Is the recommended dose of diclofenac (nonsteroidal anti-inflammatory drug (NSAID)) for pediatric patients 1 milligram (mg) per kilogram (kg) per dose or in divided doses?

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From the Research

The recommended dose of diclofenac for pediatric patients is typically 1 mg/kg per dose, given 2-3 times daily, with a maximum daily dose of 3 mg/kg or 150 mg, whichever is lower, and it is often administered in divided doses. For acute pain or inflammatory conditions, children usually receive 0.5-1 mg/kg per dose, given 2-3 times daily. The dosing should be adjusted based on the child's weight, age, and specific condition being treated. It's essential to use the lowest effective dose for the shortest duration possible to minimize side effects, as supported by a study on the population pharmacokinetics of oral diclofenac for acute pain in children 1. Diclofenac works by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), which reduces prostaglandin production and decreases inflammation, pain, and fever. Parents should be aware of potential side effects, including gastrointestinal upset, and the medication should be given with food to reduce stomach irritation. Diclofenac should only be used under medical supervision in children, as NSAIDs carry risks, including gastrointestinal bleeding and renal effects, particularly with prolonged use, as noted in a study on diclofenac for acute pain in children 2.

Some key points to consider when administering diclofenac to pediatric patients include:

  • The medication should be used at the lowest effective dose for the shortest duration possible to minimize side effects.
  • Diclofenac can be administered in divided doses, typically 2-3 times daily.
  • The maximum daily dose should not exceed 3 mg/kg or 150 mg, whichever is lower.
  • The medication should be given with food to reduce stomach irritation.
  • Parents should be aware of potential side effects, including gastrointestinal upset.
  • Diclofenac should only be used under medical supervision in children due to the risks associated with NSAIDs, as discussed in a study on the clinical pharmacokinetics of diclofenac 3.

It's also important to note that diclofenac is not licensed for all age groups, and its use in children should be carefully considered, as highlighted in a study on diclofenac for acute pain in children 2. Additionally, the use of diclofenac in combination with other medications, such as acetaminophen, may be effective in achieving analgesia with lower doses of both drugs, as shown in a study on postoperative analgesia using diclofenac and acetaminophen in children 4.

References

Research

Population pharmacokinetics of oral diclofenac for acute pain in children.

British journal of clinical pharmacology, 2008

Research

Diclofenac for acute pain in children.

The Cochrane database of systematic reviews, 2009

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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