Camphor + Diclofenac + Eucalyptus Oil + Linseed Oil + Menthol + Methyl Salicylate
Overview
Medical Information
Dosage Information
Side Effects
Safety Information
Reference Information
Usage
This topical medication is prescribed for the temporary relief of minor aches and pains of muscles and joints associated with:
- Arthritis
- Backache
- Strains
- Sprains
- Bruises
Pharmacological Classification: Topical analgesic, anti-inflammatory, counterirritant.
Mechanism of Action: This combination product exerts its effects through multiple pathways: Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), inhibits cyclooxygenase (COX) enzymes, thus reducing prostaglandin synthesis and mitigating inflammation and pain. Methyl salicylate acts as a counterirritant and NSAID, delivering analgesic and anti-inflammatory effects alongside a warming sensation. Menthol, another counterirritant, generates a cooling sensation followed by warmth, diverting attention from pain by stimulating cold receptors and increasing blood flow. Eucalyptus oil contributes anti-inflammatory and analgesic properties, possibly by interacting with TRP channels, and also acts as a counterirritant. Camphor functions as a counterirritant producing a cooling sensation through TRPM8 receptor activation, followed by warmth, distracting from pain and potentially enhancing circulation. Lastly, linseed oil improves the absorption of other ingredients and may confer additional anti-inflammatory benefits owing to its omega-3 fatty acid content.
Alternate Names
- Diclofenac Diethylamine + Eucalyptus Oil + Linseed Oil + Menthol + Methyl Salicylate
- Diclofenac + Eucalyptus Oil + Linseed Oil + Menthol + Methyl Salicylate + Camphor
- Topical Analgesic Balm/Cream/Gel/Spray
Some examples of brand names include: DICLOMINT Gel, Bang Gel, Diclosal Plus Cream, KRISHAT RELIEF GEL, Divexx Gel, and Muscoleve.
How It Works
Pharmacodynamics: This combination product works by reducing pain and inflammation through the synergistic action of its ingredients. Diclofenac inhibits prostaglandin synthesis, while methyl salicylate, menthol, eucalyptus oil, and camphor act as counterirritants, creating sensations of warmth or coolness that distract from pain. Linseed oil aids absorption.
Pharmacokinetics: When applied topically, the ingredients are absorbed through the skin to varying degrees. Diclofenac has limited systemic absorption, minimizing the risk of systemic side effects. The other ingredients also have low systemic absorption. Metabolism primarily occurs in the liver, with excretion via urine and feces.
Mode of Action:
- Diclofenac: COX-1 and COX-2 inhibition, reducing prostaglandin synthesis.
- Methyl Salicylate: Counterirritant, potential TRP channel interaction.
- Menthol: TRPM8 receptor activation.
- Eucalyptus Oil: TRP channel interaction (potential).
- Camphor: TRPM8 receptor activation.
Elimination Pathways: Primarily hepatic metabolism followed by renal and fecal excretion.
Dosage
Standard Dosage
Adults:
Apply a thin layer to the affected area 3-4 times daily. Do not exceed 16 grams of diclofenac per day per joint for lower body joints (knee, ankle, foot) or 8 grams of diclofenac per day per joint for upper body joints (hand, wrist, elbow). Total daily dose of diclofenac should not exceed 32 grams. Do not use for more than 14 days unless advised by a physician.
Children:
Not recommended for children under 12 years of age. For children 12 and older, apply to the affected area no more than 3-4 times per day.
Special Cases:
- Elderly Patients: Start with the lowest effective dose and monitor closely for adverse effects.
- Patients with Renal Impairment: Use with caution and consider dosage reduction.
- Patients with Hepatic Dysfunction: Use with caution and consider dosage reduction.
- Patients with Comorbid Conditions (e.g., asthma, cardiovascular disease, diabetes): Use with caution. Consult a physician for appropriate dosage recommendations and monitoring.
Clinical Use Cases
This combination medication is not typically used in clinical settings such as intubation, surgical procedures, mechanical ventilation, ICU, or emergency situations. Its use is limited to topical application for musculoskeletal pain.
Dosage Adjustments
Dosage adjustments may be necessary based on individual patient response and the severity of pain. For special populations (elderly, renal/hepatic impairment), start with the lowest effective dose and monitor closely for adverse events.
Side Effects
Common Side Effects:
- Skin irritation (redness, itching, burning sensation) at the application site
- Dry skin
- Rash
Rare but Serious Side Effects:
- Allergic reactions (e.g., hives, difficulty breathing)
- Blistering or swelling of the skin
Long-Term Effects:
Potential for skin thinning or discoloration with prolonged use.
Adverse Drug Reactions (ADR):
Severe allergic reactions (anaphylaxis) although rare, require immediate medical attention.
Contraindications
- Hypersensitivity to any of the ingredients.
- Open wounds or broken skin.
- Third trimester of pregnancy.
- Patients with aspirin-sensitive asthma.
Drug Interactions
- Oral NSAIDs: Increased risk of systemic side effects.
- Anticoagulants (e.g., warfarin): Increased risk of bleeding.
- Topical analgesics/counterirritants: Increased risk of local irritation.
- Medications like anisindione, apixaban, betrixaban, dabigatran, dicumarol, edoxaban, and rivaroxaban can interact with this combination medication.
Pregnancy and Breastfeeding
Use with caution during pregnancy and breastfeeding. Consult a physician before use. Diclofenac is contraindicated during the third trimester of pregnancy.
Drug Profile Summary
(See information above)
Popular Combinations
Not applicable for this topical medication.
Precautions
(See information above)
FAQs (Frequently Asked Questions)
(See information above for answers)