Noak (Aceclofenac) is indicated for the symptomatic treatment of pain and inflammation in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and primary dysmenorrhea.
Aceclofenac is contraindicated in the following situations:
Patients previously sensitive to Aceclofenac or Aspirin or other NSAIDs
Patients with active or suspected peptic or duodenal ulcer or who have GI diseases or other bleeding disorders
In severe heart failure and renal or hepatic insufficiency
During last three months of pregnancy
Dosage & Administration
The maximum recommended dose is 200 mg daily in two divided doses. Reduction of dose is not necessary in case of elderly.
In renal failure: Dose adjustment is not necessary in mild renal insufficiency.
In hepatic failure: Dose should be decreased in patients with easy to moderately severe liver malfunction. The recommended initial daily dose is 100 mg in that case.
The major side effects are gastrointestinal like dyspepsia, abdominal pain, nausea and diarrhea. Flatulence, gastritis, constipation, vomiting etc may also occur.
Aceclofenac should be used with caution in patients suffering from GI diseases and history of peptic ulceration, cerebrovascular bleeding, ulcerative colitis or coagulation disorders. Caution should be exercised in patients with mild to moderate renal, hepatic or cardiac function. Caution is also required in patients with diuretic treatment.
There is no information on the use of Aceclofenac during pregnancy and lactation. The use of Aceclofenac should, therefore, be avoided during pregnancy and lactation unless the potential benefits to the mother outweigh the possible risk.
Aceclofenac is metabolized through cytochrome P450 2C9 and a risk of pharmacokinetic interaction is, therefore, possible with Phenytoin, Digoxin, Cimetidine, Tolbutamide. There is also a risk of pharmacokinetic interaction with drugs eliminated by active renal secretion such as Methothrexate and Lithium.