📋 Indications & Clinical Dosage
*Pain and inflammation in rheumatoid arthritis, osteoarthritis and ankylosing spondylitis:*
Adults: 100 mg morning and evening. Children: Not recommended.
⛔ Contraindications
Active or recurrent GI bleeding or ulceration, cerebrovascular disease, history of GI bleeding or GI perforation related to previous NSAID therapy, history of recurrent GI haemorrhage, ischaemic heart disease, heart failure, peripheral arterial disease, moderate to severe renal impairment, aspirin/anti-inflammatory induced allergy.
⚠️ Precautions & Warnings
Renal, hepatic or cardiac impairment. GI disease, allergic disorders, avoid in acute porphyrias, coagulation defects, connective-tissue disorders, Crohns disease (may be exacerbated), elderly, oedema, risk factors for cardiovascular events, ulcerative colitis (may be exacerbated)
🔄 Drug Interactions
Lithium, digoxin, diuretics, other NSAIDS, Corti-costeroids, cyclosporin, quinolone antibiotics, antidiabetics, methotrexate.
⚠️ Adverse Reactions / Side Effects
Angioedema, blood disorders, bronchospasm, colitis, Crohns disease, depression, diarrhoea, dizziness, drowsiness, fluid retention, GI bleeding and ulceration, GI disturbances, haematuria, headache, hearing disturbances, hypersensitivity reactions, insomnia, nausea, nervousness, photosensitivity, raised blood pressure, rashes, renal failure (especially in patients with preexisting renal impairment), tinnitus, vertigo. Rare: hepatic damage, interstitial fibrosis associated with NSAIDs, Stevens-Johnson syndrome, toxic epidermal necrolysis, visual disturbances
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Contraindicated
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.