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DESCRIPTION:
Diclofenac is very commonly used NSAID. It has analgesic, anti-pyretic and anti-inflammatory action. It is well tolerated hence promotes patient's compliance. Serratiopeptidase is a versatile enzyme. It reduces the permeability and fibrinolysis in acute inflammation. It prevents post-operative bleeding, swelling and inflammatory oedema. It is highly effective in pelvic inflammatory diseases.
MECHANISM OF ACTION:
Diclofenac is an inhibitor of cyclooxygenase. It also appears to reduce intracellular concentrations of free arachidonate in leukocytes. Its potency is greater than indomethacin, naproxen etc. Serratiopeptidase binds to alpha-2-macroglobulin in the blood in the ratio of 1:1 which helps to mask its antigenicity but retain its enzymatic activity. Levels of serratiopeptidase are slowly transferred, to exude at the site of inflammation and gradually the blood level decline.
PHARMACOKINETICS:
After oral administration, Diclofenac is rapidly and almost completely absorbed. It shows substantial first pass effect and is highly protein bound. It is metabolized, excreted in urine and bile. Serratiopeptidase, by hydrolysing bradykinin, histamine and serotonin indirectly reduces dilatation of blood capillaries and controls permeability. Serratiopeptidase blocks plasmin inhibitors thus helping the fibrinolytic activity of plasmin. Degradation of 'extra fibrin' to small fragments prevents clogging of microcapillaries helps clearance of exudate, reduces swelling and improves microcirculation.
Onset of Action: Analgesic effect 1 hour. Anti rheumatic effect about 2 weeks.
Duration of Action: Up to 12 hours
ADVERSE EFFECTS:
Nausea, epi-gastric distress, vomiting, skin rash, peptic ulcer, fluid retention, oedema, impairment of hepatic function rarely.
CONTRAINDICATION: Active peptic ulcer, GI bleeding, hypersensitivity. NSAID induced allergic asthma.
SPECIAL PRECAUTIONS: Impairment of hepatic, renal or cardiac function. Children, blood coagulation disorders. Recent proctitis, GI disorders.
PREGNANCY :CONTRAINDICATED
LACTATION: Use with caution
ELDERLY: May be used in reduced dose
INDICATIONS:
Management of pain and primary dysmenorrhoea and when prompt pain relief is desired. Painful inflammatory conditions. Preventive post-operative bleeding, swelling and inflammatory oedema. Pelvic inflammatory diseases.
DOSAGE AND ADMINISTRATION:
Adults: One tablet thrice daily.
Children: Not recommended
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