Caflaamtil Uses

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What is Caflaamtil?

Caflaamtil is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and other symptoms of arthritis of the joints (eg, osteoarthritis), such as inflammation, swelling, stiffness, and joint pain. However, Caflaamtil does not cure osteoarthritis and will help you only as long as you continue to use it.

Caflaamtil topical 3% gel is also used to treat actinic keratosis, a skin problem that may become cancerous if not treated. The exact way that topical Caflaamtil helps this condition is unknown.

Caflaamtil topical solution is used to treat pain and swelling caused by osteoarthritis of the knees.

Caflaamtil topical patch is used to treat acute pain caused by minor strains, sprains, and contusions (bruises).

Caflaamtil is available only with your doctor's prescription.

Caflaamtil indications

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Intramuscular

Renal colic

Adult: As Caflaamtil Na: 75 mg, may repeat once after 30 min if needed. Max: 150 mg/day. Max period: 2 days.

Intramuscular

Bursitis, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis, Acute gout, Dysmenorrhoea

Adult: As Caflaamtil Na: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions. Max period: 2 days.

Intravenous

Postoperative pain

Adult: As Caflaamtil Na: 75 mg infusion in glucose 5% or NaCl 0.9% (previously buffered w/ Na bicarbonate) given over 30-120 min or as bolus inj, may repeat after 4-6 hr if necessary. Max period: 2 days.

Intravenous

Prophylaxis of postoperative pain

Adult: As Caflaamtil Na: Initially, 25-50 mg infusion given after surgery over 15-60 min followed by 5 mg/hr. Alternatively, initial dose may be given as bolus inj over 5-60 sec followed by additional inj, may repeat after 4-6 hr if necessary. Max: 150 mg/day. Max period: 2 days.

Ophthalmic

Postoperative ocular inflammation

Adult: As Caflaamtil Na (0.1% soln): Instill into the appropriate eye 4 times daily starting 24 hr after surgery for up to 28 days.

Ophthalmic

Inflammation and discomfort after strabismus surgery

Adult: As Caflaamtil Na (0.1% soln): Instill 1 drop 4 times daily for the 1st wk; then tid in the 2nd wk, bid in the 3rd wk, and as required for the 4th wk.

Ophthalmic

Pain and discomfort after radial keratotomy

Adult: As Caflaamtil Na (0.1% soln): Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.

Ophthalmic

Pain after accidental trauma

Adult: As Caflaamtil Na (0.1% soln): Instill 1 drop 4 times daily for up to 2 days.

Ophthalmic

Control of inflammation after argon laser trabeculoplasty

Adult: As Caflaamtil Na (0.1% soln): Instill 1 drop 4 times during the 2 hr before procedure followed by 1 drop 4 times daily, up to 7 days after procedure.

Ophthalmic

Prophylaxis of intra-operative miosis

Adult: As Caflaamtil Na (0.1% soln): Instill into appropriate eye 4 times w/in 2 hr before surgery.

Ophthalmic

Post-photorefractive keratectomy pain

Adult: As Caflaamtil Na (0.1% soln): Instill into the affected eye twice, an hr before surgery, then 1 drop twice at 5-min intervals immediately after surgery, then every 2-5 hr while awake for up to 24 hr.

Ophthalmic

Seasonal allergic conjunctivitis

Adult: As Caflaamtil Na (0.1% soln): Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.

Oral

Bursitis, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis, Acute gout, Dysmenorrhoea

Adult: As Caflaamtil Na: 75-150 mg/day in divided doses. Max: 150 mg/day.

Oral

Migraine

Adult: As Caflaamtil K: Initially, 50 mg taken at the 1st sign of an attack, an additional dose of 50 mg may be taken after 2 hr if symptoms persist. If needed, further doses of 50 mg may be taken 4-6 hrly. Max: 200 mg/day.

Rectal

Acute gout, Bursitis, Dysmenorrhoea, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis

Adult: As Caflaamtil Na: 100 mg once daily.

Topical/Cutaneous

Actinic keratoses

Adult: As Caflaamtil Na (3% gel): Apply bid for 60-90 days.

Topical/Cutaneous

Osteoarthritis

Adult: As Caflaamtil Na (1.6% soln): Apply in small amounts (20 or 40 drops) onto affected area 4 times daily. As Na: (1% gel): Apply to the affected area 4 times daily. Max: 32 g/day over the affected area.

Topical/Cutaneous

Local symptomatic relief of pain and inflammation

Adult: As Caflaamtil Na (1% gel): Apply onto affected area 3 or 4 times daily.

Transdermal

Acute pain

Adult: Sprains, strains, contusions: 1 patch bid.

How should I use Caflaamtil?

Use Caflaamtil solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Caflaamtil solution.

Uses of Caflaamtil in details

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Caflaamtil is used to relieve pain from various conditions. This form of Caflaamtil is used to treat migraine headaches. Caflaamtil is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to treat gout attacks.

How to use Caflaamtil

Read the Medication Guide provided by your pharmacist before you start taking Caflaamtil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor. Empty the contents of one packet into a cup containing 1 to 2 ounces (30 to 60 milliliters) of water. Mix well and drink all of it right away. Do not mix with any liquid other than water. If stomach upset occurs while taking this medication, take it with food, milk, or an antacid. However, if you take this medication with a meal high in fat, it may not work as well.

There are different brands and forms of this medication available. Because different forms do not have the same effects at equal strengths, do not switch forms of Caflaamtil unless your doctor tells you to.

To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose. Do not increase your dose or take it more often than prescribed.

Pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.

Tell your doctor if your condition persists or worsens.

Caflaamtil description

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The active substance is sodium-[o[(2,6-dichlorophenyl)-amino]-phenyl]-acetate (= Caflaamtil sodium).

Each enteric tablet contains 25 mg or 50 mg of Caflaamtil sodium.

One prolonged-release tablet contains 100 mg of Caflaamtil sodium.

Excipients/Inactive Ingredients: Gastro-Resistant Tablet: Core for 25 mg and 50 mg: Cellulose microcrystalline; lactose monohydrate; magnesium stearate; maize starch; povidone; silica, colloidal anhydrous; sodium starch glycolate (type A).

Coating for 25 mg and 50 mg: Hypromellose; iron oxide yellow (E172); macrogoglycerol hydroxystearate; methacrylic acid-ethyl acrylate copolymer; macrogol 8000; talc; titanium dioxide (E171); simeticone; alpha-octadecyl-omega-hydroxy-polyglykolether; sorbic acid.

Coating for 50 mg: Iron oxide red (E172).

SR Tablet: Tablet Core: Cetyl alcohol; magnesium stearate; povidone; silica; colloidal anhydrous; sucrose.

Tablet Coating: Hypromellose; iron oxide red (E172); macrogol 8000; polysorbate 80; sucrose; talc; titanium dioxide (E171). Printing Ink: Carbon black, shellac, ammonium hydroxide, simethicone.

Injection: Each ampoule also contains the following excipients: Mannitol, sodium metabisulfite (E223), benzyl alcohol, propylene glycol, water for injection, sodium hydroxide.

Caflaamtil dosage

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General Dosing Instructions

Carefully consider the potential benefits and risks of Caflaamtil and other treatment options before deciding to use Caflaamtil. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.

The effectiveness of Caflaamtil when taken with food has not been studied in clinical studies. Taking Caflaamtil with food may cause a reduction in effectiveness compared to taking Caflaamtil on an empty stomach.

Acute Pain

For management of mild to moderate acute pain, the dosage is 18 mg or 35 mg orally three times daily.

Osteoarthritis Pain

For management of osteoarthritis pain, the dosage is 35 mg orally three times daily.

Dosage Adjustments in Patients with Hepatic Impairment

Patients with hepatic disease may require reduced doses of Caflaamtil compared to patients with normal hepatic function. As with other Caflaamtil products, start treatment at the lowest dose. If efficacy is not achieved with the lowest dose, discontinue use.

Non-Interchangeability with Other Formulations of Caflaamtil

Caflaamtil capsules are not interchangeable with other formulations of oral Caflaamtil even if the milligram strength is the same. Caflaamtil capsules contain Caflaamtil free acid whereas other Caflaamtil products contain a salt of Caflaamtil, i.e., Caflaamtil potassium or sodium. A 35 mg dose of Caflaamtil is approximately equal to 37.6 mg of sodium Caflaamtil or 39.5 mg of potassium Caflaamtil. Therefore, do not substitute similar dosing strengths of other Caflaamtil products without taking this into consideration.

Caflaamtil interactions

See also:
What other drugs will affect Caflaamtil?

Aspirin: Concomitant administration of Caflaamtil and aspirin is not recommended because Caflaamtil is displaced from its binding sites during the concomitant administration of aspirin, resulting in lower plasma concentrations, peak plasma levels and AUC values.

Anticoagulants: While studies have not shown Caflaamtil to interact with anticoagulants of the warfarin type, caution should be exercised, nonetheless, since interactions have been seen with other NSAIDs. Because prostaglandins play an important role in hemostasis and NSAIDs affect platelet function as well, concurrent therapy with all NSAIDs, including Caflaamtil and warfarin, requires close monitoring of patients to be certain that no change in their anticoagulant dosage is required.

Digoxin, Methotrexate, Cyclosporine: Caflaamtil, like other NSAIDs, may affect renal prostaglandins and increase the toxicity of certain drugs. Ingestion of Caflaamtil may increase serum concentrations of digoxin and methotrexate and increase cyclosporine's nephrotoxicity. Patients who begin taking Caflaamtil or who increase their Caflaamtil dose or any other NSAID while taking digoxin, methotrexate or cyclosporine may develop toxicity characteristics for these drugs. They should be observed closely, particularly if renal function is impaired. In the case of digoxin, serum levels should be monitored.

Lithium: Caflaamtil decreases lithium renal clearance and increases lithium plasma levels. In patients taking Caflaamtil and lithium concomitantly, lithium toxicity may develop.

Oral Hypoglycemics:

Caflaamtil does not alter glucose metabolism in normal subjects nor does it alter the effects of oral hypoglycemic agents. There are rare reports, however, from marketing experiences, of changes in effects of insulin or oral hypoglycemic agents in the presence of Caflaamtil that necessitated changes in the doses of such agents. Both hypo- and hyperglycemic effects have been reported. A direct causal relationship has not been established, but physicians should consider the possibility that Caflaamtil may alter a diabetic patient's response to insulin or oral hypoglycemic agents.

Diuretics: Caflaamtil and other NSAIDs can inhibit the activity of diuretics. Concomitant treatment with potassium-sparing diuretics may be associated with increased serum potassium levels.

Other Drugs: In small groups of patients (7-10/interaction study), the concomitant administration of azathioprine, gold, chloroquine, D-penicillamine, prednisolone, doxycycline or digitoxin did not significantly affect the peak levels and AUC values of Caflaamtil. Phenobarbital toxicity has been reported to have occurred in a patient on chronic phenobarbital treatment following the initiation of Caflaamtil therapy.

Caflaamtil side effects

See also:
What are the possible side effects of Caflaamtil?

There have been cases reported of Caflaamtil being associated with the development of symptoms resembling the syndrome of inappropriate antidiuretic hormone secretion in elderly women. A patient who had been taking Caflaamtil for several years and had increasingly complained of dry, gritty eyes noticed that eye irritation disappeared within 3 days when Caflaamtil had to be discontinued because of GI effects.

The most frequent adverse effects reported in patients given Caflaamtil are GI in nature. Typical reactions include epigastric pain, nausea, vomiting and diarrhoea. Rarely, peptic ulcer and GI bleeding have occurred. Caflaamtil has also been implicated as the causative agent in colonic ulceration, small bowel perforation and pseudomembranous colitis.

Renal papillary necrosis and nephritic syndrome have been reported in patients taking Caflaamtil. Elevations of serum aminotransferase activity and clinical hepatitis, including fetal fulminant hepatitis have occurred in patients taking Caflaamtil. Self-limiting skin reaction eg, rash or pruritus may occur in patients given Caflaamtil.

Aspirin-sensitive asthmatic patients have developed reactions (rhinorrhoea, tightness of chest, wheezing, dyspnoea) when challenged with Caflaamtil in doses of 10-25 mg and the CMS in the UK have received a report of 1 aspirin-sensitive patient who died from acute asthma 4 hrs after a single 25-mg dose of Caflaamtil.

Caflaamtil contraindications

See also:
What is the most important information I should know about Caflaamtil?

Hypersensitivity to Caflaamtil sodium or to any of the excipients of Caflaamtil.

Active gastric or intestinal ulcer, bleeding or perforation.

Last trimester of pregnancy.

Hepatic, renal and severe cardiac failure.

Patients in whom attacks of asthma, urticaria or acute rhinitis are precipitated by acetylsalicylic acid and/or other drugs with prostaglandin-synthetase inhibitory activity.

Treatment of peri-operative pain in setting of coronary artery bypass graft (CABG) surgery.

The use of high dose Caflaamtil (150 mg/day) for >4 weeks is contraindicated in patients with established cardiovascular disease (congestive heart failure, established ischemic heart disease, peripheral arterial disease) or uncontrolled hypertension.

Established Cardiovascular Disease or Significant Cardiovascular Risk Factors: The use of high dose Caflaamtil (150mg/day) for >4 weeks is contraindicated in patients with established cardiovascular disease (congestive heart failure, established ischemic heart disease, peripheral arterial disease) or uncontrolled hypertension. If Caflaamtil treatment is needed, patients with established cardiovascular disease, uncontrolled hypertension or significant cardiovascular risk factors (eg, hypertension, hyperlipidaemia, diabetes mellitus and smoking) should be treated only after careful consideration and at doses ≤100 mg daily if the treatment is for >4 weeks. As the cardiovascular risks of Caflaamtil may increase with dose and duration of exposure, Caflaamtil should always be prescribed at the lowest effective daily dose and for the shortest duration possible.

Renal Impairment: Caflaamtil is contraindicated in patients with renal failure. No specific studies have been carried out in patients with renal impairment, therefore, no specific dose adjustment recommendations can be made. Caution is advised when administering Caflaamtil to patients with mild to moderate renal impairment.

Hepatic Impairment: Caflaamtil is contraindicated in patients with hepatic failure. No specific studies have been carried out in patients with hepatic impairment, therefore, no specific dose adjustment recommendations can be made. Caution is advised when administering Caflaamtil to patients with mild to moderate hepatic impairment.



Active ingredient matches for Caflaamtil:

Diclofenac in Vietnam.


Unit description / dosage (Manufacturer)Price, USD
Caflaamtil 75 mg/3 mL x 10 tube

List of Caflaamtil substitutes (brand and generic names):

CADMAX inj 75 mg x 3ml (Admac (Cadma))$ 0.08
Canefol 25 mg/1 mL x 3 mL x 10's
Cannact Diclofenac Sodium 50mg TAB / 10 (Astra-IDL Ltd)$ 0.07
50 mg x 10's (Astra-IDL Ltd)$ 0.06
Cannact 50 mg Tablet (Astra-IDL Ltd)$ 0.01
CANNACT enteric-coated tab 50 mg x 10's (Astra-IDL Ltd)$ 0.06
Capsigyl-D Gel Capsicum oleo resin 0.075 %, Diclofenac sodium 1 %, Methylsalicylate 20 %, Menthol 10 %, Camphor 5 %. GEL / 15g (Shalaks)$ 0.23
Capsigyl-D Gel Capsicum oleo resin 0.075 %, Diclofenac sodium 1 %, Methylsalicylate 20 %, Menthol 10 %, Camphor 5 %. GEL / 30g (Shalaks)$ 0.43
15g (Shalaks)$ 0.23
30g (Shalaks)$ 0.43
CAPSIGYL-D GEL topical gel 15g (Shalaks)$ 0.23
CAPSIGYL-D GEL topical gel 30g (Shalaks)$ 0.43
Capsitop Spy Capsicum 0.025 %, Diclofenacdiethylammonium 1.16 % w/w, Menthol 1 %, Methyl salicylate3 %. SPY / 40g (Stedman)$ 1.02
40g (Stedman)$ 0.90
CAPSITOP SPY topical spray 40g (Stedman)$ 1.02
Car-D Diclofenac potassium 50 mg, Serratiopeptidase 10 mg. TAB / 100 (Am. Biocare)$ 7.47
100's (Am. Biocare)$ 7.47
CAR-D tab 10's (Am. Biocare)$ 0.75
Caredec 75mg x 3mL INJ / 1 (Arvincare)$ 0.12
75 mg x 3 mL x 1's (Arvincare)$ 0.12
Caredec 75 mg Injection (Arvincare)$ 0.04
CAREDEC inj 75 mg x 3 mL x 3ml (Arvincare)$ 0.12
Catafast 50mg - 3 Powder$ 9.00
Catafast 50mg - 21 Powder$ 43.00
Catafast 50mg - 9 Powder$ 13.00
Catafen supp 50 mg 10's (Bliss GVS)
Suppositories; Rectal; Diclofenac Potassium 12.5 mg (Novartis)
Suppositories; Rectal; Diclofenac Potassium 25 mg (Novartis)
Suppositories; Rectal; Diclofenac Potassium 50 mg (Novartis)
Suspension; Oral; Diclofenac Potassium 75 mg / 5 ml (Novartis)
Tablet; Oral; Diclofenac Potassium 25 mg (Novartis)
Tablet; Oral; Diclofenac Potassium 50 mg (Novartis)
Cataflam 50 mg x 100's (Novartis)$ 49.44
Cataflam 15 mg/1 mL x 15 mL x 1's (Novartis)
Cataflam 25 mg x 10 Tablet (Novartis)

References

  1. DailyMed. "DICLOFENAC EPOLAMINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "diclofenac". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "diclofenac". http://www.drugbank.ca/drugs/DB00586 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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