From the Guidelines
Aceclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that should be used with caution due to its potential gastrointestinal risks, including symptomatic or complicated ulcers, which can lead to significant morbidity and mortality 1. When considering the use of aceclofenac, it is essential to weigh the benefits against the potential risks, particularly in patients with a history of peptic ulcers, advanced age, or concomitant use of corticosteroids, anticoagulants, or other NSAIDs 1.
- Key factors to consider when prescribing aceclofenac include:
- Dose-response relationship to adverse GI events, which appears linear 1
- Concurrent use of other medications that may increase the risk of GI complications 1
- Patient's medical history, including previous peptic ulcers or GI complications 1
- Age, as advancing age increases the risk of GI complications by about 4% per year 1
- To minimize the risks associated with aceclofenac, patients should be advised to:
- Take the medication with food to reduce gastrointestinal side effects
- Use the lowest effective dose for the shortest duration necessary to control symptoms
- Monitor for signs of GI complications, such as bleeding or perforation
- Avoid concurrent use of other NSAIDs, corticosteroids, or anticoagulants whenever possible 1
- It is crucial to note that aceclofenac, like other NSAIDs, can increase the risk of death, with an estimated yearly mortality rate of 16,500 in the United States 1. Therefore, aceclofenac should only be prescribed when the potential benefits outweigh the risks, and patients should be closely monitored for adverse effects 1.
From the Research
Definition and Properties of Aceclofenac
- Aceclofenac is an orally administered phenylacetic acid derivative with effects on a variety of inflammatory mediators 2.
- It is a nonsteroidal anti-inflammatory drug (NSAID) with anti-inflammatory and analgesic properties 3, 4, 5, 6.
- Aceclofenac provides symptomatic relief in a variety of painful conditions, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and other inflammatory or degenerative arthropathies 2, 3, 4, 5, 6.
Therapeutic Uses of Aceclofenac
- Aceclofenac is used to treat pain and inflammatory or degenerative arthropathies, such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis 2, 3, 4, 5, 6.
- It is also effective in other painful conditions, including dental and gynaecological pain, lower back pain, and ear, nose, and throat indications 2, 3, 4.
- The usual oral dosage of aceclofenac is 100 mg twice daily in adults 6.
Efficacy and Safety of Aceclofenac
- Aceclofenac is at least as effective as other NSAIDs in reducing pain and/or improving functional capacity in chronic pain conditions 2, 3, 4, 5.
- It appears to have a more favorable GI profile than other NSAIDs, with a lower incidence of gastrointestinal adverse effects 2, 3, 4, 5, 6.
- Aceclofenac is generally well tolerated, with most adverse events being minor and reversible, and affecting mainly the GI system 2.