annuva tablet uses

Written by Dr Taha Murtaza [PharmD, DOW University Of Health Sciences (DUHS)], Karachi, Pakistan)

Generic:

Diclofenac free acid

Composition:

Active pharmaceutical ingredient:

Each dispersible tablet contains 46.50mg diclofenac diclofenac-free acid (Novartis specs) equivalent to 50mg of diclofenac sodium.

Excipients:

• Cellulose

• Micro-crystalline

• Sodium starch glycolate

• colloidal anhydrous

• castor oil

• hydrogenated talc

Pack size:

Each box contains 20 dispersible tablets

Manufacturer:

Novartis Pharma (Pakistan) Ltd.

Therapeutic class:

NSAIDs

Pharmacological class:

Prostaglandin biosynthesis inhibitor

Indications:

• Pain and inflammation after surgery e.g. dental or orthopedic.

• Painful inflammation after trauma

• Flareups of joints and bones pain and inflammation

• Acute pain due to gout

• non-articular pain

• Pain in vertebral column disorders

• Dysmenorrhoea or adnexitis

• Painful inflammatory infections of ENT.

Dosage and recommendation:

• 2-3 tablets, 2-3 times daily

• For dysmenorrhoea, 1-2 tablets 2-3 times per day.

• Maximum dose: 4 tabs per day 2-3 times

Special population:

Renal impairment:

Contra-indicated

Hepatic impairment:

Contra-indicated

Children:

• <14 years; not recommended

• 14 or > 14 years; 2 tablets in divided doses should not exceed 150 mg

Elderly patients:

• 65 or >65 years; no adjustment is needed

• caution is needed for weak elderly patients or patients with low body weight.

Cardiovascular disease:

• Generally not recommended

• A dose of less than equal to 100mg can be taken if treatment is needed for more than 4 weeks.

Method of administration:

• Taken before meal

• Drop a tablet in a glass of water, stir well, and then drink it. If the remaining amount of the drug is left in the glass, it should be rinsed again with a small amount of water and drank again.

Contra-indications:

• hypersensitivity to the drug or any of its constituents.

• Gastric or intestinal ulcer

• Last trimester of pregnancy

• Hepatic impairment

• Renal failure (GFR<15ml/min/1.73m2)

• Severe cardiac failure

• NSAIDs

Side-effects (Common)

• headache

• dizziness

• vertigo

• nausea/vomiting

• diarrhoea

• dyspepsia

• abdominal pain

• flatulence

• decreased appetite

• Transaminases decreased

• Rash

Interactions:

Diclofenac sodium shows interactions with the following drugs:

• CYP2C9 inhibitors

• lithium

• digoxin

• diuretics and anti-hypertensives

• ciclosporin and tacrolimus

• drugs known to cause hyperkalemia

• Quinolone antibacterials

• Other NSAIDs and corticosteroids

• anti-coagulants and anti-platelet agents

• SSRIs

• Anti-diabetics

• phenytoin

• methotrexate

• CYP2C9 inducers

Pregnancy:

Not recommended

Lactation:

Not recommended

Fertile women:

Not recommended for women who are going to conceive

Clinical pharmacology:

"Diclofenac sodium inhibits prostaglandin biosynthesis."

Warnings and precautions:

• Risk of serious cardiovascular and G.I. events

  
  

• G.I. bleeding, ulceration, and perforation

Storage:

• Store below 25 degrees Celsius

• Protect from light and moisture

• All drugs should be kept out of reach of children.