📋 Indications & Clinical Dosage
*Pain and inflammation in rheumatoid arthritis and osteoarthritis, Postoperative pain, Mild to moderate pain:*
Adult: 500 mg tab 3 times a day
Children 6 months-1 yr: 50 mg suspension eight hourly for not more than seven days; 2-4 yr: 100 mg suspension eight hourly for not more than seven days; 5-8 yr, 150 mg suspension eight hourly for not more than seven days; 9-12 yr, 200 mg suspension eight hourly for not more than seven days; above 12 yr: same as adult.
*Acute pain including dysmenorrhea, Menorrhagia:*
Adult & Children 12 yrs: 500 mg 3 times a day.
⛔ Contraindications
Active GI bleeding and ulceration, history of GI bleeding or perforation related to previous NSAID therapy, history of recurrent GI haemorrhage or ulceration (two or more distinct episodes), inflammatory bowel disease, severe heart failure, severe renal impairment, Aspirin/anti- inflammatory induced allergy.
⚠️ Precautions & Warnings
Cardiac impairment (NSAIDs may impair renal function), allergic disorders, cerebrovascular disease, coagulation defects, acute porphyrias, connective-tissue disorders, Crohns disease (may be exacerbated), elderly, epilepsy, heart failure, ischaemic heart disease, peripheral arterial disease, risk factors for cardiovascular events, ulcerative colitis (may be exacerbated), uncontrolled hypertension, hepatic impairment
🔄 Drug Interactions
Anticoagulants, quinolones, sulphonylureas,
hydantoins
⚠️ Adverse Reactions / Side Effects
Diarrhoea, rashes (withdraw treatment), stomatitis, GI bleeding and ulceration, GI disturbances, fatigue, paraesthesia, Rare: Angioedema, blood disorders, bronchospasm, colitis, Crohns disease, depression, dizziness, drowsiness, fluid retention, haematuria, hypersensitivity reactions, insomnia, nausea, nervousness, raised blood pressure, renal failure (especially in patients with pre-existing renal impairment), tinnitus, vertigo
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Avoid unless the potential benefit outweighs the risk. Avoid during the third trimester
Lactation / Breastfeeding:
Caution advised
📚 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.