Aceclofenac tablets (Airtal, Acelak) are used to treat inflammatory conditions like Rheumatoid arthritis, Osteoarthritis, ankylosing spondylitis, muscle spasms, and non-specific arthralgias and myalgias.
Aceclofenac is an analog of Diclofenac, a Non-steroidal anti-inflammatory drug. It is considered more effective and is a safer alternative to diclofenac. Unlike diclofenac, it may be taken once or twice daily because of its longer duration of action than diclofenac.
Aceclofenac for headache:
All NSAIDs including diclofenac, aceclofenac, naproxen, and ibuprofen may be used to treat both tension and migraine headache. However, they should be used if paracetamol or other simple painkillers are not effective.
Furthermore, chronic use of aceclofenac and other NSAIDs should be avoided as they may be associated with a condition called as analgesic headache.
Aceclofenac vs diclofenac for tooth pain:
Aceclofenac, because of its anti-inflammatory properties, can be used to treat patients with tooth pain and post-operatively after dental surgery.
A study compared the efficacy and safety of diclofenac and aceclofenac in patients with dental surgery drew the following conclusions:
Both the drugs did not have any significant effects on platelet functions
Gastrointestinal side effects like nausea, vomiting, heartburn and epigastric pain were significantly more in the diclofenac group compared to the aceclofenac group.
No significant cardiovascular or cerebrovascular effects were reported in both groups.
Patients in the aceclofenac group had better compliance than those in the diclofenac group.
The overall global assessment was better in the aceclofenac group compared to patients in the diclofenac group.
Aceclofenac was superior in terms of pain relief compared to diclofenac.
Aceclofenac was effective with rapid onset and a longer duration of action compared to diclofenac and had a better side effects profile.
aceclofenac vs ibuprofen:
Aceclofenac and Ibuprofen are both anti-inflammatory drugs with little differences in terms of efficacy.
Studies comparing aceclofenac and ibuprofen had a mixture of results. Some studies suggested a superior pain relief with ibuprofen while others have found aceclofenac.
A randomized study comparing the efficacy of ibuprofen and aceclofenac after third molar surgery found a marginal superiority of ibuprofen in terms of pain relief. However, adverse effects were common in both groups.
Another study found aceclofenac more effective in relieving the symptoms of pulpitis compared to ibuprofen.
Contraindications to Aceclofenac tablets:
Active gastrointestinal bleeding
Active gastrointestinal ulceration
Cerebrovascular disease
History of gastrointestinal bleeding related to previous NSAID therapy
History of gastrointestinal perforation related to previous NSAID therapy
History of recurrent gastrointestinal hemorrhage (two or more distinct episodes)
History of recurrent gastrointestinal ulceration (two or more distinct episodes)
Ischaemic heart disease
Heart failure, and
Peripheral arterial disease.
Cautions!
Avoid in patients who are allergic to it.
Avoid aceclofenac in:
Acute Porphyrias
Cardiac impairment (NSAIDs may impair renal function)
Coagulation defects
Connective-tissue disorders
Crohn’s disease (maybe exacerbated)
Elderly (risk of serious side-effects and fatalities)
History of cardiac failure
Hypertension
Left ventricular dysfunction
Edema
Risk factors for cardiovascular events, and
Ulcerative colitis (may be exacerbated).
Usual Adult dose:
100 mg twice daily
Aceclofenac 200 mg:
Extended-release tablets that contain 200 mg may be advised to patients who require long-term treatment for osteoarthritis as a once-daily dose.
Aceclofenac dose in kidney disease:
Aceclofenac, like other NSAIDs, should be avoided in patients with renal failure.
If, however, it is used, it should be used for the shortest possible duration and the minimum effective dose.
In severe renal impairment, it should be avoided.
Acelak dose in Liver disease:
Gastrointestinal bleeding and fluid retention can occur. Avoid in patients with severe liver disease.
In mild to moderate disease, use 100 mg once daily.
How to administer Aceclofenac?
It should be taken with meals.
The risk of gastrointestinal side effects increases if it is taken on an empty stomach.
Aceclofenac in Pregnancy:
Pregnancy category C in the first two trimesters
Pregnancy category D in the third trimester
In the first two trimesters, it may be used cautiously. This could lead to premature closing of the fetal Arteriosus. This can lead to pulmonary hypertension during the third trimester.
Avoid it during the third trimester. You might delay labor’s onset. Patients trying to conceive should not use it.
Lactation:
It is best to avoid it while breastfeeding, according to the manufacturer
Side effects of Aceclofenac :
Like all NSAIDs, Aceclofenac tablets can cause gastritis, gastrointestinal ulceration, gastrointestinal bleeding, and heartburn.
Aceclofenac also causes salt and fluid retention. It may exacerbate heart and renal failure.
Rare side effects of aceclofenac include:
Alveolitis,
aseptic meningitis (patients with connective tissue disorders such as systemic lupus erythematosus may be especially susceptible),
hepatic damage,
interstitial fibrosis associated with NSAIDs can lead to renal failure,
pancreatitis,
papillary necrosis associated with NSAIDs can lead to renal failure,
pulmonary eosinophilia,
Stevens-Johnson syndrome,
toxic epidermal necrolysis, and
visual disturbances
Other rare Side effects of aceclofenac:
Angioedema,
blood disorders,
bronchospasm,
Crohn’s disease exacerbation
Depression,
diarrhea,
dizziness,
drowsiness,
fluid retention
gastrointestinal bleeding,
gastrointestinal discomfort,
gastrointestinal disturbances,
gastrointestinal ulceration,
haematuria,
headache,
hearing disturbances,
hypersensitivity reactions,
insomnia,
nausea,
nervousness,
photosensitivity,
raised blood pressure,
rashes,
renal failure (especially in patients with preexisting renal impairment),
tinnitus, and
vertigo.
In addition, long-term treatment is associated with reduced female fertility.
Mechanism of action of aceclofenac:
Aceclofenac blocks the action of cyclooxygenase, which is involved in the production of prostaglandins.
It can be used to treat painful and inflammatory conditions like arthritis.
International Brands of aceclofenac:
Air-Tal
Airtal
Aital
Barcan
Beofenac
Berlofen
Biofenac
Bristaflam
Falcol
Gerbin
Locomin
Preservex
Proflam
Sanein
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