Diclofenac - Cambia - Cataflam - Lofena - Zipsor - Voltaren - All you need to know in 5 minutes. скачать в хорошем качестве

Diclofenac - Cambia - Cataflam - Lofena - Zipsor - Voltaren - All you need to know in 5 minutes.

#analgesia #analgesics #analgesic #reumatology #osteoarthritis #osteoarthritistreatment #gout #migraine #conception #infertility #cvs #git #renalfailure #pharmaguru #medicalstudent #pharmacystudents FDA Approval Date July 28, 1988 Cambia-Cataflam-Lofena-Zipsor-Voltaren Zorvolex : Pharmacologic Category Analgesic, Nonopioid; Nonsteroidal Anti-inflammatory Drug (NSAID); Nonsteroidal Anti-inflammatory Drug (NSAID), Oral Dosage guidance: Safety: Avoid or use with caution in patients at risk for cardiovascular disease, GI disease, kidney impairment, chronic liver disease, or a bleeding diathesis. Consider proton pump inhibitor coadministration in patients at risk for GI bleeding (eg, taking dual antiplatelet therapy or an anticoagulant, 60 years of age, high diclofenac doses) Dosing: Use the lowest effective dose for the shortest duration. For diclofenac potassium and sodium salt formulations, the US maximum daily dose is 150 to 200 mg/day; however, Health Canada recommends not exceeding 100 mg/day to limit risk of vascular events (Ref). Diclofenac acid maximum dose is 105 mg/day. Dosage form information: potassium and sodium salt formulations are approximately equivalent and dosed the same. Diclofenac acid 35 mg is approximately equivalent to diclofenac salts 38.5 mg. Labeled Indications Ankylosing spondylitis: Acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis. Dysmenorrhea: Treatment of primary dysmenorrhea. Migraine, acute treatment: Acute treatment of migraine attacks with or without aura in adults. Osteoarthritis: Relief of signs and symptoms of osteoarthritis. Pain, acute: Relief of mild to moderate acute pain in pediatric patients 12 years of age (Zipsor) and adults. Rheumatoid arthritis: Relief of signs and symptoms of rheumatoid arthritis. Use: Off-Label: Adult Gout, treatment, acute flaresLevel of Evidence Mechanism of Action Reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors; has antipyretic, analgesic, and anti-inflammatory properties Other proposed mechanisms not fully elucidated (and possibly contributing to the anti-inflammatory effect to varying degrees), include inhibiting chemotaxis, altering lymphocyte activity, inhibiting neutrophil aggregation/activation, and decreasing proinflammatory cytokine levels. ALERT: US Boxed Warning Serious cardiovascular thrombotic events: Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Diclofenac is contraindicated in the setting of coronary artery bypass graft (CABG) surgery. Serious gastrointestinal bleeding, ulceration, and perforation: NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. … Nonsteroidal anti-inflammatory drugs (NSAIDs) may delay or prevent rupture of ovarian follicles. This may be associated with infertility that is reversible upon discontinuation of the medication. Consider discontinuing use in patients having difficulty conceiving or those undergoing investigation of fertility. Based on available information, NSAIDs can be continued in patients with rheumatic and musculoskeletal diseases who are planning to father a child The use of nonsteroidal anti-inflammatory drugs (NSAIDs) close to conception may be associated with an increased risk of miscarriage due to cyclooxygenase-2 inhibition interfering with implantation Diclofenac crosses the placenta. Breastfeeding Considerations Diclofenac may be present in breast milk. The milk concentration of a woman treated with oral diclofenac 150 mg/day was reported to be 100 mcg/L (equivalent to an infant dose of ~0.03 mg/kg/day). Diclofenac was not detected in breast milk when 100 mg/day orally was administered to 12 women for 7 days or as a single dose of 50 mg IM immediately postpartum. May lead to false-positive aldosterone/renin ratio (ARR) Note: Characteristics of various oral dosage forms are similar unless specifically noted below. Absorption: ~50% (systemically available). Distribution: 1.3 to 1.4 L/kg. Protein binding: 99%, primarily to albumin. Metabolism: Hepatic; undergoes first-pass metabolism; forms several metabolites Bioavailability: 55%. Half-life elimination: ~2 hours; ~1 hour (liquid filled capsule [Zipsor]). Time to peak, serum: Note: Fasted values reported; may be delayed with food. From 15 minutes to 1 hour Tablet, delayed release (diclofenac sodium): 2.3 hours. Tablet, extended release (diclofenac sodium): 5.3 hours. Excretion: Urine (~65%); bile (~35%).