📋 Indications & Clinical Dosage
*Musculoskeletal disorders; rheumatic pain, osteoarthritis, and ankylosing spondylitis, post-operative pain, traumatic pain, dysmenorrhoea, migraine, toothache:*
Adults: 20 mg once daily, can be increased to 40 mg daily. Elderly, Patients can be given 10 mg (half tab). 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, cardiac 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
Anticoagulants, other NSAIDs, hypoglycaemics, lithium.
⚠️ 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, headache, 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, oedema, CNS effects, malaise, tinnitus.
🤰 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.