Aceclofenac

Aceclofenac is a non-steroidal anti-inflammatory drug (nsaid) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Aceclofenac is used to relieve pain and inflammation in:

• Osteoarthritis (knee, hip and other joints)
• Rheumatoid arthritis
• Ankylosing spondylitis
• Low back pain and neck pain
• Dental pain and pain after minor surgery
• Sprains, strains and sports injuries
• Period (menstrual) pain
• Frozen shoulder, tendonitis and other soft-tissue pain

It controls symptoms only; persistent or recurrent pain needs proper evaluation by a doctor to treat the underlying condition.

The usual adult dose of Aceclofenac is 100 mg twice daily — one tablet in the morning and one in the evening — taken with or immediately after food with a full glass of water. Sustained-release 200 mg preparations are taken once daily where prescribed.

• Maximum 200 mg per day
• Use the lowest effective dose for the shortest possible time
• Reduced doses may be needed in liver impairment and in the elderly
• Not recommended for children

Do not exceed the prescribed dose or extend the course yourself; your doctor will review whether you still need it.

Common side effects of Aceclofenac include:

• Indigestion, stomach pain, heartburn, nausea or diarrhoea
• Dizziness or headache
• Mild rise in liver enzymes on blood tests
• Fluid retention and slightly raised blood pressure

Serious but less common: stomach or duodenal ulcer and bleeding (black stools, vomiting blood), kidney impairment, liver injury, severe skin or allergic reactions, and — with long-term high-dose use — a small increase in heart attack and stroke risk. Stop the medicine and see a doctor urgently for black stools, yellow eyes, swelling or chest pain.

Take these precautions with Aceclofenac:

• Always take it with food; for longer courses your doctor may add a gastric-protective medicine (PPI)
• Avoid in dengue fever or suspected dengue — like all NSAIDs it raises bleeding risk; use paracetamol for fever
• Use cautiously if elderly, or with a history of ulcer, kidney disease, heart disease, hypertension, liver disease or asthma
• Avoid while dehydrated (vomiting, diarrhoea, poor intake)
• Do not take two NSAIDs together, including over-the-counter painkillers
• On long-term treatment, get periodic checks of blood pressure, kidney function, liver enzymes and haemoglobin

Important interactions of Aceclofenac:

• Other NSAIDs and aspirin — greatly increased ulcer and bleeding risk
• Anticoagulants and antiplatelets (warfarin, clopidogrel, rivaroxaban) — higher bleeding risk
• Corticosteroids and SSRIs — added risk of stomach bleeding
• ACE inhibitors, ARBs and diuretics — combined use can harm the kidneys and weaken blood-pressure control
• Lithium, methotrexate and digoxin — aceclofenac can raise their blood levels
• Ciclosporin, tacrolimus — increased kidney toxicity
• Diabetes medicines — occasional blood-sugar fluctuations; monitor

Always give your doctor and pharmacist a full list of your medicines.

Do not take Aceclofenac if you have:

• Active peptic ulcer or gastrointestinal bleeding, or previous NSAID-related bleeding
• Asthma attacks, hives or allergy triggered by aspirin or other NSAIDs
• Severe heart failure, established ischaemic heart disease, cerebrovascular or peripheral arterial disease
• Severe kidney or liver impairment
• Dengue fever or suspected dengue
• The last trimester of pregnancy
• Known allergy to aceclofenac, diclofenac or any ingredient

Pregnancy: Aceclofenac should be avoided in pregnancy and is contraindicated in the last three months — like other NSAIDs it can prematurely close a vessel in the baby's heart, harm the baby's kidneys and delay labour. If pain relief is needed in pregnancy, paracetamol is the preferred choice under medical advice.

Breastfeeding: There is limited information on aceclofenac in breast milk, so it is generally not preferred during breastfeeding; doctors usually choose better-studied alternatives. Take it while nursing only if your doctor specifically advises it.

Store Aceclofenac below 30°C in a cool, dry place, protected from light and moisture. Keep tablets in the original blister pack until use. Keep all medicines out of the reach and sight of children. Do not use after the expiry date printed on the package.