What is Cataflam (Diclofenac)?

From the Guidelines

Cataflam, a nonsteroidal anti-inflammatory drug (NSAID), should be used at the lowest effective dose for the shortest duration possible to minimize risks, especially in patients with a history of heart problems, stroke, stomach ulcers, or kidney disease. Cataflam is commonly prescribed for conditions like arthritis, menstrual cramps, migraines, and acute injuries. The typical adult dosage is 50 mg taken 2-3 times daily, with a maximum daily dose of 150 mg 1. It works by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), which reduces the production of prostaglandins, chemicals in the body that cause pain and inflammation.

Key Considerations

• Common side effects include stomach upset, heartburn, headache, and dizziness.
• More serious concerns include potential cardiovascular risks and gastrointestinal bleeding, especially with long-term use.
• Patients should avoid alcohol while using Cataflam and take it with food to minimize stomach irritation.
• The medication is not recommended for patients with certain medical histories, and alternative treatments should be considered when possible.

Recent Guidelines and Recommendations

• The 2019 update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network recommendations suggests continuous treatment with NSAIDs, like Cataflam, over on-demand treatment for active ankylosing spondylitis 1.
• The CDC's 2022 clinical practice guideline for prescribing opioids for pain recommends using topical NSAIDs for osteoarthritis pain in a few joints near the surface of the skin, and systemic NSAIDs or duloxetine for pain in multiple joints or when topical NSAIDs are ineffective 1.
• The American Heart Association's 2007 scientific statement on the use of NSAIDs advises a stepped-care approach to pain management, starting with nonpharmacologic interventions and acetaminophen or aspirin, and considering NSAIDs like Cataflam for insufficient pain relief 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Overview of Cataflam (Diclofenac)

• Cataflam, also known as diclofenac, is a non-steroidal anti-inflammatory drug (NSAID) used to treat primary dysmenorrhea, which is characterized by painful, spasmodic cramping in the lower abdomen during menstruation 2.
• The efficacy of diclofenac in treating primary dysmenorrhea has been demonstrated in several studies, with results showing significant reduction in menstrual pain intensity compared to placebo 2, 3, 4.

Efficacy of Diclofenac in Treating Primary Dysmenorrhea

• A randomized, double-blinded, placebo-controlled crossover study found that diclofenac potassium significantly reduced menstrual pain intensity in women with primary dysmenorrhea, with no woman requiring rescue medication when taking diclofenac 2.
• A network meta-analysis of 35 trials with 4383 participants found that diclofenac was more effective than placebo in treating dysmenorrhea, with an odds ratio of 11.82 (95% CI 2.66-52.48) 4.
• Another network meta-analysis of 72 randomized controlled trials with 5723 patients found that diclofenac was superior to aspirin in terms of pain relief, with an odds ratio of 0.28 (95% CI 0.08-0.86) 5.

Safety of Diclofenac

• The safety of diclofenac has been evaluated in several studies, with results showing that it is generally well-tolerated, but may be associated with adverse effects such as gastrointestinal and neurological symptoms 3, 4, 5.
• A network meta-analysis found that diclofenac had a higher risk of adverse effects compared to some other NSAIDs, such as tiaprofenic acid and mefenamic acid 5.

Comparison with Other NSAIDs

• Diclofenac has been compared to other NSAIDs, such as ibuprofen, naproxen, and ketoprofen, in terms of efficacy and safety 3, 4, 5.
• A network meta-analysis found that ibuprofen was the most effective NSAID for treating primary dysmenorrhea, followed by diclofenac and ketoprofen 4.
• Another network meta-analysis found that flurbiprofen was the most effective NSAID, while tiaprofenic acid and mefenamic acid were the safest 5.