Indications And Dose
Pain and inflammation in rheumatoid arthritis, osteoarthritis and ankylosing spondylitis ▶BY MOUTH ▶Adult: 100 mg twice daily
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Drug reference
Pain and inflammation in rheumatoid arthritis, osteoarthritis and ankylosing spondylitis ▶BY MOUTH ▶Adult: 100 mg twice daily
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Active bleeding. active gastro- intestinal bleeding. active gastro-intestinal ulceration. bleeding disorders. cerebrovascular disease. history of gastro-intestinal bleeding related to previous NSAID therapy. history of gastro-intestinal perforation related to previous NSAID therapy. history of recurrent gastro- intestinal haemorrhage (two or more distinct episodes). history of recurrent gastro-intestinal ulceration (two or more distinct episodes). ischaemic heart disease. mild to severe heart failure. peripheral arterial disease
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Allergic disorders. avoid in Acute porphyrias p. 1120. cardiac impairment (NSAIDs may impair renal function). connective-tissue disorders. dehydration (risk of renal impairment). elderly (risk of serious side-effects and fatalities). history of cardiac failure. history of cerebrovascular bleeding. history of gastro-intestinal disorders (e.g. ulcerative colitis, Crohn’s disease). hypertension. oedema. risk factors for cardiovascular events
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Contra-indicated in patients with a history of hypersensitivity to aspirin or any other NSAID—which includes those in whom attacks of asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or any other NSAID.
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→Appendix 1: NSAIDs
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▶Common or very common Diarrhoea. dizziness. gastrointestinal discomfort. nausea ▶Uncommon Constipation. gastrointestinal disorders. oral disorders. skin reactions. vomiting ▶Rare or very rare Anaemia. angioedema. bone marrow disorders. depression. drowsiness. dyspnoea. fatigue. haemolytic anaemia. haemorrhage. headache. heart failure. hepatic disorders. hyperkalaemia. hypersensitivity. hypertension. inflammatory bowel disease. leg cramps. nephrotic syndrome. neutropenia. oedema. palpitations. pancreatitis. paraesthesia. renal failure (more common in patients with pre-existing renal impairment). respiratory disorders. severe cutaneous adverse reactions (SCARs). sleep disorders. taste altered. thrombocytopenia. tinnitus. tremor. vasculitis. vasodilation. vertigo. visual impairment. weight increased ▶Frequency not known Acute coronary syndrome. agranulocytosis. asthma. confusion. hallucination. increased risk of arterial thromboembolism. increased risk of ischaemic stroke. malaise. meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible). nephritis tubulointerstitial. optic neuritis. photosensitivity reaction . platelet aggregation inhibition. respiratory tract reaction SIDE-EFFECTS, FURTHER INFORMATION For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non- steroidal anti-inflammatory drugs. p. 1193
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Caution—long-term use of some NSAIDs is associated with reduced female fertility, which is reversible on stopping treatment.
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Most manufacturers advise avoiding the use of NSAIDs during pregnancy or avoiding them unless the potential benefit outweighs the risk. NSAIDs should be avoided during the third trimester because use is associated with a risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn. In addition, the onset of labour may be delayed and its duration may be increased.
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Use with caution during breast-feeding. Manufacturer advises avoid.
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Manufacturer advises caution in mild to moderate impairment; avoid in hepatic failure. Dose adjustments Manufacturer advises consider initial dose reduction to 100 mg daily in mild to moderate impairment.
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Avoid if possible or use with caution; avoid in moderate to severe impairment. Dose adjustments The lowest effective dose should be used for the shortest possible duration. Monitoring In renal impairment monitor renal function; sodium and water retention may occur and renal function may deteriorate, possibly leading to renal failure.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Aceclofenac (Non-proprietary) Aceclofenac 100 mg Aceclofenac 100mg tablets | 60 tablet P £9.62 DT = £9.62 ▶Preservex (Almirall Ltd) Aceclofenac 100 mg Preservex 100mg tablets | 60 tablet P £9.63 DT = £9.62
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100 mg twice daily
First-line fragment. Read the complete Indications and Dose section above.
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