Aceclofenac

It is a phenyl acetic acid derivative showing effective anti-inflammatory and analgesic properties, and a good tolerability profile in a variety of painful conditions. Aceclofenac has been shown to exert effects on many mediators of inflammation. It inhibits synthesis of the inflammatory cytokines interleukin-1b and tumour necrosis factor, and inhibits prostaglandin E2 production. In vitro data indicate inhibition of cyclo-oxygenase by aceclofenac in whole blood assays, with selectivity for COX-2 being evident. A unique feature of aceclofenac's pharmacology is that it, unlike diclofenac and some other NSAIDs, stimulates glycosaminoglycans (GAG) synthesis.

Indications

For the relief of pain and inflammation in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.

Dosage

100mg orally b.i.d. Dosage reductions are recommended in patients with hepatic impairment, with a suggested initial dosage of 100mg/day.

Contra-Indications

Hypersensitivity, GI bleeding, moderate to severe renal impairment, last three months of pregnancy

Special Precautions

Patients with GI disease, history of peptic ulceration, cerebrovascular bleeding, ulcerative colitis, Crohn's disease, systemic lupus erythmatosus, porphyria, hematopoietic or coagulation disorders. The dose should be reduced in patients with mild to moderate hepatic, renal or cardiac function impairment.

Side Effects

Indigestion, heartburn, dyspepsia, diarrhoea, nausea, abdominal pain and flatulence.

Drug Interactions

Aceclofenac may increase the plasma conc. of lithium and digoxin. Aceclofenac may inhibit the activity of diuretics. Activity of anticoagulants may be enhanced. Convulsions may occur due to interaction between quinolones and NSAIDs.