Usage
This combination medication is primarily prescribed for pain and inflammation associated with bacterial infections. It combines the analgesic and anti-inflammatory properties of Diclofenac, the antibacterial action of Doxycycline, and the anti-inflammatory and proteolytic effects of Serratiopeptidase.
Pharmacological Classification:
- Diclofenac: Non-steroidal anti-inflammatory drug (NSAID), analgesic, antipyretic
- Doxycycline: Tetracycline antibiotic
- Serratiopeptidase: Proteolytic enzyme, anti-inflammatory
Mechanism of Action:
Diclofenac inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis, thus decreasing pain and inflammation. Doxycycline inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit. Serratiopeptidase breaks down fibrin, a protein involved in inflammation and blood clotting, reducing swelling and promoting healing. It also deactivates bradykinin, a peptide that contributes to inflammation.
Alternate Names
- Diclofenac-Doxycycline-Serratiopeptidase
- FM KIT
- DOXCON KIT
How It Works
Diclofenac:
- Pharmacodynamics: Inhibits COX-1 and COX-2 enzymes, reducing prostaglandin synthesis, leading to decreased pain, inflammation, and fever.
- Pharmacokinetics: Well absorbed orally, metabolized in the liver, excreted primarily by the kidneys.
Doxycycline:
- Pharmacodynamics: Inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit.
- Pharmacokinetics: Absorbed orally, distributed widely in tissues, metabolized in the liver, excreted in urine and feces.
Serratiopeptidase:
- Pharmacodynamics: Breaks down fibrin, decreases inflammation, and modulates immune responses.
- Pharmacokinetics: Absorbed in the intestine, reaches peak plasma concentration in about an hour, distributed to various tissues.
Dosage
Dosage information for this combination needs to be determined by the prescribing physician based on infection, medical history, and other factors. General dosing considerations for individual components are provided below as per available source material:
Standard Dosage
Adults:
- Diclofenac: 50mg
- Doxycycline: 100mg
- Serratiopeptidase: 10mg
This combination is typically administered 2-3 times a day with food, as prescribed by a doctor.
Children:
This combination is generally not recommended for children. Individual component dosing requires adjustment based on age, weight, and medical condition under strict pediatric supervision.
Special Cases:
- Elderly Patients: Careful monitoring and potentially lower doses are recommended due to age-related decline in renal and hepatic function.
- Patients with Renal Impairment: Dose adjustments may be needed.
- Patients with Hepatic Dysfunction: Dose adjustments may be needed.
- Patients with Comorbid Conditions: Dosage should be carefully determined considering the individual patient’s health status and potential drug interactions.
Clinical Use Cases
Dosage in specific clinical use cases like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations needs to be determined on a case-by-case basis by the treating physician, considering the individual patient’s condition and concomitant medications.
Dosage Adjustments
Dose modifications may be necessary based on patient-specific factors like renal/hepatic dysfunction, metabolic disorders, or genetic polymorphisms affecting drug metabolism.
Side Effects
Common Side Effects:
- Nausea
- Vomiting
- Diarrhea
- Stomach pain or discomfort
- Headache
- Dizziness or lightheadedness
- Skin rash or itching
Rare but Serious Side Effects:
- Allergic reactions (swelling, difficulty breathing, hives)
- Gastrointestinal bleeding or ulcers
- Kidney problems
- Liver damage
- Blood disorders
- Stevens-Johnson syndrome
- Eosinophilic pneumonitis
- Bullous pemphigoid
Long-Term Effects:
Chronic use of NSAIDs like diclofenac can increase the risk of cardiovascular and gastrointestinal complications. The long-term effects of this combination specifically haven’t been rigorously studied.
Adverse Drug Reactions (ADR):
Any serious or unexpected adverse reaction should be immediately reported.
Contraindications
- Hypersensitivity to any component of the drug
- Active peptic ulcer or history of recurrent peptic ulcer/hemorrhage
- Severe heart failure, stroke, or hypertension
- Renal or hepatic impairment
- Last trimester of pregnancy
Drug Interactions
- Other NSAIDs
- Anticoagulants (e.g., warfarin)
- Antihypertensives
- Diuretics
- Methotrexate
- Lithium
- Digoxin
- Alcohol
- Antacids
- Iron, calcium, and multivitamin supplements
- Laxatives
- Antibiotic medicines such as rifampicin
Pregnancy and Breastfeeding
This combination is contraindicated in pregnancy. Diclofenac is avoided, especially in the third trimester. Doxycycline can cause teeth discoloration and affect fetal bone development. Serratiopeptidase safety in pregnancy is unknown. Diclofenac is considered acceptable during breastfeeding in small doses. Doxycycline is excreted in breast milk and can cause permanent teeth discoloration in the infant. Serratiopeptidase safety during breastfeeding is unknown.
Drug Profile Summary
- Mechanism of Action: See above.
- Side Effects: See above.
- Contraindications: See above.
- Drug Interactions: See above.
- Pregnancy & Breastfeeding: Contraindicated.
- Dosage: See above.
- Monitoring Parameters: Liver and kidney function, signs of bleeding or allergic reactions, monitor clinical response.
Popular Combinations
Diclofenac + Serratiopeptidase is a common combination for pain and inflammation.
Precautions
Screen for allergies, metabolic disorders, and organ dysfunction. Exercise caution in pregnant/breastfeeding women, children, and the elderly. Advise patients about potential lifestyle considerations, including avoiding alcohol and monitoring sun exposure due to doxycycline’s photosensitizing effects. Rest is important. Driving or operating heavy machinery should be avoided if dizziness or drowsiness occurs.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Diclofenac + Doxycycline + Serratiopeptidase?
A: Dosage is determined by the prescribing physician based on the individual patient’s needs. A common starting dose is Diclofenac 50mg, Doxycycline 100mg, and Serratiopeptidase 10mg, taken 2-3 times daily with food. Adjustments may be necessary based on various factors.
Q2: Is this combination safe for children?
A: Generally, this combination isn’t recommended for children.
Q3: What are the common side effects?
A: Common side effects include nausea, vomiting, diarrhea, stomach discomfort, headache, dizziness, and skin rash.
Q4: Are there any serious side effects I should be aware of?
A: Yes, rare but serious side effects include allergic reactions, gastrointestinal bleeding, kidney or liver problems, blood disorders, and severe skin reactions.
Q5: Can this medication be taken during pregnancy or breastfeeding?
A: No, this combination is contraindicated during pregnancy and should be used with caution during breastfeeding.
Q6: What other medications should be avoided while taking this combination?
A: Avoid other NSAIDs, anticoagulants, certain antihypertensives, diuretics, methotrexate, lithium, digoxin, alcohol, and antacids among others. Always provide a complete medication history to your doctor.
Q7: What are the key monitoring parameters for patients on this medication?
A: Monitor liver and kidney function, look for signs of bleeding or allergic reactions, and assess the clinical response to treatment.
Q8: Is it safe to consume alcohol while taking this medication?
A: No, alcohol should be avoided as it can interact with Diclofenac and Doxycycline, increasing the risk of side effects.
Q9: Are there any dietary restrictions while taking this combination?
A: Take the medication with food to reduce the risk of stomach upset. Avoid taking iron or calcium supplements, multivitamins, antacids, or laxatives within two hours of taking this medication.
Q10: What should a patient do if they miss a dose?
A: Take the missed dose as soon as you remember, unless it’s almost time for the next dose. Do not double the dose to catch up.
