Difenac Uses

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How do you administer this medicine?
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What is Difenac?

Difenac 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, Difenac does not cure osteoarthritis and will help you only as long as you continue to use it.

Difenac 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 Difenac helps this condition is unknown.

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

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

Difenac is available only with your doctor's prescription.

Difenac indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Intramuscular

Renal colic

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

Ophthalmic

Post-photorefractive keratectomy pain

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

Oral

Migraine

Adult: As Difenac 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 Difenac Na: 100 mg once daily.

Topical/Cutaneous

Actinic keratoses

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

Topical/Cutaneous

Osteoarthritis

Adult: As Difenac 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 Difenac 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 Difenac?

Use Difenac 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 Difenac.

Uses of Difenac in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Difenac is used to relieve pain from various conditions. This form of Difenac is used to treat migraine headaches. Difenac 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 Difenac

Read the Medication Guide provided by your pharmacist before you start taking Difenac 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 Difenac 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.

Difenac description

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

Each enteric tablet contains 25 mg or 50 mg of Difenac.

One prolonged-release tablet contains 100 mg of Difenac.

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.

Difenac dosage

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General Dosing Instructions

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

The effectiveness of Difenac when taken with food has not been studied in clinical studies. Taking Difenac with food may cause a reduction in effectiveness compared to taking Difenac 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 Difenac compared to patients with normal hepatic function. As with other Difenac products, start treatment at the lowest dose. If efficacy is not achieved with the lowest dose, discontinue use.

Non-Interchangeability with Other Formulations of Difenac

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

Difenac interactions

See also:
What other drugs will affect Difenac?

Aspirin: Concomitant administration of Difenac and aspirin is not recommended because Difenac 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 Difenac 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 Difenac and warfarin, requires close monitoring of patients to be certain that no change in their anticoagulant dosage is required.

Digoxin, Methotrexate, Cyclosporine: Difenac, like other NSAIDs, may affect renal prostaglandins and increase the toxicity of certain drugs. Ingestion of Difenac may increase serum concentrations of digoxin and methotrexate and increase cyclosporine's nephrotoxicity. Patients who begin taking Difenac or who increase their Difenac 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: Difenac decreases lithium renal clearance and increases lithium plasma levels. In patients taking Difenac and lithium concomitantly, lithium toxicity may develop.

Oral Hypoglycemics:

Difenac 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 Difenac 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 Difenac may alter a diabetic patient's response to insulin or oral hypoglycemic agents.

Diuretics: Difenac 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 Difenac. Phenobarbital toxicity has been reported to have occurred in a patient on chronic phenobarbital treatment following the initiation of Difenac therapy.

Difenac side effects

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

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

The most frequent adverse effects reported in patients given Difenac are GI in nature. Typical reactions include epigastric pain, nausea, vomiting and diarrhoea. Rarely, peptic ulcer and GI bleeding have occurred. Difenac 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 Difenac. Elevations of serum aminotransferase activity and clinical hepatitis, including fetal fulminant hepatitis have occurred in patients taking Difenac. Self-limiting skin reaction eg, rash or pruritus may occur in patients given Difenac.

Aspirin-sensitive asthmatic patients have developed reactions (rhinorrhoea, tightness of chest, wheezing, dyspnoea) when challenged with Difenac 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 Difenac.

Difenac contraindications

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

Hypersensitivity to Difenac or to any of the excipients of Difenac.

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 Difenac (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 Difenac (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 Difenac 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 Difenac may increase with dose and duration of exposure, Difenac should always be prescribed at the lowest effective daily dose and for the shortest duration possible.

Renal Impairment: Difenac 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 Difenac to patients with mild to moderate renal impairment.

Hepatic Impairment: Difenac 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 Difenac to patients with mild to moderate hepatic impairment.



Active ingredient matches for Difenac:

Diclofenac in Argentina, Hong Kong, India, Japan, Singapore, Thailand, Venezuela.

Diclofenac Na in Thailand.

Diclofenac diethylamine or diclofenac sodium in Venezuela.

Diclofenac sodium in Thailand.


Unit description / dosage (Manufacturer)Price, USD
50 mg x 10's$ 0.13
Difenac 25 mg x 100 x 10's
Difenac 25 mg x 1, 000's
Difenac 50 mg x 50 x 10's
Difenac 50 mg x 500's
Difenac 75 mg/3 mL x 5's
Difenac 75 mg/3 mL x 50's
Difenac 50mg TAB / 10$ 0.13
Difenac 25 mg x 10 x 10 x 10's
Difenac 50 mg x 10 x 10 x 10's
Tablets, Enteric Coated; Oral; Diclofenac Sodium 25 mg
Tablets, Enteric Coated; Oral; Diclofenac Sodium 50 mg
Difenac 25 mg x 1000's
Difenac 50 mg x 1000's
Difenac 50 mg Tablet$ 0.01
Difenac enteric-coated tab 25 mg 10 x 10 x 10's (DHA)
Difenac enteric-coated tab 50 mg 10 x 10 x 10's (DHA)
DIFENAC tab 50 mg x 10's (Intermed)$ 0.20

List of Difenac substitutes (brand and generic names):

Difena 25 mg x 100's (Standard)
Difenac DHA 25 mg x 10 Box x 10 Blister x 10 Tablet
Difenac Gel Diclofenac diethylamine 1.16%, Linseed oil 3 %, methylsalicylate 10 %, Menthol 5 %. GEL / 30g (Intermed)$ 0.52
30g (Intermed)$ 0.52
Difenac Gel 30 gm Gel (Intermed)$ 0.52
DIFENAC GEL topical gel 30g (Intermed)$ 0.66
Difenac T P 75 mg/3 mL x 5 tube
Difenac T P 75 mg/3 mL x 50 tube
Difenamin 50 mg x 100's
Difenax 50 mg x 100's (GXI)$ 0.12
Difenax tab 50 mg 100's (GXI)$ 0.12
Difeno 25 mg x 500's (Milano)
Difeno 75 mg/3 mL x 10's (Milano)
Difensic 25 mg x 500's
Difensic 25 mg x 1, 000's
Difgesic 50 mg Tablet (Friends Pharma)$ 0.01
Difin Plus Gel Diclofenac, Linseed oil, Methyl salicylate, Menthol. GEL / 40g (Positif (Afive))$ 0.58
40g (Positif (Afive))$ 0.58
DIFIN PLUS GEL topical gel 40g (Positif (Afive))$ 0.58
Difin-S Diclofenac sodium 50 mg, Serratiopeptidase 15 mg. TAB / 20 (Positif (Afive))$ 0.67
20's (Positif (Afive))$ 0.67
DIFIN-S tab 10's (Positif (Afive))$ 0.67
DIFISAL Capsule/ Tablet / 50mg / 10 units (Kresp (Kopran Pharma Ltd))$ 0.11
DIFISAL Modified Release Capsule/ Tablet / 100mg / 10 units (Kresp (Kopran Pharma Ltd))$ 0.20
Difisal 50mg TAB / 10 (Kresp (Kopran Pharma Ltd))$ 0.09
Difisal 100mg TAB / 10 (Kresp (Kopran Pharma Ltd))$ 0.18
50 mg x 10's (Kresp (Kopran Pharma Ltd))$ 0.09
100 mg x 10's (Kresp (Kopran Pharma Ltd))$ 0.18

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).

Reviews

The results of a survey conducted on ndrugs.com for Difenac are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Difenac. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

Consumer reported useful

No survey data has been collected yet


Consumer reported price estimates

No survey data has been collected yet


1 consumer reported time for results

To what extent do I have to use Difenac before I begin to see changes in my health conditions?
As part of the reports released by ndrugs.com website users, it takes 1 day and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Difenac. To get the time effectiveness of using Difenac drug by other patients, please click here.
Users%
1 day1
100.0%


3 consumers reported age

Users%
46-602
66.7%
30-451
33.3%


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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