📋 Indications & Clinical Dosage
*Osteoarthritis, rheumatoid arthritis:*
Adult: 10 mg once daily; max 20 mg once daily.
*Dysmenorrhoea:*
Adult: 40 mg once daily. On first day of treatment an additional 40 mg dose may be taken if necessary; max 40 mg once daily.
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
Warfarin, other anticoagulants, antihypertensives cyclosporin, tacrolimus, rifampicin, lithium, oral con-traceptives, inhibitors or substrates of CYP3A4, 2C9, 2C19 or 2D6.
⚠️ 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),dry mouth, hypertension, peripheral oedema, insomnia, somnolence, anaemia, respiratory symptoms, skin reactions.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Use only when no safer alternative exists for a serious problem.
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.