📋 Indications & Clinical Dosage
*Painful joint and rheumatic disorders, arthritis, poly-arthritis, acute articular rheumatism, osteoarthrosis spondylarthritis acute gouty arthritis, muscular sprains and strainsin distortions and fractures, extra articular and peri-articular affections:*
Adults: Initial: 450-600 mg daily in 2 divided doses at meals for 2 week. Maintenance: 300-450 mg daily in 2 divided doses at meals.
Children: Not recommended.
⛔ Contraindications
Active GI bleeding or ulceration, history of GI bleeding or perforation related to previous NSAID therapy, history of recurrent GI haemorrhage or ulceration (two or more distinct episodes), severe heart failure, aspirin/anti-inflammatory induced allergy, hepatic and renal failure
⚠️ Precautions & Warnings
Allergic disorders, impairment, cerebrovascular disease, coagulation defects, connective-tissue disorders, Crohns disease, elderly, heart failure, ischaemic heart disease, peripheral arterial disease, risk factors for cardiovascular events, ulcerative colitis (may be exacerbated), uncontrolled hypertension, renal or hepatic impairment, monitor on long-term therapy, asthma
🔄 Drug Interactions
Salicylates, anticoagulants, lithium, corticosteroids, diuretics, beta-blockers, probenecid, quinolones.
⚠️ Adverse Reactions / Side Effects
Abdominal pain, angioedema, blood disorders, bronchospasm, colitis, Crohns disease, depression, diarrhoea, dizziness, drowsiness, fluid retention, GI bleeding and ulceration, GI disturbances, haematuria, persistent headache (discontinue if occur), corneal deposits, retinal disturbances (perform periodic eye tests on long term use), hearing disturbances, hypersensitivity reactions, 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
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Positive evidence of risk: Use only when no safer alternative exists for a serious problem.
Lactation / Breastfeeding:
Caution advised, avoid
📚 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.