Tarjena Uses

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What is Tarjena?

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

Tarjena 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 Tarjena helps this condition is unknown.

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

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

Tarjena is available only with your doctor's prescription.

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

Ophthalmic

Post-photorefractive keratectomy pain

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

Oral

Migraine

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

Topical/Cutaneous

Actinic keratoses

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

Topical/Cutaneous

Osteoarthritis

Adult: As Tarjena 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 Tarjena 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 Tarjena?

Use Tarjena 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 Tarjena solution.

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

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

Tarjena description

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

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

One prolonged-release tablet contains 100 mg of Tarjena.

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.

Tarjena dosage

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General Dosing Instructions

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

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

Non-Interchangeability with Other Formulations of Tarjena

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

Tarjena interactions

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What other drugs will affect Tarjena?

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

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

Oral Hypoglycemics:

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

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

Tarjena side effects

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What are the possible side effects of Tarjena?

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

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

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

Tarjena contraindications

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

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

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

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

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



Active ingredient matches for Tarjena:

Diclofenac in Thailand.

Diclofenac Na in Thailand.

Diclofenac sodium in Thailand.


Unit description / dosage (Manufacturer)Price, USD
Tarjena 25 mg/1 mL x 3 mL x 50's$ 5.76

List of Tarjena substitutes (brand and generic names):

Tarjen 1 % x 20 g (Samakeephaesaj)$ 0.61
Tablet; Oral; Diclofenac Sodium 25 mg
Tablet; Oral; Diclofenac Sodium 50 mg
Tablets; Oral; Diclofenac Sodium 25 mg
Tablets; Oral; Diclofenac Sodium 50 mg
Taro-diclofenac solution 1.5 % (Taro Pharmaceuticals Inc (Canada))
Terase Serratiopeptidase 10 mg, Diclofenac potassium 50 mg. TAB / 10 (Technica Labs & Pharma Pvt Ltd)$ 0.59
10's (Technica Labs & Pharma Pvt Ltd)$ 0.59
Terase 50+10 Tablet (Technica Labs & Pharma Pvt Ltd)$ 0.09
TERASE tab 10's (Technica Labs & Pharma Pvt Ltd)$ 0.59
Tablet, Enteric Coated; Oral; Diclofenac Sodium 25 mg
Tablet, Enteric Coated; Oral; Diclofenac Sodium 50 mg
Tablets, Enteric Coated; Oral; Diclofenac Sodium 25 mg
Tablets, Enteric Coated; Oral; Diclofenac Sodium 50 mg
Teva-diclofenac suppository 100 mg (Teva Canada Limited (Canada))
Teva-diclofenac suppository 50 mg (Teva Canada Limited (Canada))
Teva-diclofenac EC tablet / enteric-coated 25 mg (Teva Canada Limited (Canada))
Teva-diclofenac EC tablet / enteric-coated 50 mg (Teva Canada Limited (Canada))
Teva-diclofenac SR tablet / extended-release 100 mg (Teva Canada Limited (Canada))
Teva-diclofenac SR tablet / extended-release 75 mg (Teva Canada Limited (Canada))
Thioact-D Thiocolchicoside 4 mg, diclofenac sodium / EC 50 mg. CAP / 10 (Sun)
Thioact-D Thiocolchicoside 8 mg, diclofenac sodium / EC 50 mg. CAP / 10 (Sun)
THIOACT-D cap 10's (Sun)$ 2.14
Thioage D 4+50 Capsule (Allenge India)$ 0.17
Tifenac 75 mg Injection (Trigenesis Lifesciences Pvt. Ltd.)$ 0.03
Tirmaclo 50 mg x 5 x 10's (Mersifarma TM)$ 9.30
Tise 75mg x 3mL INJ / 1 (Elfin Drugs Pvt. Ltd. (Elfin Pharma Pvt Ltd))$ 0.12
75 mg x 3 mL x 1's (Elfin Drugs Pvt. Ltd. (Elfin Pharma Pvt Ltd))$ 0.12
Tise 75 mg Injection (Elfin Drugs Pvt. Ltd. (Elfin Pharma Pvt Ltd))$ 0.04
TISE inj 75 mg x 3 mL x 3ml (Elfin Drugs Pvt. Ltd. (Elfin Pharma Pvt Ltd))$ 0.12
Tizidal D 50+2 Tablet (Adley Formulation)$ 0.06
Toferaren 75 mg/2 mL x 10 tube

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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