Description and Indications
After advancing in age, individuals are prone to orthopedic diseases such as rheumatic arthritis due to bone degeneration or environmental factors. Such conditions often result in unbearable joint pain. Diclofenac Sodium Suppositories are western prescription medications primarily used for the treatment of rheumatic arthritis to alleviate patient discomfort. Additionally, these suppositories are also effective in treating inflammation and fever.
Pharmacological Actions
Diclofenac Sodium is a derivative of the isobutylphenolic acid class, exhibiting analgesic, anti-inflammatory, and antipyretic effects that are 2 to 2.5 times stronger than indomethacin and 26 to 50 times stronger than aspirin. Its analgesic and anti-inflammatory actions are achieved through the inhibition of cyclooxygenase, reducing prostaglandin production, and also inhibiting lipoxygenase, leading to decreased levels of leukotrienes, bradykinin, and other products.
Drug Interactions
1. Concurrent use with alcohol or other non-steroidal anti-inflammatory drugs may increase gastrointestinal side effects and pose a risk of ulceration. Long-term concurrent use with acetaminophen may increase renal toxicity.
2. Concurrent use with aspirin or other salicylates does not enhance efficacy but may increase the incidence of gastrointestinal adverse reactions and bleeding tendencies.
3. Concurrent use with anticoagulants such as heparin or dicoumarol, and platelet aggregation inhibitors may increase the risk of bleeding.
4. Concurrent use with furosemide may weaken the latter's sodium excretion and antihypertensive effects.
5. Concurrent use with verapamil or nifedipine may increase the blood concentration of diclofenac.
Adverse Reactions
1. Gastrointestinal reactions may include anal irritation, gastric discomfort, burning sensation, acid reflux, anorexia, nausea, etc. These symptoms usually resolve upon discontinuation of the drug or with appropriate treatment. In rare cases, ulceration, bleeding, or perforation may occur.
2. Neurological manifestations may include headache, dizziness, drowsiness, and excitement.
3. Renal adverse reactions may lead to edema, oliguria, and electrolyte imbalance.
4. Other rare reactions include transient elevations in liver enzymes, jaundice, rash, arrhythmia, granulocytopenia, thrombocytopenia, all of which are reversible.
Precautions
1. Caution should be exercised in patients with liver or renal dysfunction, or a history of ulceration, especially in the elderly. Routine monitoring of liver and renal function is recommended during drug administration.
2. This medication contains sodium, and should be used with caution in patients who are restricted in their sodium intake.
3. Potential interference with diagnosis: This medication may transiently elevate serum liver enzymes, decrease serum uric acid levels, and increase urinary uric acid levels due to increased renal clearance.
