester of pregnancy.
Use in Lactation: Very small quantities of Diclofenac may
be detected in breast milk, but no undesirable effects on the infant are to be
expected.
Precautions & Warnings
Renal: Patients with severe hepatic, cardiac or
renal insufficiency or the elderly should be kept under close observation,
since the use of NSAIDs may result in deterioration of renal function. The
lowest effective dose should be used and renal function should be monitored.
Hepatic: If abnormal liver function tests persist
or worsen, clinical signs or symptoms consistent with liver disease develop or
if other manifestations occur (eosinophilia, rash), Diclofenac should be
discontinued. All patients who are receiving long term treatment with NSAIDs
should be monitored as a precautionary measure (e.g., renal, hepatic function
and blood counts).
Overdose Effects
Symptoms following
acute NSAIDs overdoses are usually limited to lethargy, drowsiness, nausea,
vomiting, and epigastric pain, which are generally reversible with supportive
care. Gastrointestinal bleeding can occur. Hypertension, acute renal failure,
respiratory depression and coma may occur, but are rare. Anaphylactoid
reactions have been reported with therapeutic ingestion of NSAIDs, and may
occur following an overdose
Therapeutic Class
Drugs for
Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal
Anti-inflammatory Drugs (NSAIDs)
Storage Conditions
Store at temparature
not exceeding 30° C in a dry place. Protected from light.
Tags: Clofenac Plus