Megafen 75 mg + 20 mg/2 ml IM Injection

Megafen 75 mg + 20 mg/2 ml im injection by Jayson Pharmaceuticals Ltd. is an intramuscular injection that contains Diclofenac + Lidocaine Hydrochloride. In Bangladesh, it is mainly used for short-term relief of acute pain and inflammation when an injectable medicine is considered necessary by a doctor.

Diclofenac + Lidocaine Hydrochloride combines diclofenac, a non-steroidal anti-inflammatory drug that reduces pain and inflammation by inhibiting prostaglandin production, with lidocaine hydrochloride, a local anesthetic added to help reduce injection-site pain. A key caution is that diclofenac can increase the risk of stomach bleeding, kidney problems, and heart-related events, especially in susceptible patients.

• Short-term treatment of acute painful inflammatory conditions when intramuscular diclofenac is appropriate.
• Acute musculoskeletal pain, sprains, strains, or back pain when prescribed.
• Post-operative or post-traumatic pain when an NSAID injection is suitable.
• Renal colic or biliary colic where a doctor decides diclofenac injection is appropriate.

This medicine is given by deep intramuscular injection, usually into the gluteal muscle, by a trained healthcare professional. Adult dose, frequency, and duration depend on the condition, age, weight, kidney and liver function, cardiovascular and gastrointestinal risk, and other medicines being used. It should be used for the shortest possible time; do not self-inject or repeat doses without the prescribing doctor’s instructions.

• Common: injection-site pain, swelling or irritation, nausea, vomiting, indigestion, abdominal pain, diarrhoea, dizziness, headache, and raised blood pressure.
• Serious: stomach ulcer or bleeding, black stools or vomiting blood, severe allergic reaction, wheezing or facial swelling, chest pain, stroke-like symptoms, severe skin reactions, liver injury, kidney problems, fluid retention, and worsening heart failure.
• Lidocaine-related effects are uncommon at usual doses but may include numbness around the mouth, ringing in the ears, drowsiness, tremor, seizures, or abnormal heartbeat if excessive systemic exposure occurs.

Use with caution in people with a history of stomach ulcer or bleeding, heart disease, stroke, high blood pressure, kidney disease, liver disease, asthma or NSAID-sensitive breathing problems, dehydration, bleeding disorders, older age, or those taking blood thinners. It is for intramuscular use only and should be administered by trained personnel. Use Diclofenac + Lidocaine Hydrochloride under the guidance of a registered doctor or pharmacist.

• Other NSAIDs, including aspirin for pain relief, can increase side effects and bleeding risk.
• Anticoagulants, antiplatelet medicines, SSRIs/SNRIs, and corticosteroids may increase gastrointestinal bleeding risk.
• ACE inhibitors, ARBs, diuretics, and dehydration can increase kidney injury risk and may reduce blood pressure control.
• Lithium, digoxin, methotrexate, ciclosporin, and tacrolimus may have increased toxicity when used with diclofenac.
• Alcohol can increase the risk of stomach irritation and bleeding.
• Medicines affecting heart rhythm or other local anesthetics may increase lidocaine-related risks.

• Allergy to diclofenac, lidocaine, other amide-type local anesthetics, aspirin, or any NSAID.
• History of asthma, urticaria, or severe allergic reaction triggered by aspirin or another NSAID.
• Active or recurrent peptic ulcer, gastrointestinal bleeding, or perforation.
• Severe heart failure, severe liver failure, or severe kidney failure.
• Use for pain around coronary artery bypass graft surgery.
• Third trimester of pregnancy.

Diclofenac should generally be avoided during pregnancy unless a doctor decides it is essential, and it must not be used in the third trimester because it may harm the baby and affect labour. From around mid-pregnancy onward, NSAIDs may also affect fetal kidney function and amniotic fluid. During breastfeeding, diclofenac and lidocaine usually pass into milk in low amounts, but this injection should be used only on medical advice, especially for newborn or premature infants.

Store at room temperature, protected from light and excessive heat, and keep out of the reach of children. Do not freeze. Use only if the ampoule is intact and the solution is clear and free from particles; discard any unused portion safely.