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Diclofenac sodium.

R E Small1

  • 1Medical College of Virginia/Virginia Commonwealth University, Richmond 23298-0581.

Clinical Pharmacy
|August 1, 1989
PubMed
Summary
This summary is machine-generated.

Diclofenac sodium, a phenylacetic acid derivative nonsteroidal anti-inflammatory agent (NSAID), effectively treats rheumatological conditions by inhibiting prostaglandin formation. It demonstrates comparable efficacy to other NSAIDs with fewer gastrointestinal and central nervous system adverse effects.

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Area of Science:

  • Pharmacology and Therapeutics
  • Rheumatology
  • Drug Metabolism and Pharmacokinetics

Background:

  • Diclofenac is a phenylacetic acid derivative and the first approved nonsteroidal anti-inflammatory agent (NSAID) in its class.
  • It functions by inhibiting cyclo-oxygenase, thereby reducing prostaglandin synthesis, leading to analgesic and antipyretic effects.

Purpose of the Study:

  • To review the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of diclofenac sodium.
  • To compare diclofenac's efficacy and safety profile against other nonsteroidal anti-inflammatory agents in treating various rheumatological conditions.

Main Methods:

  • Review of existing literature on diclofenac sodium.
  • Analysis of clinical trial data comparing diclofenac with other NSAIDs for rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis.

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  • Evaluation of pharmacokinetic data, including absorption, metabolism, and excretion.

    • Main Results:

    • Diclofenac sodium is efficiently absorbed, with peak plasma concentrations at 1.5-2.0 hours, and persists in synovial fluid despite a short plasma half-life (1.5 hours).
    • Clinical trials show diclofenac is as effective as aspirin, ibuprofen, naproxen, and indomethacin in managing pain and improving function in rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis.
    • Adverse effects, primarily gastrointestinal, were less frequent and severe compared to aspirin and indomethacin, with fewer central nervous system reactions than indomethacin.

    Conclusions:

    • Diclofenac sodium is an effective NSAID for rheumatological conditions, offering comparable efficacy to other agents.
    • Its distinct structure provides an alternative treatment option with a potentially more favorable safety profile regarding gastrointestinal and CNS adverse effects.
    • Recommended dosages vary by condition, with administration in divided doses with meals for optimal management.