Difenac PLUS IM (Injection)
Manufactured by: Rephco Pharmaceuticals Ltd.
Diclofenac + Lidocaine Hydrochloride Similar medicine
Difenac PLUS IM is indicated for
- Rheumatoid arthritis
- Osteoarthritis
- Ankylosing spondylitis
- Pain
- Acute gout
- Inflammation
- Tendinitis
- Actinic keratoses
- Bursitis
Precautions and warnings
People with a history of stomach ulcers, vomiting blood, black stools, ulcerative colitis, asthma or past asthma, Crohn’s disease, bleeding problems, or blood disorders need to be careful. Those who have serious liver, heart, or kidney problems, are elderly, or who have current or past high blood pressure should be closely watched. Anyone taking NSAIDs (like Diclofenac sodium) for a long time should have regular check-ups, including tests for kidney, liver, and blood function. If liver tests stay abnormal, get worse, or symptoms of liver disease appear, Diclofenac sodium should be stopped.
Side-effects
- Side-effects of Diclofenac is usually mild
- transient. It is generally well tolerated. At the starting of the treatment
- however
- patients may sometimes complain of gastrointestinal discomfort
- epigastria pain
- eructation
- nausea
- Diarrhoea
- headache
- bleeding sometime may occur. Occasionally skin rash
- peripheral oedema
- abnormalities of serum transaminase have been reported.Very rarely reported side effects include activation of peptic ulcer
- haematemesis or melena
- blood dyscrasia (extensive usage). There have been isolated reports of anaphylactoid reactions. The adverse effects due to Lidocaine mainly involve the CNS
- are usually of short duration
- and are dose related. The CNS reaction may be manifested by drowsiness
- dizziness
- disorientation
- confusion
- lightheadness
- etc. Incase of eye drops ocular burning sensation or allergic reaction may occur in 5-10% patients.
Drug Interactions
Diclofenac may raise the blood levels of methotrexate. Taking it together with other NSAIDs or blood thinners (like warfarin) increases the risk of stomach and gut bleeding. The risk of kidney problems is higher if used with ciclosporin or triamterene. In patients with serious existing corneal inflammation, using diclofenac eye drops with steroid eye drops may increase the chance of corneal damage. Colestyramine and colestipol lower the amount of diclofenac your body absorbs. Taking diclofenac after sucralfate decreases its level in the blood. Diclofenac eye drops may make acetylcholine and carbachol eye drops less effective. Diclofenac might also raise lithium and digoxin blood levels.
Diclofenac blood levels may go up if taken with cimetidine or propranolol. There is a higher chance of heart problems if taken with beta-blockers or other drugs for irregular heartbeats. Diclofenac given with IV phenytoin can increase unwanted heart effects. Low potassium from drugs like acetazolamide, loop diuretics, or thiazides can reduce how well lidocaine works. If you use phenytoin or other enzyme-inducing drugs for a long time, you may need higher doses.
Contraindications
This medication should not be used in patients who have an active or suspected peptic ulcer, gastrointestinal bleeding, or a history of asthma, hives, or severe nasal allergies triggered by aspirin or other NSAIDs.
Lidocaine should not be given to patients who are known to be allergic to amide-type local anesthetics.
Mode of actions
Diclofenac is a common NSAID (non-steroidal anti-inflammatory drug) that belongs to the phenylacetic acid group. It helps reduce inflammation, pain, and fever. It works by blocking the enzyme cyclooxygenase, which lowers the production of substances (prostaglandins) that cause inflammation.
Lidocaine is a local anesthetic of the amide type. It works by stabilizing nerve cell membranes and blocking sodium ions, which are needed for nerve signals to travel. In the heart, lidocaine decreases abnormal electrical activity and automatic signals in the ventricles and conduction system (His-Purkinje system), and shortens the time for which heart cells are activated.
Dosage & Administration
Adults: The dosage is generally one 75 mg ampoule daily. In severe cases (e.g. colic) the daily dose can exceptionally be increased to two ampoules of 75 mg, separated by an interval of a few hours.
Children: In juvenile chronic arthritis, 1-3 mg of Diclofenac sodium/kg body weight daily in divided doses.
Elderly patients: The lowest effective dosage is recommended, commensurate with age and physical status or as prescribed by the physician.
Pregnancy & Lactation
This medicine is not allowed during pregnancy. Do not use it if you are pregnant. It can be absorbed through the skin and lungs caused can damage your unborn child’s organs and cause congenital disabilities. Strict effective birth control during treatment and for six months after stopping this medicine. If you do become pregnant, stop taking this medicine and discuss your doctor right away.
There is no specific information on whether this medicine passes into breast milk or not. Considering the possible risks for the children, breastfeeding while using this medicine is not recommended and at least two weeks after the last dose. Consult your doctor before breastfeeding.
Pack Size & Price
10 amps pack Price : ৳100
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