Naclofen

Drug name: Naclofen

Other names used:

Abitren®
Cataflam®
Modifenac®
Naklofen®
Rhumalgan®
Voltaren®

Active Ingredients: Diclofenac sodium

Therapeutic actions :
Diclofenac belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). It works by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced in response to injury or certain diseases and would otherwise go on to cause pain, swelling and inflammation. Arthritic conditions are one example of such a diseases. Diclofenac is used to relieve pain and inflammation in a wide range of conditions, including arthritis, gout, sprains, fractures, back pain and following minor surgery. All the medicines in the NSAID group reduce inflammation caused by the body's own immune system and are effective painkillers, but must be taken with or after food to avoid stomach related side effects

Indications:

A form of arthritis (ankylosing spondylitis)
Acute gout
Inflammatory disease of the joints
Lower back pain
Musculoskeletal disorders such as tendon inflammation (tendinitis), sprains, strains, dislocations and fractures
Osteoarthritis
Pain and inflammation in dental, orthopaedic and other minor surgery
Severe childhood inflammatory disease of the joints (juvenile chronic arthritis) in children aged 1-12

Contraindications and cautions:
Not to be used in:

Bleeding from the stomach or intestines or a history of this
Current or previous peptic ulcer
People in whom aspirin or other medicines in this class (NSAIDs), cause attacks of asthma, itchy rash (urticaria) or nasal inflammation (rhinitis)
Suspected peptic ulcer

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Use with caution in:

A type of life long inherited blood disease caused by a defect in the liver (hepatic porphyria)
Asthma or history of asthma
Bleeding tendencies
Blood clotting disorders
Blood disorders
Crohn's disease
Current or previous heart failure
Current or previous high blood pressure
Decreased heart function
Decreased kidney function
Decreased liver function
Elderly people
Inflammation of the bowel and back passage
People who have recently had major surgery
People with symptoms of stomach or intestinal disorders
This medicine is not recommended for use in pregnancy, particularly the third trimester, unless considered essential by your doctor. Seek medical advice from your doctor.
The medicine passes into the breast milk, but at normal doses it is unlikely to harm the baby. Discuss with your doctor.

Important

This medicine may cause dizziness and so may affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
During long-term treatment, routine blood tests are recommended to monitor kidney function, liver function and levels of blood components, particularly in the elderly.
This medicine may mask the signs and symptoms of infection.
Close medical supervision is important in people with symptoms of gastrointestinal disorders, particularly in the elderly.
Close medical supervision is important in people suffering from severe impairment of liver function

Adverse effects: Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache
Dizziness or loss of balance
Excess gas in the stomach and intestines (flatulence)
Inability of the heart to pump blood efficiently (heart failure)
Blood disorders
Skin rashes
Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
Indigestion (dyspepsia)
Ulceration of the stomach or intestine
Inflammation of the liver (hepatitis)
Loss of appetite
Severe blistering skin reaction affecting the tissues of the eyes, mouth, throat and genitals.(Stevens-Johnson Syndrome)
Bleeding from the stomach or intestine
Decreased kidney function
Allergy to active ingredients (hypersensitivity) such as facial flushing, skin rash, itch, narrowing of airways (bronchospasm) or swelling of lips, tongue or throat (angioedema)
Alteration in results of liver function tests

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

Interactions: It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Diclofenac may increase the blood levels of lithium, digoxin and methotrexate. There may be an increased risk of bleeding from the gut if diclofenac is taken with blood thinning or anti-clotting medicines such as warfarin. The effect of diuretics such as frusemide (furosemide) may be reduced by diclofenac. The use of diclofenac with potassium-sparing diuretics may result in an increase in blood potassium levels. Potassium levels should be monitored. When taken together with ciclosporin, there may an increased risk of kidney damage. There may be an increased risk of side effects such as stomach irritation if diclofenac is taken with corticosteroids such as prednisolone. Diclofenac should not be taken with any other NSAID, due to an increased risk of side effects. Convulsions may occur when diclofenac is taken together with quinolone antibiotics. This may occur in patients with or without previous history of epilepsy or convulsions.

Drug name: Naclofen suppositories
Therapeutic actions:
Naclofen suppositories contain the active ingredient diclofenac sodium, which is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are used to relieve pain and inflammation. (NB. Diclofenac is also available without a brand name, ie as the generic medicine.)
Diclofenac works by blocking the action of a substance in the body called cyclo-oxygenase (COX). Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced by the body in response to injury and certain diseases and conditions, and cause pain, swelling and inflammation.
Diclofenac blocks the production of these prostaglandins and is therefore effective at reducing inflammation and pain. Naclofen suppositories may be especially useful for people who can't take diclofenac by mouth, for example because they feel or are being sick, or have just had an operation. The suppositories melt in the rectum and the diclofenac is then absorbed into the bloodstream through the rich supply of blood vessels found in this area.

Indications:

Rheumatoid arthritis.
Osteoarthritis.
A form of arthritis affecting the joints of the spine (ankylosing spondylitis).
Acute gout.
Acute disorders of the muscles and skeleton, such as frozen shoulder (periarthritis), tendon inflammation (tendinitis), tenosynovitis, bursitis.
Painful conditions due to accidents, such as sprains, strains, dislocations, fractures.
Lower back pain.
Pain and inflammation following dental, orthopaedic (bone) and other minor surgery.

Itching or burning of the rectum.
Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting, indigestion or abdominal pain.
Excess gas in the stomach and intestines (flatulence).
Loss of appetite.
Headache.
Dizziness.
Balance disorders involving the inner ear (vertigo).
Skin rashes.
Ulceration of the stomach or intestine.
Bleeding from the stomach or intestine.
Drowsiness.
Anxiety.
Depression.
Difficulty sleeping (insomnia).
Fluid retention (oedema).
Changes in blood pressure.
Sensation of ringing or other noise in the ears (tinnitus).
Allergic reactions such as severe skin rashes, swelling of the lips, tongue and throat (angioedema) or narrowing of the airways (bronchospasm).
Kidney, liver or blood disorders.
Small increased risk of heart attack (myocardial infarction) or stroke, particularly at high doses (150mg daily) and in long-term treatment.