From the Research
Diclofenac suppositories are typically dosed at 50-100 mg per rectum, administered 1-2 times daily with a maximum daily dose of 150 mg. For adults with acute pain or inflammatory conditions, the usual starting dose is 100 mg on the first day, followed by 50 mg twice daily as needed 1. The dosing for children is weight-based: 1-3 mg/kg/day divided into 2-3 doses, with 12.5 mg and 25 mg suppositories available for pediatric use. Elderly patients or those with renal impairment should start with lower doses, typically 50 mg once daily. The suppository should be inserted rectally after bowel movements, and patients should remain lying down for a few minutes after insertion. Diclofenac works by inhibiting cyclooxygenase enzymes, reducing prostaglandin synthesis and thereby decreasing inflammation and pain. Common side effects include rectal irritation, while serious risks include gastrointestinal bleeding, cardiovascular events, and renal impairment, so the lowest effective dose should be used for the shortest duration necessary 2.
Some key points to consider when prescribing diclofenac suppositories include:
- The patient's medical history, including any history of gastrointestinal bleeding or renal impairment
- The patient's current medications, including any other NSAIDs or medications that may interact with diclofenac
- The patient's age and weight, as these may affect the dosing and potential side effects of the medication
- The potential for serious side effects, such as gastrointestinal bleeding or cardiovascular events, and the need for regular monitoring and follow-up appointments.
It's also important to note that diclofenac suppositories may not be suitable for all patients, and alternative treatments may be necessary in some cases. For example, patients with severe renal impairment or a history of gastrointestinal bleeding may require alternative pain management options. Additionally, patients who are taking other medications that may interact with diclofenac, such as anticoagulants or other NSAIDs, may require closer monitoring and dose adjustments. Overall, diclofenac suppositories can be an effective treatment option for acute pain and inflammatory conditions, but they should be used with caution and under the guidance of a healthcare professional.