Emifenac Uses

• Emifenac indications
• Uses of Emifenac in details
• Emifenac description
• Emifenac dosage
• Emifenac interactions
• Emifenac side effects
• Emifenac contraindications

What is Emifenac?

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

Emifenac 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 Emifenac helps this condition is unknown.

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

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

Emifenac is available only with your doctor's prescription.

Emifenac indications

Intramuscular

Renal colic

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

Ophthalmic

Post-photorefractive keratectomy pain

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

Oral

Migraine

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

Topical/Cutaneous

Actinic keratoses

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

Topical/Cutaneous

Osteoarthritis

Adult: As Emifenac 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 Emifenac 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 Emifenac?

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

• Emifenac solution comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Emifenac solution refilled.
• Do not apply Emifenac solution to infected skin; open wounds; or red, swollen, or peeling skin.
• Wash your hands immediately before and after using Emifenac solution.
• Wash the affected area and dry completely before using Emifenac solution.
• To apply Emifenac solution, dispense 10 drops at a time onto the knee or into your hand. Spread Emifenac solution evenly around the front, back, and sides of the knee. Repeat until you have used the whole dose.
• Be sure that you cover your entire knee with your dose of Emifenac solution. Do not use more than the recommended amount.
• Do not apply sunscreens, cosmetics, insect repellants, other topical medicines, or any other substance to the treated area until it is completely dry.
• Do not put on clothes over the treated area until it is completely dry.
• Do not wrap, bandage, or apply heat to the treated area.
• Let the treated skin dry before touching it or letting it touch anyone else's skin.
• Do not shower, bathe, or wash the treated area for at least 30 minutes after you use Emifenac solution.
• If you miss a dose of Emifenac solution, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

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

Uses of Emifenac in details

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

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

Emifenac description

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

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

One prolonged-release tablet contains 100 mg of Emifenac.

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.

Emifenac dosage

General Dosing Instructions

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

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

Non-Interchangeability with Other Formulations of Emifenac

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

Emifenac interactions

See also:
What other drugs will affect Emifenac?

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

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

Oral Hypoglycemics:

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

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

Emifenac side effects

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

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

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

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

Emifenac contraindications

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

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

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

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

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

Active ingredient matches for Emifenac:

Diclofenac in Bahrain, Oman.

Diclofenac Sodium

List of Emifenac substitutes (brand and generic names)	Sort by popularity
Unit description / dosage (Manufacturer)	Price, USD
Emflam Gel (India)
EMFLAM GEL topical gel 1.16 % w/w x 30g (Merck)
Emifenac DT 50mg (Oman)
Eminocs (Italy)
Emov (Bangladesh)
Enractin-D (India)
Enractin-D Trypsin 48 mg, bromelain 90mg, rutoside trihydrate 100mg, diclofenac 50 mg. EC-TAB / 10 (Molekule)	$ 1.87
Enractin-D Trypsin 48 mg, bromelain 90mg, rutoside trihydrate 100mg, diclofenac 50 mg. EC-TAB / 10 (Molekule)	$ 1.87
ENRACTIN-D enteric-coated tab 10's (Molekule)	$ 1.87
Enzoflam Gel (India)
Enzoflam Gel Diclofenac 1.16 % w/w, Linseedoil 3 % w/w, Methylsalicylate12 % w/w, Menthol 5.5 % w/w. GEL / 30g (Alkem (Bergen))	$ 0.55
30g (Alkem (Bergen))	$ 0.55
ENZOFLAM GEL topical gel 30g (Alkem (Bergen))	$ 0.55
Enzomac Plus (India)
Enzomac Plus Trypsin 48 mg, bromelain 90mg, rutoside 100 mg, diclofenac 50 mg. TAB / 10 (Macleods (Gencare))	$ 1.93
ENZOMAC PLUS TABLET 1 strip / 10 tablets each (Macleods (Gencare))	$ 2.33
ENZOMAC PLUS tab 10's (Macleods (Gencare))	$ 2.12
Enzomac Plus Tablet (Macleods (Gencare))	$ 0.23
Enzovexx (India)
Enzovexx - TAB / 10 (Zuventus)	$ 0.72
10's (Zuventus)	$ 0.72
ENZOVEXX tab 10's (Zuventus)	$ 0.72
Epardex (Lebanon)
Ephanac (Pakistan)
Epifenac (Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Qatar, Romania, Saudi Arabia, Sudan, United Arab Emirates, Yemen)
Epifenac 0.1% (Egypt)
Epifenac 75mg/3ml (Oman)
Eplopot (Pakistan)
Erase-D (India)
Erase-D Diclofenac sodium 50 mg, Serratiopeptidase 10 mg. TAB / 10 (Stalwart)	$ 0.48
10's (Stalwart)	$ 0.48
ERASE-D tab 10's (Stalwart)	$ 0.48
Erdon (Bangladesh, Hong Kong, Myanmar)
Erdon Gel (Sri Lanka)
Erdon Gel 1 % x 10 g
Erdon Gel 1 % x 20 g
Erdon gel 1 tube 10 g
Erdon gel 1 tube 20 g
Erdon gel 10 mg/1 g x 1 tube 10 g
Erdon gel 10 mg/1 g x 1 tube 20 g
Erdon-100 TR (Bangladesh, Hong Kong)
Erdon-100 TR 100 mg x 10 x 10's
ESGIPYRIN - DS
ESGIPYRIN - DS Injection / 25mg per ml / 5x3ml units (Nicholas Piramal (Sarabhai Piramal))	$ 0.35
ESGIPYRIN AQ
ESGIPYRIN AQ 75 MG INJECTION 1 vial / 1 ML injection each (Abbott India Ltd)	$ 0.22
Esgipyrin AQ 75mg Injection (Abbott India Ltd)	$ 0.22
Esgipyrin DS (India)
Esgipyrin DS 25mg/ml INJ / 5x3ml (Sarabhai piramal)	$ 0.33
Injectable; Injection; Diclofenac Sodium 25 mg / ml (Sarabhai piramal)
ESGIPYRIN-AQ (India)
ESGIPYRIN-AQ inj 75 mg x 1ml (AHPL)	$ 0.22
Esgipyrin-DS (India)
Esgipyrin-DS 25mg/ml INJ / 3ml (AHPL)	$ 0.09
25 mg x 1 mL x 3ml (AHPL)	$ 0.09
See 8658 substitutes for Emifenac

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 Emifenac 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 Emifenac. 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.

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Information checked by Dr. Sachin Kumar, MD Pharmacology