What is the use of Diclofenac (nonsteroidal anti-inflammatory drug (NSAID)) suppository in pediatrics?

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Last updated: March 19, 2025View editorial policy

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From the Research

Diclofenac suppositories can be used in pediatric patients for short-term management of pain and fever, but should be used cautiously, with a recommended dose of 0.5 mg/kg for suppositories, as supported by the most recent and highest quality study 1.

Key Considerations

  • The use of diclofenac suppositories in pediatric patients should be guided by the principle of minimizing morbidity, mortality, and improving quality of life.
  • The recommended pediatric dosage is typically based on weight, with a dose of 0.5 mg/kg for suppositories, as indicated by pharmacokinetic studies 2.
  • Treatment duration should generally not exceed 3 days for fever and 7 days for pain unless specifically directed by a healthcare provider.
  • Diclofenac works by inhibiting cyclooxygenase enzymes, reducing prostaglandin synthesis and thereby decreasing inflammation, pain, and fever.
  • Common side effects include gastrointestinal irritation, and the drug should be avoided in children with known hypersensitivity to NSAIDs, active gastrointestinal bleeding, renal impairment, or heart failure.

Administration and Safety

  • Diclofenac suppositories are particularly useful when oral administration is difficult due to vomiting or when rapid pain relief is needed.
  • Parents should be instructed to store suppositories in a cool place and ensure proper insertion technique for effective medication delivery.
  • The safety profile of diclofenac in children is generally favorable, with a low incidence of serious adverse events, as reported in recent reviews 1.

Clinical Evidence

  • A recent Cochrane review 1 assessed the efficacy and safety of diclofenac for acute postoperative pain in children, and found that diclofenac probably results in less nausea and vomiting compared with opioids, but more bleeding events.
  • Another study 2 provided pharmacokinetic data to support the use of diclofenac suppositories in pediatric patients, with a recommended dose of 0.5 mg/kg.
  • Earlier studies 3, 4 also supported the use of diclofenac suppositories in pediatric patients for short-term management of pain and fever.

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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