diclofenac metabolism

Diffusion into the joint occurs when plasma levels are higher than those in the synovial fluid, after which the process reverses and synovial fluid levels are higher than plasma levels.

Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals After observing the response to initial therapy with Diclofenac, the dose and frequency should be adjusted to suit an individual patient's needs.For the relief of osteoarthritis, the recommended dosage is 100-150 mg/day in divided doses (50 mg twice a day or three times a day, or 75 mg twice a day).For the relief of rheumatoid arthritis, the recommended dosage is 150-200 mg/day in divided doses (50 mg three times a day. 2006 Jan;79(1):125-33. doi: 10.1016/j.clpt.2005.09.014.Grenier J, Fradette C, Morelli G, Merritt GJ, Vranderick M, Ducharme MP.Clin Pharmacol Ther.

In that open-label study, a higher incidence of borderline (less than 3 times the ULN), moderate (3-8 times the ULN), and marked (greater than 8 times the ULN) elevations of ALT or AST was observed in patients receiving Diclofenac when compared to other NSAIDs.

Diclofenac sodium is a white or slightly yellowish crystalline powder and is sparingly soluble in water at 25°C.

If a patient treated with Diclofenac, has any signs or symptoms of anemia, monitor hemoglobin or hematocrit.NSAIDs, including Diclofenac, may increase the risk of bleeding events. Little or no free unchanged Diclofenac is excreted in the urine.

The average peak plasma concentration with recommended use of diclofenac sodium topical gel (4 x 4 g per day applied to 1 knee) is 158 times lower than with the oral treatment.

Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment.

Upper GI ulcers, gross bleeding, or perforation caused by NSAIDs occurred in approximately 1% of patients treated for 3-6 months, and in about 2%-4% of patients treated for one year. ).For the relief of ankylosing spondylitis, the recommended dosage is 100-125 mg/day, administered as 25 mg four times a day, with an extra 25-mg dose at bedtime if necessary.Bottles of 60 ..................................................................NDC 61442-102-60Bottles of 100 ................................................................NDC 61442-102-01Bottles of 1000 ..............................................................NDC 61442-102-10Bottles of 60 ..................................................................NDC 61442-103-60Bottles of 100 ................................................................NDC 61442-103-01Bottles of 500 ................................................................NDC 61442-103-05Bottles of 1000 ..............................................................NDC 61442-103-10Store at room temperature 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature].NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as different types of arthritis, menstrual cramps, and other types of short-term pain.These are not all the possible side effects of NSAIDs. If Diclofenac is used in patients with severe heart failure, monitor patients for signs of worsening heart failure.Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury.Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. Diclofenac is contraindicated in patients with previous serious skin reactions to NSAIDs Diclofenac may cause premature closure of the fetal ductus arteriosus.

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