Dicloran Tablet 50mg

About Dicloran Tablet 50mg

Dicloran Tablet Uses

• Rheumatoid arthritis, including joint pain, swelling, heat, and morning stiffness.
• Osteoarthritis, including pain and reduced mobility in the knees, hips, and hands.
• Ankylosing spondylitis causing progressive stiffness and pain in the spine and sacroiliac joints.
• Acute gout attacks causing sudden severe joint pain, swelling, and redness.
• Acute musculoskeletal injuries including sprains, strains, and sports-related soft tissue injuries.
• Low back pain (lumbago) and lumbosciatica.
• Tendinitis, bursitis, and periarthritis including frozen shoulder.
• Post-operative and post-traumatic pain and swelling.
• Dental pain following procedures or oral infections.
• Menstrual cramps (primary dysmenorrhea).
• Migraine headaches during acute attacks.

Dicloran Tablet Benefits

• Diclofenac Sodium is one of the most clinically studied and widely prescribed NSAIDs globally, with a well-established efficacy profile across inflammatory and non-inflammatory pain conditions.
• Provides both analgesic and anti-inflammatory effects, addressing both the pain and the underlying swelling simultaneously.
• Effective for a broad range of pain types from joint disease to acute injury to visceral pain such as menstrual cramps.
• Available in multiple formulations including standard tablets, dispersible tablets, and enteric-coated versions, allowing selection based on speed of onset and gastrointestinal tolerability.
• Affordable and widely available across Pakistan, making it accessible for both acute and short-term chronic pain management.

What Experts Say

Dicloran contains Diclofenac Sodium, a phenylacetic acid derivative NSAID with well-characterized COX-1 and COX-2 inhibitory activity and one of the most extensively documented analgesic and anti-inflammatory medicines available.

How It Works

Diclofenac Sodium inhibits cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes, which catalyze the conversion of arachidonic acid into prostaglandins, the primary chemical mediators of pain, inflammation, and fever. By reducing prostaglandin synthesis at sites of tissue injury, Diclofenac decreases peripheral sensitization of pain receptors, reduces vascular permeability that causes swelling, and lowers elevated body temperature. Diclofenac also inhibits the lipoxygenase pathway to a minor degree, providing broader anti-inflammatory coverage than pure COX inhibitors. Its analgesic effect begins within 30 to 60 minutes of oral administration, with peak effect at 1 to 2 hours.

Sodium vs Potassium Salt

Dicloran contains Diclofenac Sodium, the original and most widely used salt form. Compared to Diclofenac Potassium, the Sodium salt has a slower rate of gastrointestinal absorption, resulting in a peak plasma concentration reached at approximately 2 hours rather than 1 hour. This makes Diclofenac Sodium better suited for regular scheduled dosing in chronic inflammatory conditions such as arthritis, where sustained plasma levels are more important than rapid onset. The enteric-coated formulation of Diclofenac Sodium further delays absorption but reduces the risk of direct gastric irritation, making it preferable for patients with a sensitive stomach.

Clinical Evidence

According to a randomized, double-blind, vehicle-controlled trial published in the journal Physical and Sports Medicine involving 492 adults with knee osteoarthritis, Diclofenac Sodium treatment over 12 weeks produced statistically significant improvements in WOMAC pain scores (p = 0.01), physical function (p = 0.001), and global disease rating (p < 0.001) compared to controls. Efficacy advantages were measurable from week 1 of treatment.

Drug Class

• Non-Steroidal Anti-Inflammatory Drug (NSAID).
• Phenylacetic Acid Derivative.

Packaging and Quantity

• Pack of 10 tablets (single strip of 10): PKR 113.
• Pack of 30 tablets (3 strips of 10): PKR 365.

When Not to Use Dicloran

• Known allergy or hypersensitivity to Diclofenac, Aspirin, or any other NSAID.
• History of asthma, urticaria, or allergic reactions triggered by Aspirin or other NSAIDs.
• Active stomach or duodenal ulcers, or a history of gastrointestinal bleeding.
• Severe liver, kidney, or heart failure.
• Third trimester of pregnancy.
• Recent or upcoming coronary artery bypass graft (CABG) surgery.

Dicloran Tablet 50mg formula

• Diclofenac Sodium

Available forms

• Tablet
• Gel
• Injection

How to use Dicloran Tablet 50mg?

• Dicloran should always be taken with food, milk, or immediately after a meal to minimize gastric irritation.
• The tablet should be swallowed whole with a full glass of water. Enteric-coated tablets must not be crushed or chewed.
• For the dispersible tablet formulation, dissolve in a glass of water before drinking. Do not swallow the tablet whole.
• Alcohol should be avoided during treatment as it significantly increases the risk of gastrointestinal bleeding.
• A doctor should be informed immediately if black or tarry stools, vomiting blood, or severe stomach pain occurs.
• The standard adult dose for pain and inflammation is 50mg two to three times daily with food, not exceeding 150mg per day. For primary dysmenorrhea, 50mg to 100mg initially, then 25mg to 50mg every 6 to 8 hours as required.
• The dose should not be changed or the course extended without consulting a doctor.

Drug Interactions

All current medicines, supplements, and herbal products must be disclosed to the prescribing doctor before starting Dicloran. Key interactions include:

• Anticoagulants such as warfarin: Diclofenac inhibits platelet aggregation and can enhance the anticoagulant effect, significantly increasing bleeding risk. INR must be monitored closely.
• Aspirin and other NSAIDs: Combining two NSAIDs provides no additional benefit and substantially increases the risk of gastrointestinal ulcers and bleeding.
• ACE inhibitors and ARBs: Concurrent use reduces their antihypertensive effect and raises the risk of acute kidney injury, particularly in elderly or volume-depleted patients.
• Diuretics: Diclofenac can reduce the effectiveness of diuretics and increase the risk of kidney impairment.
• Lithium: Diclofenac reduces renal clearance of lithium, raising blood levels and the risk of lithium toxicity. Lithium levels must be monitored.
• Methotrexate: Diclofenac reduces renal clearance of methotrexate, raising its blood levels and the risk of serious methotrexate toxicity.
• SSRIs such as fluoxetine and sertraline: Concurrent use increases the risk of gastrointestinal bleeding.
• Cyclosporine: Diclofenac may increase cyclosporine nephrotoxicity.
• Corticosteroids: Concurrent use substantially raises the risk of gastrointestinal ulcers and bleeding.

Risks and warnings

• Cardiovascular risk: All NSAIDs including Diclofenac carry an increased risk of serious cardiovascular events including heart attack and stroke. The risk is higher with long-term use and in patients with existing cardiovascular disease. Diclofenac has a higher cardiovascular risk profile than some other NSAIDs including Naproxen and Ibuprofen at equivalent doses.
• Gastrointestinal risk: Dicloran can cause gastrointestinal ulcers, bleeding, and perforation, which can be fatal. The risk is higher in patients above 65, those with a history of ulcers, and those on concurrent anticoagulants or corticosteroids.
• Kidney disease: Long-term NSAID use can reduce blood flow to the kidneys and impair function. Patients with existing kidney disease should use the lowest effective dose under close monitoring.
• Liver disease: Diclofenac is metabolized by the liver and has been associated with hepatotoxicity. Liver enzymes should be monitored in patients on long-term therapy.
• Pregnancy: Dicloran is contraindicated in the third trimester. Use in the first and second trimesters should only occur under direct medical supervision.
• Breastfeeding: Diclofenac passes into breast milk in small amounts. A doctor should be consulted before use during breastfeeding.
• Asthma: Dicloran can trigger or worsen asthma attacks, particularly in patients with aspirin-sensitive asthma. It should be stopped immediately if breathing worsens.
• Elderly patients: The risk of serious gastrointestinal bleeding, kidney impairment, and cardiovascular events is significantly higher in patients above 65. The lowest effective dose should always be used.
• Driving and machinery: Dicloran may cause dizziness. Caution is advised when driving or operating heavy machinery.

Dicloran Tablet Side Effects

Most patients tolerate Dicloran well at recommended doses when taken with food. Side effects are more common at higher doses and with prolonged use.

• Nausea or stomach discomfort.
• Acid reflux or heartburn.
• Diarrhea or constipation.
• Headache or dizziness.
• Mild ankle swelling due to fluid retention.
• Skin rash or itching.
• Elevated liver enzymes on blood tests, usually without symptoms.

Serious side effects are rare but require immediate medical attention:

• Black or tarry stools, vomiting blood, or severe abdominal pain, which may indicate gastrointestinal bleeding.
• Chest pain, sudden shortness of breath, or weakness on one side, which may indicate a cardiovascular event.
• Significant reduction in urination or unusual swelling, which may indicate kidney damage.
• Yellowing of the skin or eyes, which may indicate liver damage.
• Severe allergic reaction including facial swelling, difficulty breathing, or widespread rash.
• Worsening of asthma symptoms after taking Dicloran.

Storage Conditions

• The medication should be kept out of reach and sight of children.
• Dicloran should be kept at room temperature.