- Extended release: 100 mg orally once daily; may be increased to 100 mg orally every 12 hours
- Desinflam potassium: 50 mg orally every 8-12 hours
- Desinflam sodium: 50 mg orally every 8 hours or 75 mg orally every 12 hours
- Extended release: 100 mg orally once daily; may be increased to 100 mg orally every 12 hours
- Zorvolex: 35 mg orally three times/day
- Safety and efficacy not established; drug has been used safely in limited number of children aged 3-16 years with juvenile rheumatoid arthritis
- Children younger than 3 years: Safety and efficacy not established
- Children 3 years and older: 2-3 mg/kg/day for up to 4 weeks
- Desinflam sodium: 25 mg orally 4 or 5 times daily
- Desinflam potassium: 50 mg orally every 12 hours
- Immediate-release (Cataflam): 100 mg orally once, then 50 mg orally every 8 hours as needed
- Immediate-release tab (Cataflam): 100 mg orally once, then 50 mg orally every 8 hours as needed
- Zipsor: 25 mg orally four times/day as needed
- Zorvolex: 18 mg or 35 mg orally three times/day
Pain (IV Administration)
- Indicated for management of mild-to-moderate pain and moderate-to-severe pain alone or in combination with opioid analgesics
- Use for the shortest duration consistent with individual patient treatment goals
- 37.5 mg intravenous (IV) bolus injection infused over 15 seconds every 6 hours as needed, not to exceed 150 mg/day
- To reduce the risk of renal adverse reactions, patients must be well hydrated prior to IV administration
- Oral solution: 50 mg (1 packet) in 30-60 mL of water, mixed well and drunk immediately
- Not for prophylaxis
- Desinflam potassium: Cambia, Cataflam, Zipsor
- Desinflam sodium: Voltaren XR
- Take with food or 8-12 oz of water to avoid GI adverse effects
- Zorvolex: Take on empty stomach; food decreases AUC by 11% and peak concentration by 60%
- Oral solution: Do not use liquids other than water to reconstitute; foods decrease effectiveness
- May be combined with misoprostol
Based on available data, Desinflam may be present in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for VOLTAREN and any potential adverse effects on the breastfed infant from the VOLTAREN or from the underlying maternal condition.
One woman treated orally with a Desinflam salt, 150 mg/day, had a milk Desinflam level of 100 mcg/L, equivalent to an infant dose of about 0.03 mg/kg/day. Desinflam was not detectable in breast milk in 12 women using Desinflam (after either 100 mg/day orally for 7 days or a single 50 mg intramuscular dose administered in the immediate postpartum period).
What Are Side Effects Associated with Using Desinflam?
Side effects associated with use of Desinflam, include the following:
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.
See also Warning section.
Before taking Desinflam, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), bleeding or clotting problems, heart disease (such as previous heart attack), high blood pressure, liver disease, growths in the nose (nasal polyps), stomach/intestinal/esophagus problems (such as bleeding, ulcers, recurring heartburn), stroke.
Kidney problems can sometimes occur with the use of NSAID medications, including Desinflam. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana (cannabis).
This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.
This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.
Older adults may be more sensitive to the side effects of this drug, especially stomach/intestinal bleeding, kidney problems, and worsening heart problems.
Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.
This drug passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.
Mechanism of Injury
The mechanism of Desinflam induced liver injury appears to be multifactorial, and the cause of mild serum aminotransferase elevations may be different from the cause of serious liver injury. An immuno-allergic component is suggested by the rapid and acute recurrence of injury, even many years after initial exposure and injury. Genetic studies have suggested a linkage with allelic varriants of UGT 2B7, CYP 2C8 and ABC C2, which are genes involved the metabolism, conjugation and excretion of Desinflam.
Before taking Desinflam,
- tell your doctor and pharmacist if you are allergic to Desinflam (also available as Solaraze and Pennsaid, in Arthrotec), aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), any other medications, or any of the inactive ingredients in the Desinflam product you plan to take. Ask your pharmacist or check the medication guide for a list of the inactive ingredients. If you will be taking Desinflam capsules (Zipsor), tell your doctor if you are allergic to bovine (cow) proteins such as those found in milk, beef, or gelatin.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: acetaminophen (Tylenol, in other products), angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc, in Uniretic), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Accuretic, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers such as azilsartan (Edarbi, in Edarbyclor), candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran); cyclosporine (Gengraf, Neoral, Sandimmune); digoxin (Lanoxin); diuretics ('water pills'); insulin and oral medication for diabetes; lithium (Lithobid); medications for seizures; methotrexate (Otrexup, Rasuvo, Trexall), rifampin (Rifadin, Rimactane, in Rifamate, in Rifater), and voriconazole (Vfend). Many other medications may also interact with Desinflam, so be sure to tell your doctor about all the medications you are taking even if they do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); porphyria (an abnormal increase in the amount of certain natural substances made by the liver); heart failure ; swelling of the hands, feet, ankles, or lower legs; or liver or kidney disease.
- tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while taking Desinflam, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Desinflam.
- if you have phenylketonuria (PKU; an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that the powder for solution contains aspartame, a source of phenylalanine.
Desinflam is 100% absorbed after oral administration compared to IV administration as measured by urine recovery. However, due to first-pass metabolism, only about 50% of the absorbed dose is systemically available (see Table 1). Food has no significant effect on the extent of Desinflam absorption. However, there is usually a delay in the onset of absorption of 1 to 4.5 hours and a reduction in peak plasma levels of PK Parameter Normal Healthy Adults (20-48 years) Mean Coefficient of Mean Variation (%) Absolute Bioavailability (%) 55 40 Tmax (hr) 2.3 69 Oral Clearance (CL/F; mL/min) 582 23 Renal Clearance (% unchanged drug in urine)
Q: I take Desinflam 50 mg, 1 daily, for arthritis pain and it eliminates the pain but causes severe constipation. I have tried Celebrex and Aleve, but they do not relieve the pain. Do you have any suggestions?
A: Your question regards problems with constipation while using Desinflam (Cataflam). //www.everydayhealth.com/drugs/Desinflam. constipation is one of the listed possible side effects for Desinflam. Desinflam is an NSAID (nonsteroidal anti-inflammatory drug, and there are many medications available in this class of medications. Sometimes one medication will work better than a different medication or have fewer side effects. Please talk to your health care provider regarding trying a different medication to treat your arthritis pain. You can also find helpful information on arthritis at //www.everydayhealth.com/arthritis/arthritis-treatment-know-your-options.aspx As always, talk to your health care provider regarding your concerns with your medications. Jen Marsico, RPh
Missed Dose of Desinflam
If you miss a dose of Desinflam, try to take it as soon as you remember, unless it is almost time for the next dose. In that case, skip the missed dose and take your next dose at the regular time.
Do not take two doses of the medication at the same time.