Difenak Uses

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What is Difenak?

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

Difenak 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 Difenak helps this condition is unknown.

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

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

Difenak is available only with your doctor's prescription.

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

Ophthalmic

Post-photorefractive keratectomy pain

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

Oral

Migraine

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

Topical/Cutaneous

Actinic keratoses

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

Topical/Cutaneous

Osteoarthritis

Adult: As Difenak 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 Difenak 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 Difenak?

Use Difenak 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 Difenak solution.

Uses of Difenak 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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Difenak is used to relieve pain from various conditions. This form of Difenak is used to treat migraine headaches. Difenak 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 Difenak

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

Difenak description

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

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

One prolonged-release tablet contains 100 mg of Difenak.

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.

Difenak dosage

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Difenak Dosage

Generic name: Difenak 18mg

Dosage form: capsule

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

General Dosing Instructions

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

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

Non-Interchangeability with Other Formulations of Difenak

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

More about Difenak (Difenak)

Consumer resources

Professional resources

Related treatment guides

Difenak interactions

See also:
What other drugs will affect Difenak?

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

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

Oral Hypoglycemics:

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

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

Difenak side effects

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

Fluid Retention and Edema: Fluid retention and edema have been observed in some patients taking Difenak. Therefore, as with other NSAIDs, Difenak should be used with caution in patients with history of cardiac decompensation, hypertension or other conditions predisposing to fluid retention.

Hematological Effects: Anemia is sometimes seen in patients receiving Difenak or other NSAIDs. This may be due to fluid retention, GI blood loss or an incompletely described effect upon erythropoiesis.

Renal Effects: As a class, NSAIDs have been associated with renal papillary necrosis and other abnormal renal pathology in long-term administration to animals. In patients treated with Difenak, rare cases of interstitial nephritis and papillary necrosis have been reported. A second form of renal toxicity, generally associated with NSAIDs, is seen in patients with conditions leading to a reduction in renal blood flow or blood volume, where renal prostaglandins have a supported role in the maintenance of renal perfusion. In these patients, administration of an NSAID results in a dose-dependent decrease in prostaglandin synthesis and secondarily, in a reduction of renal blood flow, which may precipitate over the renal failure. Patients at greater risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and the elderly.

Porphyria: The use of Difenak in patients with hepatic porphyria should be avoided.

Aseptic Meningitis: As with other NSAIDs, aseptic meningitis with fever and coma has been observed in rare occasions in patients on Difenak therapy. Although it is probably more likely to occur in patients with systemic lupus erythematosus and related connective tissue diseases, it has been reported in patients who do not have an underlying chronic disease. If signs or symptoms of meningitis develop in a patient on Difenak, the possibility of it being related to Difenak should be considered.

There may be pain and occasionally tissue damage at the site of injection when given IM.

Difenak contraindications

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

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

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

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

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



Active ingredient matches for Difenak:

Diclofenac in Peru, Turkey.

Diclofenac sodium in Turkey.


List of Difenak substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
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)$ 0.02
Difin Plus Gel Diclofenac, Linseed oil, Methyl salicylate, Menthol. GEL / 40g (Positif (Afive))$ 0.76
40g (Positif (Afive))$ 0.76
DIFIN PLUS GEL topical gel 40g (Positif (Afive))$ 0.76
Difin-S Diclofenac sodium 50 mg, Serratiopeptidase 15 mg. TAB / 20 (Positif (Afive))$ 0.89
20's (Positif (Afive))$ 0.89
DIFIN-S tab 10's (Positif (Afive))$ 0.89
DIFISAL Capsule/ Tablet / 50mg / 10 units (Kresp (Kopran Pharma Ltd))$ 0.14
DIFISAL Modified Release Capsule/ Tablet / 100mg / 10 units (Kresp (Kopran Pharma Ltd))$ 0.27
Difisal 50mg TAB / 10 (Kresp (Kopran Pharma Ltd))$ 0.12
Difisal 100mg TAB / 10 (Kresp (Kopran Pharma Ltd))$ 0.23
50 mg x 10's (Kresp (Kopran Pharma Ltd))$ 0.12
100 mg x 10's (Kresp (Kopran Pharma Ltd))$ 0.23
Difisal 75 mg Injection (Kresp (Kopran Pharma Ltd))$ 0.02
Difisal 50 mg Tablet (Kresp (Kopran Pharma Ltd))$ 0.01
DIFISAL tab 50 mg x 10's (Kresp (Kopran Pharma Ltd))$ 0.12
DIFISAL SR tab 100 mg x 10's (Kresp (Kopran Pharma Ltd))$ 0.23
Difisal 50mg TAB / 10 (Kresp (Kopran Pharma Ltd))$ 0.12
Difisal 100mg TAB / 10 (Kresp (Kopran Pharma Ltd))$ 0.23
Difisal SR 100 mg Tablet (Kopran Pharma Ltd)$ 0.03
Difital 50+650 Tablet (Brussels Laboratories Pvt. Ltd.)$ 0.03
DIFLAC GEL 1 tube / 30 GM gel each (Radicura)$ 0.81
DIFLAC topical gel 30g (Radicura)$ 0.94
Diflam 25 mg x 5 x 10's (Elder Pharmaceuticals Pvt Ltd)
Diflam 50 mg x 5 x 10's (Elder Pharmaceuticals Pvt Ltd)
Diflam 20 gm Gel (Elder Pharmaceuticals Pvt Ltd)$ 0.72

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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