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Emifenac

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Indications:

Emifenac is indicated in the following conditions: - Post-operative pain, inflammation, and swelling e.g. following dental or orthopedic surgery. - Painful post-traumatic inflammatory states, e.g. due to sprains. - Non-articular rheumatism - Painful symptoms of the vertebral column. - Painful and/or inflammatory conditions in gynaecology, e.g. primary dysmenorrhoea - Acute attacks of gout. - As an adjuvant in severe painful inflammatory infections of the ear, nose, or throat, e.g. pharyngitis, otitis. In keeping with general therapeutic principles, the underlying disease should be treated with basic therapy, as appropriate. Fever alone is not an indication.

Contraindications:

Emifenac like other non-steroidal anti-inflammatory drugs, should not be given to patients with active peptic ulcer and to patients in whom attacks of asthma, angioedema, urticaria or acute rhinitis have been precipitated by aspirin or any other drugs with prostaglandin-synthetase inhibiting activity. Emifenac should be avoided in patients with a history of acute prophyria. Emifenac 50 DT contains phenylalanine and should not be given to phenylketonurics patients.

Adverse reactions:

Emifenac is generally well tolerated. The reported adverse effects include gastrointestinal disturbances, such as epigastric pain, heartburn, nausea, vomiting, diarrhea, and indigestion. Rarely gastrointestinal bleeding, gastric or intestinal ulcer with or without bleeding or perforation may occur. Fluid retention, liver function disorders, rash and prurtitis have been reported.

Interactions:

Concomitant treatment with potassium-sparing diuretics may be associated with increased serum potassium levels, which should therefore be monitored frequently. When given simultaneously with preparations contain digoxin, methotrexate, cyclosporin, sulfonylureas or lithium diclofenac may raise their plasma concentrations. Like other NSAIDs concomitant administration with beta-blockers may antagonize the hypotensive effect of the beta-blockers. Concomitant administration of other systemic NSAIDs or corticosteroids may increase the occurrence of side effects. Patients taking diclofenac and oral anticoagulants should undergo routine blood tests.

Warnings:

Emifenac should be used cautiously with the elderly. In patients with congestive heart failure, hypertension, decreased renal, or hepatic function, history of gastrointestinal disease or those receiving anticoagulants. Emifenac 50 DT is recommended for short-term treatment only. Use in Pregnancy and Lactation: diclofenac should not be used during pregnancy particularly the last three months owing to the possibility of uterine inertia and/or premature closure of the ductus arteriosus. diclofenac is excreted in breast milk, but in quantities so small that no undesirable effects on the infant are to be expected. Management of acute poisoning with NSAIDs consists essentially of supportive and symptomatic measures. There is no typical clinical picture associated with overdosage of diclofenac. The following therapeutic measures should be taken in cases of overdosage: Absorption should be prevented as soon as possible after the overdosage by means of gastric lavage and treatment with activated charcoal. Supportive and symptomatic treatment should be given for complications such as hypotension, renal failure, convulsions, gastrointestinal irritation and respiratory depression. Specific therapy such as forced diuresis, dialysis or haemoperfusion is unlikely to be helpful in accelerating the elimination of NSAIDs because of their high protein binding rate and extensive metabolism.

Form:

sustained release tablet

Dosage and Administration

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Consultants Corner

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

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Dr. Hani Najjar

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Dr. Faisal Dibsi

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