Medical Uses and Adverse Effects of Diclofenac

About the Study

Diclofenac is a nonsteroidal anti-inflammatory medicine used to treat pain and inflammatory conditions including gout. It is also marketed under the trade names Voltaren and other names. It can be used topically, injected, or taken by mouth or rectally via a suppository. Pain relief can persist for up to eight hours. It can also be used in conjunction with misoprostol to lessen gastric issues. It is renowned for causing population declines in vultures. Abdominal pain, gastrointestinal bleeding, nausea, vertigo, headaches, and edoema are typical adverse effects. Heart disease, stroke, kidney issues, and stomach ulcers are examples of serious adverse effects. It is thought to function via reducing prostaglandin synthesis. It is a COX-2 inhibitor since it inhibits both COX-1 and COX-2.

Musculoskeletal complaints, particularly arthritis, rheumatoid arthritis, polymyositis, dermatomyositis, and osteoarthritis, as well as dental pain, temporomandibular joint pain, spondylarthritis, ankylosing spondylitis, gout attacks, and pain control for kidney and gallstones are examples of inflammatory disorders. The management of acute migraines is a further indication. It is particularly beneficial for treating endometriosis and menstrual pain. Ciba-Geigy received the patent for diclofenac in 1965, and it wasn't until 1988 that it was used in American medicine. As a generic drug, it is accessible. It comes in sodium or potassium salt forms Musculoskeletal complaints, such as arthritis, rheumatoid arthritis, polymyositis, dermatomyositis, osteoarthritis, dental pain, temporomandibular joint pain, spondylarthritis, ankylosing spondylitis, gout attacks, and pain control in cases of kidney stones and gallstones, can be caused by inflammatory disorders. Another possibility is the treatment of severe migraines. When inflammation is also present, diclofenac is usually used to treat mild to severe postoperative or posttraumatic pain. It is also effective against menstruation pain and endometriosis. Diclofenac is also available topically, however it has only been found to be effective in treating osteoarthritis and not in treating other persistent musculoskeletal pain conditions. Additionally, actinic keratosis and acute discomfort from small contusions, sprains, and strains may benefit from it. Eye drops are available for purchase in several nations to treat both acute and persistent nonbacterial inflammation of the eyes' anterior segments. Using diclofenac eye drops to treat severe corneal abrasion discomfort is another option. 32 grammes of diclofenac gel should not be used per day. A study involving coxib, diclofenac, ibuprofen, and naproxen also included diclofenac and found that its use was substantially more likely to raise the risk of vascular and cardiovascular disease. Other reported issues involved the upper gastrointestinal system. Diclofenac caused a roughly 30% increase in significant adverse cardiovascular events, mostly because there were more major coronary events. Of the 1000 patients given diclofenac for a year as opposed to the placebo, three more experienced significant vascular events, one of which was fatal. Diclofenac dramatically raised the risk of vascular death in October 2020 in US. Like with most NSAIDs, it is believed that COX-inhibition inhibits prostaglandin synthesis, which is the main mechanism underlying its anti-inflammatory, antipyretic, and analgesic effects. Both COX-1 and COX-2 are relatively equally inhibited by diclofenac. Prostaglandin-endoperoxide synthase-2 (PGES-2), also known as cycloxygenase-2, appears to be the primary target in the suppression of prostaglandin synthesis (COX-2). By stopping the creation of bacterial DNA, it also seems to have bacteriostatic properties. Diclofenac is one of the few NSAIDs that can reach the brain via bridging the blood-brain barrier because of its relatively high lipid solubility. It is believed that it works by inhibiting COX-2 in the brain as well.