Diclofenamide: Difference between revisions

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{{DrugProjectFormSinglePage
{{DrugProjectFormSinglePage
|genericName=generic name
|authorTag={{SS}}
|aOrAn=a
|genericName=Diclofenamide
|drugClass=Adrenergic receptor agonist
|aOrAn=an
|indication=a list of indications, separated by commas.
|drugClass=adrenergic receptor agonist
|hasBlackBoxWarning=Yes
|indicationType=treatment
|adverseReactions=a list of adverse reactions, separated by commas.
|indication=elevated [[intraocular pressure]]
|adverseReactions=[[anorexia]], [[nausea]], [[vomiting]], [[drowsiness]], and [[paresthesias]]
|blackBoxWarningTitle=Warning Title
|blackBoxWarningTitle=Warning Title
|blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content)
|blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content)
|fdaLIADAdult======Condition 1=====
|fdaLIADAdult======Elevated Intraocular Pressure=====


* Dosing Information
* Dosing Information


:* (Dosage)
:* Recommended initial dosage: '''100-200 mg PO bid'''
:* Recommended maintenence dosage: '''25-50 mg PO qd or bid or tid'''
|offLabelAdultGuideSupport=* There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Diclofenamide in adult patients.
|offLabelAdultNoGuideSupport=* There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Diclofenamide in adult patients.
|fdaLIADPed=* There is limited information regarding the Pediatric Indication and Dosage.
|offLabelPedGuideSupport=* There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Diclofenamide in pediatric patients.
|offLabelPedNoGuideSupport=* There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Diclofenamide in pediatric patients.
|contraindications=* Hepatic Insufficiency
:* Diclofenamide (dichlorphenamide tablets USP) is contraindicated in [[hepatic insufficiency]].


=====Condition 2=====
* Electrolyte Imbalance


* Dosing Information
:* Diclofenamide is contraindicated in [[renal failure]], [[adrenocortical insufficiency]], [[hyperchloremic acidosis]], or in conditions in which serum levels of sodium or potassium are depressed.
 
:* (Dosage)
|offLabelAdultGuideSupport======Condition 1=====
 
* Developed by: (Organisation)
 
* Class of Recommendation: (Class) (Link)
 
* Strength of Evidence: (Category A/B/C) (Link)
 
* Dosing Information/Recommendation


:* (Dosage)
* Obstructive Pulmonary Disease


=====Condition 2=====
:* DARANIDE should not be used in patients with severe pulmonary obstruction who are unable to increase their alveolar ventilation since their acidosis may be increased.


* Developed by: (Organisation)
* Hypersensitivity


* Class of Recommendation: (Class) (Link)
:* Diclofenamide is contraindicated in patients who are [[hypersensitive]] to this product.
|warnings======Hypokalemia=====


* Strength of Evidence: (Category A/B/C) (Link)
* Potassium excretion is increased by DARANIDE (dichlorphenamide tablets USP) and [[hypokalemia]] may develop.


* Dosing Information/Recommendation
* Interference with adequate oral electrolyte intake will also contribute to [[hypokalemia]]. [[Hypokalemia]] can sensitize or exaggerate the response of the heart to the toxic effects of digitalis (e.g., increased [[ventricular irritability]]). [[Hypokalemia]] may be avoided or treated by use of potassium supplements such as foods with a high potassium content.
|clinicalTrials=* The most common adverse reactions include gastrointestinal disturbances ([[anorexia]], [[nausea]], and [[vomiting]]), [[drowsiness]] and [[paresthesias]].


:* (Dosage)
* Certain adverse reactions characteristic of carbonic anhydrase inhibitors may result with Dichlorphenamide  particularly with increasing doses. The following are adverse reactions which have been reported with systemic carbonic anhydrase inhibitors. The pharmacological similarities among the carbonic anhydrase inhibitors make it advisable to consider the following reactions when dichlorphenamide is administered: [[agranulocytosis]], [[ataxia]], [[confusion]], [[constipation]], [[depression]], [[disorientation]], [[dizziness]], electrolyte imbalance ([[hypokalemia]], [[hyperchloremia]]), [[fever]], [[globus hystericus]], [[headache]], [[hepatic insufficiency]], [[hyperuricemia]], kidney stones, [[lassitude]], [[leucopenia]], [[metabolic acidosis]], [[nervousness]], [[phosphaturia]], [[pruritus]], renal colic, [[skin eruptions]], [[thrombocytopenia]], [[tinnitus]], [[tremor]], urinary frequency, weakness, and weight loss.
|offLabelAdultNoGuideSupport======Condition 1=====
|drugInteractions=* High-dose Aspirin


* Dosing Information
:* [[Anorexia]], [[tachypnea]], [[lethargy]] and [[coma]] have been rarely reported due to a possible drug interaction with high-dose [[aspirin]].
|FDAPregCat=C
|useInPregnancyFDA=* Pregnancy Category C. Dichlorphenamide has been shown to be teratogenic in the rat (skeletal anomalies) when given in doses 100 times the human dose. There are no adequate and well-controlled studies in pregnant women. Dichlorphenamide should not be used in women of childbearing age or in pregnancy, especially during the first trimester, unless the potential benefits outweigh the potential risks.
|useInNursing=* It is not known whether dichlorphenamide is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when dichlorphenamide is administered to a nursing woman.
|useInPed=* Safety and effectiveness in pediatric patients have not been established.
|useInGeri=* Metabolic acidosis, which can be severe, may occur in the elderly with reduced renal function.
|administration=* The recommended initial dosage for adults is 2 to 4 tablets (100-200 mg). Two tablets (100 mg) should be given every 12 hours until the desired dose response is obtained.
* The recommended maintenence dosage for adults is one-half to 1 tablet (25-50 mg) one to three times daily.
* In acute angle-closure glaucoma, it may be used together with miotics and osmotic agents in an attempt to reduce intraocular pressure rapidly.
|monitoring=* There is limited information regarding the drug monitoring.
|IVCompat=* There is limited information regarding the IV Compatibility.
|overdose=* Symptoms of overdosage or toxicity may include [[drowsiness]], [[anorexia]], [[nausea]], [[vomiting]], [[dizziness]], [[paresthesias]], [[ataxia]], [[tremor]] and [[tinnitus]].


:* (Dosage)
* In the event of overdosage, induce emesis or perform gastric lavage. The electrolyte disturbance most likely to be encountered from overdosage is [[hyperchloremic acidosis]] that may respond to bicarbonate administrations. Potassium supplementation may be required. The patient should be carefully observed and given supportive treatment.
 
=====Condition 2=====
 
* Dosing Information
 
:* (Dosage)
 
=====Condition 3=====
 
* Dosing Information
 
:* (Dosage)
|fdaLIADPed======Condition 1=====
 
* Dosing Information
 
:* (Dosage)
 
=====Condition 2=====
 
* Dosing Information
 
:* (Dosage)
|offLabelPedGuideSupport======Condition 1=====
 
* Developed by: (Organisation)
 
* Class of Recommendation: (Class) (Link)
 
* Strength of Evidence: (Category A/B/C) (Link)
 
* Dosing Information/Recommendation
 
:* (Dosage)
 
=====Condition 2=====
 
* Developed by: (Organisation)
 
* Class of Recommendation: (Class) (Link)
 
* Strength of Evidence: (Category A/B/C) (Link)
 
* Dosing Information/Recommendation
 
:* (Dosage)
|offLabelPedNoGuideSupport======Condition 1=====
 
* Dosing Information
 
:* (Dosage)
 
=====Condition 2=====
 
* Dosing Information
 
:* (Dosage)
 
=====Condition 3=====
 
* Dosing Information
 
:* (Dosage)
|contraindications=* Condition 1
* Condition 2
* Condition 3
* Condition 4
* Condition 5
|warnings======Conidition 1=====
 
(Description)
 
=====Conidition 2=====
 
(Description)
 
=====Conidition 3=====
 
(Description)
|clinicalTrials=======Central Nervous System======
 
: (list/description of adverse reactions)
 
======Cardiovascular======
 
: (list/description of adverse reactions)
 
======Respiratory======
 
: (list/description of adverse reactions)
 
======Gastrointestinal======
 
: (list/description of adverse reactions)
 
======Hypersensitive Reactions======
 
: (list/description of adverse reactions)
 
======Miscellaneous======
 
: (list/description of adverse reactions)
 
=====Condition 2=====
 
======Central Nervous System======
 
: (list/description of adverse reactions)
 
======Cardiovascular======
 
: (list/description of adverse reactions)
 
======Respiratory======
 
: (list/description of adverse reactions)
 
======Gastrointestinal======
 
: (list/description of adverse reactions)
 
======Hypersensitive Reactions======
 
: (list/description of adverse reactions)
 
======Miscellaneous======
 
: (list/description of adverse reactions)
|postmarketing=(Description)
|drugInteractions=* Drug 1
* Drug 2
* Drug 3
* Drug 4
* Drug 5
 
=====Drug 1=====
 
(Description)
 
=====Drug 2=====
 
(Description)
 
=====Drug 3=====
 
(Description)
 
=====Drug 4=====
 
(Description)
 
=====Drug 5=====
 
(Description)
|useInPregnancyFDA=(Description)
|useInPregnancyAUS=(Description)
|useInLaborDelivery=(Description)
|useInNursing=(Description)
|useInPed=(Description)
|useInGeri=(Description)
|useInGender=(Description)
|useInRace=(Description)
|useInRenalImpair=(Description)
|useInHepaticImpair=(Description)
|useInReproPotential=(Description)
|useInImmunocomp=(Description)
|othersTitle=Others
|useInOthers=(Description)
|administration=(Oral/Intravenous/etc)
|monitoring======Condition 1=====
 
(Description regarding monitoring, from ''Warnings'' section)
 
=====Condition 2=====
 
(Description regarding monitoring, from ''Warnings'' section)
 
=====Condition 3=====
 
(Description regarding monitoring, from ''Warnings'' section)
|IVCompat====Solution===
 
====Compatible====
 
* Solution 1
* Solution 2
* Solution 3
 
====Not Tested====
 
* Solution 1
* Solution 2
* Solution 3
 
====Variable====
 
* Solution 1
* Solution 2
* Solution 3
 
====Incompatible====
 
* Solution 1
* Solution 2
* Solution 3
 
===Y-Site===
 
====Compatible====
 
* Solution 1
* Solution 2
* Solution 3
 
====Not Tested====
 
* Solution 1
* Solution 2
* Solution 3
 
====Variable====
 
* Solution 1
* Solution 2
* Solution 3
 
====Incompatible====
 
* Solution 1
* Solution 2
* Solution 3
 
===Admixture===
 
====Compatible====
 
* Solution 1
* Solution 2
* Solution 3
 
====Not Tested====
 
* Solution 1
* Solution 2
* Solution 3
 
====Variable====
 
* Solution 1
* Solution 2
* Solution 3
 
====Incompatible====
 
* Solution 1
* Solution 2
* Solution 3
 
===Syringe===
 
====Compatible====
 
* Solution 1
* Solution 2
* Solution 3
 
====Not Tested====
 
* Solution 1
* Solution 2
* Solution 3
 
====Variable====
 
* Solution 1
* Solution 2
* Solution 3
 
====Incompatible====
 
* Solution 1
* Solution 2
* Solution 3
 
===TPN/TNA===
 
====Compatible====
 
* Solution 1
* Solution 2
* Solution 3
 
====Not Tested====
 
* Solution 1
* Solution 2
* Solution 3
 
====Variable====
 
* Solution 1
* Solution 2
* Solution 3
 
====Incompatible====
 
* Solution 1
* Solution 2
* Solution 3
|overdose====Acute Overdose===
 
====Signs and Symptoms====
 
(Description)
 
====Management====
 
(Description)
 
===Chronic Overdose===
 
====Signs and Symptoms====
 
(Description)
 
====Management====
 
(Description)
|drugBox={{Drugbox2
|drugBox={{Drugbox2
| verifiedrevid =  
| Verifiedfields = changed
| IUPAC_name =  
| verifiedrevid = 460783591
| image =  
| IUPAC_name = 4,5-dichlorobenzene-1,3-disulfonamide
| drug_name =  
| image = Diclofenamide drugbox 01.png
| alt = Skeletal formula of diclofenamide
| image2 = Diclofenamide-3D-spacefill.png
| alt2 = Diclofenamide drugbox 02.png


<!--Clinical data-->
<!--Clinical data-->
| tradename =  
| tradename =
| MedlinePlus =  
| Drugs.com = {{drugs.com|international|diclofenamide}}
| licence_US =  
| MedlinePlus = a601233
| pregnancy_AU =  
| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US =  
| pregnancy_US = <!-- A / B / C / D / X -->
| legal_status =  
| pregnancy_category = 
| routes_of_administration =
| legal_AU = <!-- Unscheduled / S2 / S4 / S8 -->
| legal_UK = <!-- GSL / P / POM / CD -->
| legal_US = <!-- OTC / Rx-only -->
| legal_status =
| routes_of_administration =


<!--Pharmacokinetic data-->
<!--Pharmacokinetic data-->
| bioavailability =  
| bioavailability =
| metabolism =  
| protein_bound = 55%
| elimination_half-life =  
| metabolism =
| excretion =  
| elimination_half-life =
| excretion =


<!--Identifiers-->
<!--Identifiers-->
| CAS_number_Ref =  
| CASNo_Ref = {{cascite|correct|CAS}}
| CAS_number =  
| CAS_number_Ref = {{cascite|correct|??}}
| ATC_prefix =  
| CAS_number = 120-97-8
| ATC_suffix =  
| ATC_prefix = S01
| PubChem =  
| ATC_suffix = EC02
| IUPHAR_ligand =  
| ATC_supplemental =
| DrugBank_Ref =  
| PubChem = 3038
| DrugBank =  
| DrugBank_Ref = {{drugbankcite|changed|drugbank}}
| ChemSpiderID_Ref =  
| DrugBank = DB01144
| ChemSpiderID =  
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| UNII_Ref =  
| ChemSpiderID = 2930
| UNII =  
| UNII_Ref = {{fdacite|correct|FDA}}
| KEGG_Ref =  
| UNII = VVJ6673MHY
| KEGG =  
| KEGG_Ref = {{keggcite|correct|kegg}}
| ChEBI_Ref =  
| KEGG = D00518
| ChEBI =  
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEMBL_Ref =  
| ChEBI = 101085
| ChEMBL =  
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 17


<!--Chemical data-->
<!--Chemical data-->
| C= | H= | N= | O=  
| C=6 | H=6 | Cl=2 | N=2 | O=4 | S=2
| molecular_weight =  
| molecular_weight = 305.16 g/mol
| smiles =  
| smiles = Clc1c(cc(cc1Cl)S(=O)(=O)N)S(=O)(=O)N
| InChI =  
| InChI = 1/C6H6Cl2N2O4S2/c7-4-1-3(15(9,11)12)2-5(6(4)8)16(10,13)14/h1-2H,(H2,9,11,12)(H2,10,13,14)
| InChIKey =  
| InChIKey = GJQPMPFPNINLKP-UHFFFAOYAI
| StdInChI_Ref =  
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI =  
| StdInChI = 1S/C6H6Cl2N2O4S2/c7-4-1-3(15(9,11)12)2-5(6(4)8)16(10,13)14/h1-2H,(H2,9,11,12)(H2,10,13,14)
| StdInChIKey_Ref =  
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey =  
| StdInChIKey = GJQPMPFPNINLKP-UHFFFAOYSA-N
| melting_point =
}}
}}
|mechAction=(Description)
|mechAction=* Carbonic anhydrase inhibitors reduce [[intraocular pressure]] by partially suppressing the secretion of aqueous humor (inflow), although the mechanism by which they do this is not fully understood. Evidence suggests that bicarbonate ions are produced in the ciliary body by hydration of carbon dioxide under the influence of carbonic anhydrase and diffuse into the posterior chamber with sodium ions. The aqueous fluid contains more sodium and bicarbonate ions than does plasma and consequently is hypertonic. Water is attracted to the posterior chamber by osmosis. Systemic administration of a carbonic anhydrase inhibitor has been shown to inactivate carbonic anhydrase in the ciliary body of the rabbit's eye and to reduce the high concentration of bicarbonate ions in ocular fluids. As is the case with all carbonic anhydrase inhibitors, Dichlorphenamide in high doses causes some decreases in renal blood flow and glomerular filtration rate.
|structure=(Description with picture)
|structure=* Dichlorphenamide is an oral carbonic anhydrase inhibitor. Dichlorphenamide, a dichlorinated benzenedisulfonamide, is known chemically as 4,5-dichloro-1,3-benzenedisulfonamide. Its empirical formula is C6H6Cl2N2O4S2 and its structural formula is:
|PD=(Description)
|PK=(Description)
|nonClinToxic=(Description)
|clinicalStudies======Condition 1=====


(Description)
[[File:Dichlorphenamide_description_01.jpg|thumb|none|400px]]


=====Condition 2=====
* Dichlorphenamide USP is a white or practically white, crystalline compound with a molecular weight of 305.16. It is very slightly soluble in water but soluble in dilute solutions of sodium carbonate and sodium hydroxide. Dilute alkaline solutions of dichlorphenamide are stable at room temperature.


(Description)
* Dichlorphenamide is supplied as tablets, for oral administration, each containing 50 mg dichlorphenamide. Inactive ingredients are D&C yellow lake #10, lactose monohydrate, magnesium stearate and pregelatinized starch.
|PK=* In man, dichlorphenamide begins to act within an hour and maximal effect is observed in two to four hours. The lowered [[intraocular tension]] may be maintained for approximately 6 to 12 hours.
|nonClinToxic======Carcinogenesis, Mutagenesis, Impairment of Fertility=====


=====Condition 3=====
* Long-term studies in animals have not been performed to evaluate the effects upon fertility or carcinogenic potential of Dichlorphenamide.
|clinicalStudies=* There is limited information regarding the Clinical Studies.
|howSupplied=* Each Dichlorphenamide, 50 mg - round, yellow tablet, scored on one side, engraved with "TARO" on one side and on the other side "D" above the score and "50" below the score.
Dichlorphenamide is supplied as follows:
|storage=* Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].
|fdaPatientInfo=* Patients should be advised that adverse reactions common to all sulfonamide derivatives may occur, including anaphylaxis, fever, rash (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), crystalluria, renal calculus, bone marrow depression, thrombocytopenic purpura, hemolytic anemia, leucopenia, pancytopenia, and agranulocytosis. If such reactions occur, the drug should be discontinued and appropriate therapy instituted.


(Description)
* Patients should be advised on the potential for anorexia, tachypnea, lethargy, coma, and death with the concomitant use of high-dose aspirin and Dichlorphenamide.
|howSupplied=(Description)
 
|fdaPatientInfo=(Patient Counseling Information)
* Dichlorphenamide may cause drowsiness/fatigue and myopia in some patients. Patients should be cautioned on the potential for impaired ability to drive and operate machinery.
|nlmPatientInfo=(Link to patient information page)
|alcohol=* Alcohol-Diclofenamide interaction has not been established. Talk to your doctor regarding the effects of taking alcohol with this medication.
|lookAlike=* (Paired Confused Name 1a) — (Paired Confused Name 1b)
|brandNames=* Daranide
* (Paired Confused Name 2a) — (Paired Confused Name 2b)
}}
* (Paired Confused Name 3a) — (Paired Confused Name 3b)
{{LabelImage
|drugShortage=Drug Shortage
|fileName=Diclofenamide label 01.jpg
}}
{{LabelImage
|fileName=Dichlorphenamide panel 01.jpg
}}
}}
[[Category:Carbonic anhydrase inhibitors]]
[[Category:Sulfonamides]]
[[Category:Drug]]

Latest revision as of 15:59, 23 March 2015

Diclofenamide
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sheng Shi, M.D. [2]

Disclaimer

WikiDoc MAKES NO GUARANTEE OF VALIDITY. WikiDoc is not a professional health care provider, nor is it a suitable replacement for a licensed healthcare provider. WikiDoc is intended to be an educational tool, not a tool for any form of healthcare delivery. The educational content on WikiDoc drug pages is based upon the FDA package insert, National Library of Medicine content and practice guidelines / consensus statements. WikiDoc does not promote the administration of any medication or device that is not consistent with its labeling. Please read our full disclaimer here.

Overview

Diclofenamide is an adrenergic receptor agonist that is FDA approved for the treatment of elevated intraocular pressure. Common adverse reactions include anorexia, nausea, vomiting, drowsiness, and paresthesias.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Elevated Intraocular Pressure
  • Dosing Information
  • Recommended initial dosage: 100-200 mg PO bid
  • Recommended maintenence dosage: 25-50 mg PO qd or bid or tid

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

  • There is limited information regarding Off-Label Guideline-Supported Use of Diclofenamide in adult patients.

Non–Guideline-Supported Use

  • There is limited information regarding Off-Label Non–Guideline-Supported Use of Diclofenamide in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

  • There is limited information regarding the Pediatric Indication and Dosage.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

  • There is limited information regarding Off-Label Guideline-Supported Use of Diclofenamide in pediatric patients.

Non–Guideline-Supported Use

  • There is limited information regarding Off-Label Non–Guideline-Supported Use of Diclofenamide in pediatric patients.

Contraindications

  • Hepatic Insufficiency
  • Electrolyte Imbalance
  • Obstructive Pulmonary Disease
  • DARANIDE should not be used in patients with severe pulmonary obstruction who are unable to increase their alveolar ventilation since their acidosis may be increased.
  • Hypersensitivity
  • Diclofenamide is contraindicated in patients who are hypersensitive to this product.

Warnings

Hypokalemia
  • Potassium excretion is increased by DARANIDE (dichlorphenamide tablets USP) and hypokalemia may develop.
  • Interference with adequate oral electrolyte intake will also contribute to hypokalemia. Hypokalemia can sensitize or exaggerate the response of the heart to the toxic effects of digitalis (e.g., increased ventricular irritability). Hypokalemia may be avoided or treated by use of potassium supplements such as foods with a high potassium content.

Adverse Reactions

Clinical Trials Experience

Postmarketing Experience

There is limited information regarding Diclofenamide Postmarketing Experience in the drug label.

Drug Interactions

  • High-dose Aspirin

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): C

  • Pregnancy Category C. Dichlorphenamide has been shown to be teratogenic in the rat (skeletal anomalies) when given in doses 100 times the human dose. There are no adequate and well-controlled studies in pregnant women. Dichlorphenamide should not be used in women of childbearing age or in pregnancy, especially during the first trimester, unless the potential benefits outweigh the potential risks.


Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Diclofenamide in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Diclofenamide during labor and delivery.

Nursing Mothers

  • It is not known whether dichlorphenamide is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when dichlorphenamide is administered to a nursing woman.

Pediatric Use

  • Safety and effectiveness in pediatric patients have not been established.

Geriatic Use

  • Metabolic acidosis, which can be severe, may occur in the elderly with reduced renal function.

Gender

There is no FDA guidance on the use of Diclofenamide with respect to specific gender populations.

Race

There is no FDA guidance on the use of Diclofenamide with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Diclofenamide in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Diclofenamide in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Diclofenamide in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Diclofenamide in patients who are immunocompromised.

Administration and Monitoring

Administration

  • The recommended initial dosage for adults is 2 to 4 tablets (100-200 mg). Two tablets (100 mg) should be given every 12 hours until the desired dose response is obtained.
  • The recommended maintenence dosage for adults is one-half to 1 tablet (25-50 mg) one to three times daily.
  • In acute angle-closure glaucoma, it may be used together with miotics and osmotic agents in an attempt to reduce intraocular pressure rapidly.

Monitoring

  • There is limited information regarding the drug monitoring.

IV Compatibility

  • There is limited information regarding the IV Compatibility.

Overdosage

  • In the event of overdosage, induce emesis or perform gastric lavage. The electrolyte disturbance most likely to be encountered from overdosage is hyperchloremic acidosis that may respond to bicarbonate administrations. Potassium supplementation may be required. The patient should be carefully observed and given supportive treatment.

Pharmacology

Template:Px
Template:Px
Diclofenamide
Systematic (IUPAC) name
4,5-dichlorobenzene-1,3-disulfonamide
Identifiers
CAS number 120-97-8
ATC code S01EC02
PubChem 3038
DrugBank DB01144
Chemical data
Formula Template:OrganicBox atomTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox atomTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBoxTemplate:OrganicBox 
Mol. mass 305.16 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability ?
Protein binding 55%
Metabolism ?
Half life ?
Excretion ?
Therapeutic considerations
Pregnancy cat.

?

Legal status
Routes ?

Mechanism of Action

  • Carbonic anhydrase inhibitors reduce intraocular pressure by partially suppressing the secretion of aqueous humor (inflow), although the mechanism by which they do this is not fully understood. Evidence suggests that bicarbonate ions are produced in the ciliary body by hydration of carbon dioxide under the influence of carbonic anhydrase and diffuse into the posterior chamber with sodium ions. The aqueous fluid contains more sodium and bicarbonate ions than does plasma and consequently is hypertonic. Water is attracted to the posterior chamber by osmosis. Systemic administration of a carbonic anhydrase inhibitor has been shown to inactivate carbonic anhydrase in the ciliary body of the rabbit's eye and to reduce the high concentration of bicarbonate ions in ocular fluids. As is the case with all carbonic anhydrase inhibitors, Dichlorphenamide in high doses causes some decreases in renal blood flow and glomerular filtration rate.

Structure

  • Dichlorphenamide is an oral carbonic anhydrase inhibitor. Dichlorphenamide, a dichlorinated benzenedisulfonamide, is known chemically as 4,5-dichloro-1,3-benzenedisulfonamide. Its empirical formula is C6H6Cl2N2O4S2 and its structural formula is:
  • Dichlorphenamide USP is a white or practically white, crystalline compound with a molecular weight of 305.16. It is very slightly soluble in water but soluble in dilute solutions of sodium carbonate and sodium hydroxide. Dilute alkaline solutions of dichlorphenamide are stable at room temperature.
  • Dichlorphenamide is supplied as tablets, for oral administration, each containing 50 mg dichlorphenamide. Inactive ingredients are D&C yellow lake #10, lactose monohydrate, magnesium stearate and pregelatinized starch.

Pharmacodynamics

There is limited information regarding Diclofenamide Pharmacodynamics in the drug label.

Pharmacokinetics

  • In man, dichlorphenamide begins to act within an hour and maximal effect is observed in two to four hours. The lowered intraocular tension may be maintained for approximately 6 to 12 hours.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment of Fertility
  • Long-term studies in animals have not been performed to evaluate the effects upon fertility or carcinogenic potential of Dichlorphenamide.

Clinical Studies

  • There is limited information regarding the Clinical Studies.

How Supplied

  • Each Dichlorphenamide, 50 mg - round, yellow tablet, scored on one side, engraved with "TARO" on one side and on the other side "D" above the score and "50" below the score.

Dichlorphenamide is supplied as follows:

Storage

  • Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

  • Patients should be advised that adverse reactions common to all sulfonamide derivatives may occur, including anaphylaxis, fever, rash (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), crystalluria, renal calculus, bone marrow depression, thrombocytopenic purpura, hemolytic anemia, leucopenia, pancytopenia, and agranulocytosis. If such reactions occur, the drug should be discontinued and appropriate therapy instituted.
  • Patients should be advised on the potential for anorexia, tachypnea, lethargy, coma, and death with the concomitant use of high-dose aspirin and Dichlorphenamide.
  • Dichlorphenamide may cause drowsiness/fatigue and myopia in some patients. Patients should be cautioned on the potential for impaired ability to drive and operate machinery.

Precautions with Alcohol

  • Alcohol-Diclofenamide interaction has not been established. Talk to your doctor regarding the effects of taking alcohol with this medication.

Brand Names

  • Daranide

Look-Alike Drug Names

There is limited information regarding Diclofenamide Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

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