Diclofenac sodium, a phenylacetic acid derivative, is a non-steroidal, anti-inflammatory, analgesic agent advocated for use in rheumatoid arthritis, degenerative joint disease, ankylosing spondylitis and allied conditions, and in the treatment of pain resulting from minor surgery, trauma and dysmenorrhoea. Published data indicate that diclofenac 75 to 150mg daily (25 to 50mg 3 times daily) is comparable in efficacy with ordinary aspirin 3 to 5g daily and indomethacin 75 to 150mg daily in rheumatoid arthritis and with indomethacin in osteoarthritis. Available data suggest that in patients with osteoarthritis diclofenac sodium is comparable in efficacy and tolerability with naproxen, ibuprofen, sulindac and diflunisal. As oral diclofenac is generally given in 3 divided daily doses it may be at a disadvantage relative to less frequent administration with naproxen, diflunisal and sulindac in rheumatoid arthritis, although there is some evidence of diclofenac's efficacy when administered twice daily, or once daily as a slow release tablet. The drug is also available as suppositories and ampoules for intramuscular injection. No one of the non-steroidal anti-inflammatory agents is the most suitable drug for all patients requiring such therapy, and diclofenac should be considered along with other drugs of its type in the arthritic patient.

Diclofenac Sodium: A Review of its Pharmacological Properties and Therapeutic Use in Rheumatic Diseases and Pain of Varying Origin

Diclofenac sodium is a nonsteroidal antiinflammatory drug (NSAID) that has been used in 120 countries since its introduction in Japan in 1974. It is currently the eighth largest-selling drug and the most frequently used NSAID in the world. Diclofenac, a phenylacetic acid derivative, is a potent inhibitor of cyclooxygenase enzyme activity, and may also interact with the lipoxygenase enzyme pathway, and with the release and reuptake of arachidonic acid. Diclofenac is almost completely absorbed, highly protein-bound, penetrates well into synovial fluid, and is extensively metabolized. Comparative studies have shown that diclofenac is at least equivalent in efficacy to aspirin and other NSAID when used for the treatment of rheumatic diseases such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Diclofenac also possesses potent analgesic properties. Clinical trials suggest that diclofenac has a favorable side-effect profile, excellent patient tolerability, and a lower patient dropout rate when compared with aspirin and other NSAID.

Review of diclofenac and evaluation of its place in therapy as a nonsteroidal antiinflammatory agent

The increases in medan scoresfluence on gastroduodenal mucosa of naproxen, 500 mg/day, and diclofenac, 100 mg/day, for 1 wk was investigated in 14 subjects in a double-blind randomized crossover study. Endoscopic examination of the gastroduodenal mucosa was carried out before and after each drug with regard to gastritis and hemorrhagic and erosive lesions. A 20-cm visual analogue scale was used for grading severity of mucosal changes. Naproxen caused statistically significant increases inmedian scores for all 3 variables, and 10 subjects showed a score increase in at least 1 variable; reaction to diclofenac occurred in only 4 subjects and the changes in median scores were not significant.

Effect of diclofenac and naproxen on gastroduodenal mucosa

Worldwide clinical safety experience with diclofenac

Voltarol: diclofenac sodium

In this two-week, double-blind, between-patient trial conducted in 79 patients with osteoarthrosis of the hip, diclofenac sodium (Voltaren®) in a dosage of 50 mg b.i.d. was compared with naproxen in a dosage of 250 mg b.i.d. At the end of the trial, 81.6% of the patients treated with diclofenac sodium and 70.3 % of those treated with naproxen felt that they had experienced an improvement in the status of their arthritic condition. In this and other parameters of therapeutic efficacy a significant improvement over pre-treatment status occurred. However, no difference was detected between the two treatment groups. In this trial the four centres differed significantly with regard to characteristics of the trial population and pre-treatment severity of disease. Nevertheless, by applying the method of Mantel & Haenszel (6), it was found that there were no statistically significant differences in the. nature of the response to the two trial treatments in the various centres. Hence, the results obtained in the t...

A double-blind multicentre comparison of diclofenac sodium and naproxen in osteoarthrosis of the hip.

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A double-blind multicentre comparison of diclofenac sodium and naproxen in osteoarthrosis of the hip.