Diclofenac Sodium + Pantoprazole Pharmacology

Diclofenac Sodium + Pantoprazole

About Diclofenac Sodium + Pantoprazole
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Mechanism of Action of Diclofenac Sodium + Pantoprazole
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Pharmacokinets of Diclofenac Sodium + Pantoprazole
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Onset of Action for Diclofenac Sodium + Pantoprazole
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Duration of Action for Diclofenac Sodium + Pantoprazole
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Half Life of Diclofenac Sodium + Pantoprazole
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Side Effects of Diclofenac Sodium + Pantoprazole
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Contra-indications of Diclofenac Sodium + Pantoprazole
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Special Precautions while taking Diclofenac Sodium + Pantoprazole
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Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution,Under 14 years:Contraindicated
Indications for Diclofenac Sodium + Pantoprazole
1.Musculoskeletal complaints, especially arthritis, rheumatoid arthritis, polymyositis, dermatomyositis, osteoarthritis, dental pain, TMJ, spondylarthritis, ankylosing spondylitis, gout attacks.
2.Pain management in cases of kidney stones and gallstones.
3.Treatment of acute migraines.
4.Moderate post-operative or post-traumatic pain, in particular when inflammation is also present.
5.Dysmenorrhea and endometriosis.
Interactions for Diclofenac Sodium + Pantoprazole
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Typical Dosage for Diclofenac Sodium + Pantoprazole
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Schedule of Diclofenac Sodium + Pantoprazole
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Storage Requirements for Diclofenac Sodium + Pantoprazole
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Effects of Missed Dosage of Diclofenac Sodium + Pantoprazole
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Effects of Overdose of Diclofenac Sodium + Pantoprazole
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Diclofenac Sodium

About Diclofenac Sodium
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Mechanism of Action of Diclofenac Sodium
Diclofenac possess analgesic, anti-inflammatory and antipyretic action. It inhibits the enzyme cyclo-oxygenase and there by inhibits the synthesis of Prostaglandins (PGs). It is more potent against cyclo-oxygenase-2 enzyme as compared to other NSAIDs like Indomethacin, Naproxen etc. It reduces intracellular concentrations of free arachidonic acid in leukocyte by altering its release or uptake. .
Pharmacokinets of Diclofenac Sodium
Absorption: Diclofenac sodium is rapidly absorbed after oral administration. It undergoes first pass metabolism and its bioavailability is 50 % only. Distribution: It is distributed in highly protein bound form. Metabolism: Diclofenac sodium is metabolised in the liver. Excretion: Drug and metabolites are primarily excreted in urine and some amount in the bile.
Onset of Action for Diclofenac Sodium
1- 4.5 hours
Duration of Action for Diclofenac Sodium
Hours
Half Life of Diclofenac Sodium
2 hours
Side Effects of Diclofenac Sodium
1.Nausea
2.Vomiting
3.Anorexia
4.Diarrhoea
5.Gastrointestinal bleeding
6.Abdominal distress
7.Constipation
8.Flatulence
9.Ulceration of the stomach or intestine
10.Dyspepsia
11.Headache
12.Dizziness
13. Rash
Contra-indications of Diclofenac Sodium
1.Hypersensitivity to Indomethacin and other Non steroidal anti inflammatory drugs(NSAID)
2.Peptic ulcer
3.Asthma
Special Precautions while taking Diclofenac Sodium
1.Hepatic impairment
2.Renal impairment
3.Hypertension
4.Blood clotting disorders
5.Gastrointestinal diseases
6.Proctitis
7.Asthma
8.Cautioned against driving, operating or activities requiring concentration
9.Avoid alcohol
10.Heart failure
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
CHILDREN below 14: contraindicated
Indications for Diclofenac Sodium
1.Ankylosing spondylitis
2.Acute gout
3.Joint disorders e.g. inflammatory disease in joints, crystal deposition in the joints
4.Osteoarthritis
5.For the relief of pain and inflammation in dental minor surgery and orthopedic
6.Dysmenorrhoea
7.Juvenile chronic arthritis
8.Migraine
Interactions for Diclofenac Sodium
Lithium & Digoxin : Blood levels of lithium and digoxin increased leading to enhanced efficacy and posible toxicity.
Diuretics : Inhibits diuretics but efficacy of potassium sparing diuretics enhanced.
Methotrexate : Toxicity enhanced.
Salicylates : Efficacy of salicylates reduced.
Cyclosporine : Increases nephrotoxicity of both agents.
Hydantoins : Increases serum levels resulting in toxicity.
Typical Dosage for Diclofenac Sodium
Adult: 100 - 150 mg / day in 2 - 3 divided doses.
For the relief of pain, Migraine, Dysmenorrhoea: 150 mg / day in 3 divided doses.
Osteoarthritis: 50 mg 2 - 3 times daily
Rheumatoid arthritis: 150 - 200 mg / day in 3 - 4 divided doses.
Ankylosing spondylitis: 25 mg 4 times daily give an extra dose of 25 mg at bed time if necessary.
Children Juvenile rheumatoid arthritis: 0.5 - 2 mg / kg body weight / day in divided doses.
Maximum dose: 3 mg / kg body weight / day in divided doses
Schedule of Diclofenac Sodium
H
Storage Requirements for Diclofenac Sodium
Store Diclofenac sodium at room temperature in a tightly closed light resistant container.
Effects of Missed Dosage of Diclofenac Sodium
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Diclofenac Sodium
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal.

Pantoprazole

About Pantoprazole
A proton pump inhibitor, Benzimidazole derivative, Anti ulcer.
Mechanism of Action of Pantoprazole
Pantoprazole is a proton pump inhibitor. It is a prodrug. After administration it diffuses in to the parietal cell of the stomach and accumulates in the secretory canaliculi. In the acidic medium Pantoprazole is converted to sulfenamide. This sulfenamide covalently interacts with sulfhydryl (SH) group in the proton pump
(H+ K+ATPase) and inhibits the exchange of extracellular K+ for intracellular H+ ion. Pantoprazole irreversibly inhibits proton pumps activity and decreases gastric acid secretion. Pantoprazole is more acid stable and its activity is lowered in higher pH. It is the only proton pump inhibitor which is available as parenteral form.



Pharmacokinets of Pantoprazole
Absorption: Pantoprazole is well absorbed after oral administration. Its bioavailability is about 77% since it`s undergoes first pass metabolism.
Distribution: It is widely distributed in the body in protein bound form.
Metabolism: Pantoprazole is extensively metabolised in the liver.
Excretion: It is excreted mainly in the urine and small amount in faeces.
Onset of Action for Pantoprazole
2-4 hours
Duration of Action for Pantoprazole
1 day
Half Life of Pantoprazole
60 minutes
Side Effects of Pantoprazole
1. Diarrhoea
2. Nausea
3. Vomiting
4. Headache
5. Flatulence
6. Abdominal pain
7. Pruritis
8. Dizziness
9. Rash

Contra-indications of Pantoprazole
1. Hypersensitivity to Pantoprazole
Special Precautions while taking Pantoprazole
1. Hepatic impairment
2. Monitor liver function
3. Avoid prolonged use
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated.
Children Related Information
Use with caution
Below 12 years : Contraindicated
Indications for Pantoprazole
1. Duodenal ulcer
2. Benign Gastric ulcer
3. Zollinger- Ellison syndrome
4. Gastroesophageal reflux disease
Interactions for Pantoprazole
Phenazone (antipyrine), diazepam, digoxin, theophylline, carbamazepine, diclofenac, phenprocoumon, phenytoin, warfarin, nifedipine, caffeine, metoprolol or ethanol : No clinically relevant interaction at therapeutic doses.
Oral contraceptives : Does not appear to compromise hormonal contraceptive efficacy as no interaction with a low dose combined oral contraceptive has been seen.
Typical Dosage for Pantoprazole
Oral :
Adult: 20-40mg / day before breakfast.
Duodenal ulcer: 40mg / day to be taken before breakfast for 2 - 4 weeks.
Benign Gastric ulcer: 40mg / day to be taken before breakfast for 1 - 2months.
Zollinger- Ellison syndrome: 80 mg / day in 2 divided doses increase the dose to 240 mg/ day if needed.
Gastroesophageal reflux disease: 20 - 40 mg / day to be taken before breakfast for 1 month and continue the treatment for 1 more month if needed.
Parenteral: 40 mg once daily as IV injection over 15 minutes.
Children below 12 years : Not recommended
Schedule of Pantoprazole
H
Storage Requirements for Pantoprazole
Store at 15 - 30 degree C in a tightly closed container. Protect from light.
Effects of Missed Dosage of Pantoprazole
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Pantoprazole
Give supportive measures and symptomatic treatment.

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