What is Esgipyrin - DS?
Esgipyrin - DS 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, Esgipyrin - DS does not cure osteoarthritis and will help you only as long as you continue to use it.
Esgipyrin - DS 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 Esgipyrin - DS helps this condition is unknown.
Esgipyrin - DS topical solution is used to treat pain and swelling caused by osteoarthritis of the knees.
Esgipyrin - DS topical patch is used to treat acute pain caused by minor strains, sprains, and contusions (bruises).
Esgipyrin - DS is available only with your doctor's prescription.
Esgipyrin - DS indications
Carefully consider the potential benefits and risks of Esgipyrin - DS delayed-release tablets and other treatment options before deciding to use Esgipyrin - DS delayed-release tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
Esgipyrin - DS delayed-release tablets are indicated:
- •
- For relief of the signs and symptoms of osteoarthritis
- •
- For relief of the signs and symptoms of rheumatoid arthritis
- •
- For acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis
How should I use Esgipyrin - DS?
Use Esgipyrin - DS as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Esgipyrin - DS comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Esgipyrin - DS refilled.
- Do not apply Esgipyrin - DS to infected skin; open wounds; or red, swollen, or peeling skin.
- Wash your hands immediately before and after using Esgipyrin - DS.
- Wash the affected area and dry completely before using Esgipyrin - DS.
- To apply Esgipyrin - DS, dispense 10 drops at a time onto the knee or into your hand. Spread Esgipyrin - DS 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 Esgipyrin - DS. 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 Esgipyrin - DS.
- If you miss a dose of Esgipyrin - DS, 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 Esgipyrin - DS.
Uses of Esgipyrin - DS in details
Use: Labeled Indications
Ankylosing spondylitis (delayed-release tablets only): Acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis.
Dysmenorrhea (immediate-release tablets only): Treatment of primary dysmenorrhea.
Migraine (powder for oral solution only): Acute treatment of migraine attacks with or without aura in adults.
Osteoarthritis (immediate-release, extended-release, and delayed-release tablets; capsules [Zorvolex]; and suppositories [Canadian product] only): Relief of signs and symptoms of osteoarthritis.
Pain
Capsules/immediate-release tablets only: Relief of mild to moderate acute pain.
Injection only: Management of mild to moderate pain and moderate to severe pain (alone or in combination with opioid analgesics) in adults.
Rheumatoid arthritis (immediate-release, extended-release, and delayed-release tablets; and suppositories [Canadian product] only): Relief of signs and symptoms of rheumatoid arthritis.
Off Label Uses
Gout, treatment (acute flares)
Data from a limited number of trials support the efficacy of Esgipyrin - DS in the treatment of acute gout flares.
Based on the 2012 American College of Rheumatology guidelines for management of gout, nonsteroidal anti-inflammatory drugs are effective and recommended agents in the treatment of acute gout flares.
Esgipyrin - DS description
A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.
Esgipyrin - DS dosage
Carefully consider the potential benefits and risks of Esgipyrin - DS extended-release tablets, and other treatment options before deciding to use Esgipyrin - DS extended-release tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
After observing the response to initial therapy with Esgipyrin - DS extended-release tablets the dose and frequency should be adjusted to suit an individual patient’s needs.
For the relief of osteoarthritis, the recommended dosage is 100 mg daily.
For the relief of rheumatoid arthritis, the recommended dosage is 100 mg daily. In the rare patient where Esgipyrin - DS extended-release tablets 100 mg/day is unsatisfactory, the dose may be increased to 100 mg twice a day if the benefits outweigh the clinical risks of increased side effects.
Different formulations of Esgipyrin - DS (Esgipyrin - DS enteric-coated tablets; Esgipyrin - DS extended-release tablets; Esgipyrin - DS potassium immediate-release tablets) are not necessarily bioequivalent even if the milligram strength is the same.
Esgipyrin - DS interactions
See also:
What other drugs will affect Esgipyrin - DS?
Aspirin: Concomitant administration of Esgipyrin - DS and aspirin is not recommended because Esgipyrin - DS 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 Esgipyrin - DS 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 Esgipyrin - DS, and warfarin requires close monitoring of patients to be certain that no change in their anticoagulant dosage is required.
Digoxin, Methotrexate, Cyclosporine: Esgipyrin - DS, like other NSAIDs, may affect renal prostaglandins and increase the toxicity of certain drugs. Ingestion of Esgipyrin - DS may increase serum concentrations of digoxin and methotrexate and increase cyclosporineís nephrotoxicity. Patients who begin taking Esgipyrin - DS or who increase their Esgipyrin - DS 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: Esgipyrin - DS decreases lithium renal clearance and increases lithium plasma levels. In patients taking Esgipyrin - DS and lithium concomitantly, lithium toxicity may develop.
Oral Hypoglycemics:
Esgipyrin - DS 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 Esgipyrin - DS 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 Esgipyrin - DS may alter a diabetic patientís response to insulin or oral hypoglycemic agents.
Diuretics: Esgipyrin - DS 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 Esgipyrin - DS. Phenobarbital toxicity has been reported to have occurred in a patient on chronic phenobarbital treatment following the initiation of Esgipyrin - DS therapy.
Protein Binding
In vitro, Esgipyrin - DS interferes minimally or not at all with the protein binding of salicylic acid (20% decrease in binding), tolbutamide, prednisolone (10% decrease in binding), or warfarin. Benzylpenicillin, ampicillin, oxacillin, chlortetracycline, doxycycline, cephalothin, erythromycin, and sulfamethoxazole have no influence in vitro on the protein binding of Esgipyrin - DS in human serum.
Drug/Laboratory Test Interactions
Effect on Blood Coagulation: Esgipyrin - DS increases platelet aggregation time but does not affect bleeding time, plasma thrombin clotting time, plasma fibrinogen, or factors V and VII to XII. Statistically significant changes in prothrombin and partial thromboplastin times have been reported in normal volunteers. The mean changes were observed to be less than 1 second in both instances, however, and are unlikely to be clinically important. Esgipyrin - DS is a prostaglandin synthetase inhibitor, however, and all drugs that inhibit prostaglandin synthesis interfere with platelet function to some degree; therefore, patients who may be adversely affected by such an action should be carefully observed.
Esgipyrin - DS side effects
See also:
What are the possible side effects of Esgipyrin - DS?
Ocular
Transient burning and stinging were reported in approximately 15% of patients across studies with the use of Esgipyrin - DS ophthalmic solution, 0.1%. In cataract surgery studies, keratitis was reported in up to 28% of patients using Esgipyrin - DS ophthalmic solution, 0.1%, although in many of these cases keratitis was initially noted prior to the initiation of treatment. Elevated intraocular pressure following cataract surgery was reported in approximately 15% of patients undergoing cataract surgery. Lacrimation complaints were reported in approximately 30% of case studies undergoing incisional refractive surgery. The following adverse reactions were reported in approximately 10% or less of the patients: abnormal vision, acute elevated IOP, blurred vision, conjunctivitis, corneal deposits, corneal edema, corneal opacity, corneal lesions, discharge, eyelid swelling, eye pain, injection (redness), iritis, irritation, itching, lacrimation disorder, and ocular allergy.
Systemic
The following adverse reactions were reported in 3% or less of the patients: abdominal pain, asthenia, chills, dizziness, facial edema, fever, headache, insomnia, nausea, pain, rhinitis, viral infection and vomiting.
Clinical Practice
The following reactions have been identified during postmarketing use of topical Esgipyrin - DS ophthalmic solution, 0.1% in clinical practice. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. The reactions, which have been chosen for inclusion due to either their seriousness, frequency of reporting, possible causal connection to topical Esgipyrin - DS ophthalmic solution, 0.1%, or a combination of these factors, include corneal erosion, corneal infiltrates, corneal perforation, corneal thinning, corneal ulceration and epithelilal breakdown.
TO REPORT SUSPECTED ADVERSE REACTIONS, contact Altaire Pharmaceuticals, Inc., at 1-800-258-2471 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Esgipyrin - DS contraindications
See also:
What is the most important information I should know about Esgipyrin - DS?
Esgipyrin - DS in all formulations, Cataflam, Voltaren, and Voltaren-XR, is contraindicated in patients with known hypersensitivity to Esgipyrin - DS and Esgipyrin - DS-containing products. Esgipyrin - DS should not be given to patients who have experienced asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to Esgipyrin - DS have been reported in such patients.
Active ingredient matches for Esgipyrin - DS:
| Unit description / dosage (Manufacturer) | Price, USD |
| ESGIPYRIN - DS Injection / 25mg per ml / 5x3ml units (Nicholas Piramal (Sarabhai Piramal)) | $ 0.35 |
List of Esgipyrin - DS substitutes (brand and generic names): | |
| EDIC (India) | |
| EDIC inj 75 mg x 1 mL x 1ml (Edelweiss) | $ 0.14 |
| Eslofen (Philippines) | |
| Famoov | |
| Famoov 50 mg Tablet (Libra Drugs (India)) | $ 0.01 |
| FAMOOV 50MG TABLET 1 strip / 10 tablets each (Libra Drugs (India)) | $ 0.34 |
| Famoov 50mg Tablet (Libra Drugs (India)) | $ 0.03 |
| Farflam Gel | |
| Farflam Gel 20 gm Gel (Cosset Pharmaceuticals Pvt Ltd) | $ 0.54 |
| Farotrin 100 | |
| Fasmic D | |
| Fasmic D 10+50 Tablet (Allure Remedies Pvt Ltd) | $ 0.06 |
| FENAP-AQ (India) | |
| FENAP-AQ inj 75 mg x 1's (Pax Healthcare) | $ 0.23 |
| Fencure | |
| Fencure 25 mg Injection (Paksons Pharmaceuticals (P) Ltd.) | $ 0.24 |
| FENEC | |
| FENEC Capsule/ Tablet / 50mg / 10 units (Core Healthcare) | $ 0.07 |
| FENIC-AQ (India) | |
| FENIC-AQ inj 75 mg x 1ml (Shinto Biotec) | $ 0.19 |
| Fenogesic | |
| Fenogesic 75 mg Injection (Tribhawan Injectables) | $ 0.02 |
| FENOZIL (India) | |
| FENOZIL inj 25 mg x 1 mL x 3ml (Lifekyor) | $ 0.06 |
| FENOZIL inj 75 mg x 1 mL x 10ml (Lifekyor) | $ 0.54 |
| FENOZIL inj 75 mg x 1 mL x 1ml (Lifekyor) | $ 0.22 |
| Fensaide SR | |
| Fensaide SR 100 mg Tablet (Abbott Healthcare Pvt Ltd (AHPL)) | $ 0.01 |
| FINEACT (India) | |
| 25 mg x 1 mL x 3ml (Datla) | $ 0.10 |
| Fineact 25mg x 1mL INJ / 3ml (Datla) | $ 0.10 |
| FINEACT inj 25 mg x 1 mL x 3ml (Datla) | $ 0.10 |
| Fineact 25mg x 1mL INJ / 3ml (Datla) | $ 0.10 |
| Flanzed D | |
| Flanzed D 10+50 Tablet (Ace (Svizera Healthcare) (Maneesh Pharmaceuticals Ltd)) | $ 0.07 |
| Flaser D | |
| Flaser D 10+50 Tablet (Vanguard Therapeutics) | $ 0.07 |
| FORSUN INJ (India) | |
| FORSUN INJ inj 25 mg x 3ml (Wonder (Forrit)) | $ 0.05 |
| Frenchise DP | |
| Frenchise DP 50+10 Tablet (French Formulations) | $ 0.07 |
| G Nac | |
| G Nac 30 gm Gel (Gujarat Pharmalab Pvt. Ltd.) | $ 0.01 |
| Gedase D | |
| Gedase D 50+10 Tablet (G R Laboratories Pvt. Ltd.) | $ 0.06 |
| Godec | |
| Godec 75 mg Injection (Indo Safe Pharmaceuticals) | $ 0.04 |
| Godec 750 mg Injection (Indo Safe Pharmaceuticals) | $ 0.02 |
| Godic S | |
| Godic S 10+50 Tablet (CMG Biotech) | $ 0.07 |
| GUDGESIC-AQ (India) | |
| GUDGESIC-AQ inj 75 mg x 1 mL x 1's (Mankind (Magnet)) | $ 0.24 |
| HALORAN (India) | |
| HALORAN Modified Release Capsule/ Tablet / 100mg / 10 units (Hindustan Antibiotics Ltd.) | $ 0.10 |
| HALORAN Capsule/ Tablet / 50mg / 10 units (Hindustan Antibiotics Ltd.) | $ 0.05 |
| Haloran 50mg TAB / 10 (Hindustan Antibiotics Ltd.) | $ 0.05 |
| Haloran 100mg SR-TAB / 10 (Hindustan Antibiotics Ltd.) | $ 0.10 |
| 50 mg x 10's (Hindustan Antibiotics Ltd.) | $ 0.05 |
| 100 mg x 10's (Hindustan Antibiotics Ltd.) | $ 0.10 |
| Haloran 50 mg Tablet (Hindustan Antibiotics Ltd.) | $ 0.01 |
| HALORAN 100MG TABLET SR 1 strip / 10 tablet srs each (Hindustan Antibiotics Ltd.) | $ 0.14 |
| HALORAN 50MG TABLET 1 strip / 10 tablets each (Hindustan Antibiotics Ltd.) | $ 0.07 |
| HALORAN tab 50 mg x 10's (Hindustan Antibiotics Ltd.) | $ 0.05 |
| HALORAN SR tab 100 mg x 10's (Hindustan Antibiotics Ltd.) | $ 0.10 |
See 919 substitutes for Esgipyrin - DS | |
References
- 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).
- PubChem. "diclofenac". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "diclofenac". http://www.drugbank.ca/drugs/DB00586 (accessed September 17, 2018).
Reviews
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Information checked by Dr. Sachin Kumar, MD Pharmacology
