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Aceclofenac, History, Uses, Side effects, Dosage, and Brands

Aceclofenac, History, Uses, Side effects, Dosage, and Brands

  • May 6, 2024
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Introduction

Aceclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and reduce inflammation. It is a derivative of phenylacetic acid and is classified as a COX-2 inhibitor, which means it works by blocking the production of certain enzymes in the body that cause pain and inflammation.

Chemical Structure

The chemical structure of aceclofenac is:

  • C₁₆H₁₃Cl₂NO₄

History

Aceclofenac was first introduced in the 1990s and has since become widely used in many countries, including Pakistan, to treat various painful conditions.

Brand Names

Aceclofenac is marketed under various brand names, including:

  • Aceclofenac (generic)
  • Rofenac (Pakistan)
  • Preserve (Pakistan)
  • Aceclon (India)
  • Dolobid (USA)

Mechanism of Action

Aceclofenac works by inhibiting the production of prostaglandins, hormone-like substances that cause pain and inflammation. It does this by blocking the action of cyclooxygenase (COX), an enzyme responsible for producing prostaglandins.

Specifically, aceclofenac

  1. Inhibits COX-2: Aceclofenac selectively inhibits the COX-2 enzyme, which is involved in the production of prostaglandins that cause pain and inflammation.
  2. Reduces prostaglandin production: By inhibiting COX-2, aceclofenac reduces the production of prostaglandins, reducing pain and inflammation.
  3. Relieves pain: Aceclofenac relieves pain by blocking the production of pain-causing prostaglandins.
  4. Reduces inflammation: Aceclofenac reduces inflammation by inhibiting the production of inflammatory prostaglandins.

Additional mechanisms

  1. Inhibits leukotriene synthesis: Aceclofenac also inhibits the production of leukotrienes, which are involved in inflammation.
  2. Antioxidant activity: Aceclofenac has antioxidant properties, which help protect cells from damage caused by free radicals.

Overall, aceclofenac’s mechanism of action is similar to other NSAIDs, but its selectivity for COX-2 makes it a more targeted and potentially safer option for pain relief.

Clinical Uses

Aceclofenac is used to treat a variety of conditions, including:

  1. Osteoarthritis

  • Relieves pain and inflammation in osteoarthritis of the hip, knee, and spine
  • Reduces joint stiffness and improves functional ability
  1. Rheumatoid Arthritis

  • Relieves pain, inflammation, and morning stiffness
  • Reduces joint swelling and improves functional ability
  1. Ankylosing Spondylitis

  • Relieves pain, inflammation, and stiffness in the spine and joints
  • Improves mobility and reduces fatigue
  1. Dental Conditions

  • Relieves toothache pain, including pain from pulpitis, abscesses, and dental caries
  • Manages post-extraction pain and inflammation
  • Relieves pain and inflammation after dental implant surgery
  1. Gynecological Conditions

  • Relieves menstrual cramps (dysmenorrhea)
  • Reduces pain and inflammation associated with endometriosis
  1. Musculoskeletal Pain

  • Relieves pain and inflammation in muscles and joints, including back pain, sciatica, and fibromyalgia
  1. Postoperative Pain

  • Manages pain and inflammation after surgery, including orthopedic and gynecological procedures

Aceclofenac’s clinical uses are based on its ability to reduce pain and inflammation, making it a versatile medication for various conditions. However, it’s essential to consult a healthcare professional for proper diagnosis and treatment.

Dosage and Administration

For Adults

The recommended dosage for adults is 100 mg of aceclofenac taken orally twice daily. This dosage may vary depending on the severity of the treated condition and individual patient response.

For Elderly Patients

Elderly patients or those with compromised renal function may require a lower dosage. In such cases, the dosage should be adjusted under the supervision of a healthcare professional.

Pediatric Use

Aceclofenac is not typically recommended for use in children under the age of 18, as its safety and efficacy have not been established in this population.

Timing

Aceclofenac is usually taken after meals to reduce the risk of stomach upset. It’s important to adhere to the prescribed dosing schedule provided by your healthcare provider.

Tablet Formulation

Aceclofenac is commonly available in tablet form. The tablets should be swallowed whole with a glass of water. Do not crush or chew the tablets, as this may alter the drug’s release profile and efficacy.

Duration of Treatment

The duration of aceclofenac treatment varies depending on the condition being treated and individual patient response. It’s essential to follow your healthcare provider’s recommendations regarding the duration of treatment.

Missed Dose

If you forget to take a dose of aceclofenac, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses to make up for a missed dose.

Overdose

In the event of an overdose, seek immediate medical attention. Symptoms of overdose may include nausea, vomiting, stomach pain, drowsiness, and dizziness.

Side effects and adverse reaction

Aceclofenac, like other nonsteroidal anti-inflammatory drugs (NSAIDs), can potentially cause various side effects. Here are some possible side effects and adverse reactions associated with aceclofenac:

Gastrointestinal Effects

  • Indigestion
  • Diarrhea
  • Gastric ulceration
  • Gastrointestinal bleeding
  • Perforation of the stomach or intestines

Cardiovascular Effects

  • Increased blood pressure
  • Fluid retention
  • Edema (swelling)
  • Increased risk of cardiovascular events such as heart attack or stroke, especially with long-term use or at high doses

Renal Effects

  • Impaired kidney function
  • Kidney injury
  • Fluid retention leading to edema

Hepatic Effects

Aceclofenac may cause liver damage or liver function abnormalities in some individuals.

Symptoms of liver damage may include yellowing of the skin or eyes (jaundice), dark urine, abdominal pain, and unusual tiredness.

Allergic Reactions

Some people may experience allergic reactions to aceclofenac, characterized by symptoms such as rash, itching, swelling (especially of the face, lips, or throat), and difficulty breathing.

Severe allergic reactions, known as anaphylaxis, are rare but can be life-threatening and require immediate medical attention.

Central Nervous System Effects

Aceclofenac may rarely cause central nervous system side effects such as headache, dizziness, drowsiness, or confusion.

These effects are usually mild and transient but should be monitored, especially when initiating treatment or adjusting the dosage.

Hematological Effects

NSAIDs, including aceclofenac, may affect blood clotting and increase the risk of bleeding or bruising, particularly when used in combination with anticoagulant medications or in individuals with bleeding disorders.

Precautions and Considerations

While using Aceclofenac it is essential to be aware of certain precautions:

Allergies and Sensitivities

If you have a known allergy or sensitivity to Aceclofenac or any other NSAIDs (such as diclofenac, ibuprofen, or aspirin), it is important to inform your healthcare professional. They can recommend an alternative medication or take necessary precautions to avoid any potential adverse reactions.

Gastrointestinal Health

Aceclofenac, like other NSAIDs, may increase the risk of gastrointestinal side effects, including stomach ulcers or bleeding. If you have a history of gastrointestinal disorders or are currently experiencing symptoms such as stomach pain, indigestion, or bleeding, it is essential to discuss this with your healthcare professional.

Cardiovascular Health

NSAIDs, including Aceclofenac, have been associated with an increased risk of cardiovascular events such as heart attack or stroke. If you have a history of cardiovascular disease, high blood pressure, or other risk factors, your healthcare professional will need to weigh the benefits and risks of using Aceclofenac.

Renal and Hepatic Impairment

Individuals with impaired kidney or liver function may require dosage adjustments or closer monitoring while taking Aceclofenac. Inform your healthcare professional about any pre-existing kidney or liver conditions.

Pregnancy and Breastfeeding

Aceclofenac is generally not recommended during pregnancy, especially in the third trimester, as it may pose risks to the developing fetus. It is also advised to avoid Aceclofenac while breastfeeding, as the medication can pass into breast milk.

Drug interaction with Aceclofenac

Aceclofenac, a nonsteroidal anti-inflammatory drug (NSAID), can interact with several other medications, which can affect how Aceclofenac works or increase the risk of side effects. Here are some key interactions to be aware of:

Anticoagulants

Aceclofenac may increase the anticoagulant activities of drugs like Abciximab. This can increase the risk of bleeding. Other blood thinners such as Acenocoumarol, Warfarin, and Strontium may also interact with Aceclofenac.

Other NSAIDs or Pain Relievers

The risk or severity of adverse effects can be increased when Aceclofenac is combined with other NSAIDs or pain relievers like Acetaminophen.

Certain Antibiotics

The metabolism of Aceclofenac can be decreased when combined with certain antibiotics like Acetyl sulfisoxazole, which could potentially increase the risk of side effects.

Skin Medications

The risk or severity of adverse effects can be increased when a skin medication like Adapalene is combined with Aceclofenac.

Esomeprazole

There may be a drug-drug interaction between Aceclofenac and Esomeprazole, a medication commonly used to treat conditions caused by excess stomach acid.

Alcohol

Consumption of alcohol while taking Aceclofenac may increase the risk of stomach bleeding.

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