📋 Indications & Clinical Dosage
*Pain and inflammation in rheumatic disease and other musculo-skeletal disorders:*
Adult: 75-150 mg daily in 2-3 divided doses
Children 14-17 years: 75-100 mg daily in 2-3 divided doses.
*Acute gout:*
Adult: 75-150 mg daily in 2-3 divided doses.
*Postoperative pain:*
Adult: 75-150 mg daily in 2-3 divided doses
Children 9-13 years (body-weight 35 kg and above): Up to 2 mg/kg daily in 3 divided doses; max. 100 mg per day Children 14-17 years: 75-100 mg daily in 2-3 divided doses.
*Migraine:*
Adult: 50 mg, to be given at onset of migraine, then 50 mg after 2 hours if required, then 50 mg after 4-6 hours; max. 200 mg per day.
*Fever in ear, nose, or throat infection:*
Adult & Children above 9 (body-weight 35 kg and above): Up to 2 mg/kg daily in 3 divided doses; max. 100 mg per Day.
*Dysmenorrhea:*
Adult: 50 mg every 8 hr or 100 mg 1st dose, then 50 mg every 8 hr. Max: 150 mg/day (200 mg/day on 1st day).
⛔ 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
Anticoagulants, antidiabetics, diuretics.
⚠️ 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 or not recommended.
📚 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.