Diclofenac + Famotidine + Serratiopeptidase

Usage

This combination medication is primarily prescribed for the management of pain and inflammation associated with musculoskeletal conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, back pain, and post-operative pain. It also aids in reducing swelling. It combines the analgesic and anti-inflammatory action of diclofenac, a non-steroidal anti-inflammatory drug (NSAID), with the gastroprotective effects of famotidine, an H2 receptor antagonist, and the anti-inflammatory and proteolytic action of serratiopeptidase.

• Pharmacological Classifications:

  • Diclofenac: Non-Steroidal Anti-Inflammatory Drug (NSAID), Analgesic
  • Famotidine: H2 Receptor Antagonist (Antacid)
  • Serratiopeptidase: Proteolytic enzyme, Anti-inflammatory

• Mechanism of Action:

  • Diclofenac: Inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis, thereby decreasing pain and inflammation.
  • Famotidine: Reduces gastric acid production by blocking H2 receptors in the stomach, protecting against NSAID-induced ulcers.
  • Serratiopeptidase: Breaks down fibrin, a protein involved in inflammation and blood clotting, thereby reducing swelling and facilitating tissue repair.

Alternate Names

No widely recognized alternate names exist for this specific three-drug combination. However, each individual component has various generic and brand names. Brand names for combinations containing these ingredients vary regionally. Some examples from India include Yekin-S (Diclofenac, Famotidine, and Serratiopeptidase).

How It Works

• Pharmacodynamics: The combined effect results in reduced pain, inflammation, and swelling. Famotidine minimizes the gastric side effects often associated with diclofenac.
• Pharmacokinetics:
  • Diclofenac: Well-absorbed orally, metabolized in the liver, excreted renally.
  • Famotidine: Absorbed orally, partially metabolized in the liver, excreted renally.
  • Serratiopeptidase: Absorbed orally, mechanism of metabolism and excretion less well-defined.
• Mode of Action: Diclofenac inhibits COX enzymes. Famotidine blocks H2 receptors. Serratiopeptidase breaks down fibrin.
• Receptor Binding/Enzyme Inhibition: Diclofenac: COX-1 and COX-2 inhibition. Famotidine: H2 receptor blockade.
• Elimination Pathways: Primarily renal excretion for diclofenac and famotidine.

Dosage

The dosage varies based on individual patient needs and the specific condition. Always consult with a doctor for the correct dosage and duration of treatment.

Standard Dosage

Adults: The typical dose is Diclofenac 50mg + Famotidine 20mg + Serratiopeptidase 10mg, taken twice a day, usually after meals.

Children: This combination is generally not recommended for children.

Special Cases: Dose adjustments should be made in elderly patients, and those with renal or hepatic impairment.

Clinical Use Cases

This combination is not typically used in the clinical settings you mentioned (intubation, surgical procedures, mechanical ventilation, ICU, emergency situations). Other formulations of Diclofenac may be utilized in some of these instances.

Dosage Adjustments

Adjustments are necessary for patients with renal or hepatic impairment. Dosage should be individualized.

Side Effects

Common Side Effects: Nausea, vomiting, stomach pain, diarrhea, constipation, dizziness, headache.

Rare but Serious Side Effects: Allergic reactions (rash, itching, swelling), gastrointestinal bleeding, liver dysfunction, kidney problems.

Long-Term Effects: Long-term use of NSAIDs like diclofenac carries a risk of cardiovascular and gastrointestinal complications.

Adverse Drug Reactions (ADR): Severe allergic reactions, gastrointestinal bleeding, Stevens-Johnson Syndrome (rare).

Contraindications

• Hypersensitivity to any component of the medication.
• Active peptic ulcer or gastrointestinal bleeding.
• Severe hepatic or renal impairment.
• Aspirin triad (asthma, nasal polyps, aspirin sensitivity).
• Last trimester of pregnancy.

Drug Interactions

• Anticoagulants (warfarin, heparin)
• Other NSAIDs (aspirin, ibuprofen)
• Diuretics
• Corticosteroids
• Lithium
• Methotrexate
• Alcohol

Pregnancy and Breastfeeding

This combination is generally avoided during pregnancy, especially in the third trimester. Caution is advised during breastfeeding.

Drug Profile Summary

Refer to sections above for detailed explanations.

Popular Combinations

While diclofenac is combined with other drugs, the specific combination of Diclofenac + Famotidine + Serratiopeptidase is less common compared to Diclofenac + Serratiopeptidase or Diclofenac + Famotidine.

Precautions

As detailed above.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Diclofenac + Famotidine + Serratiopeptidase?

A: The typical adult dose is Diclofenac 50mg + Famotidine 20mg + Serratiopeptidase 10mg twice daily, ideally after meals. Dosage should be adjusted based on individual patient needs and medical conditions.

Q2: What are the primary uses of this drug combination?

A: Primarily indicated for pain and inflammation associated with musculoskeletal conditions like osteoarthritis, rheumatoid arthritis, and post-surgical pain.

Q3: What are the common side effects patients should be aware of?

A: Common side effects may include nausea, vomiting, stomach discomfort, dizziness, and headache.

Q4: Are there any contraindications for this combination?

A: Yes. Contraindications include hypersensitivity to the ingredients, active peptic ulcer or GI bleeding, severe liver or kidney disease, and the last trimester of pregnancy.

Q5: Can this combination be used in children?

A: Generally not recommended for children.

Q6: Does this drug interact with other medications?

A: Yes. It can interact with anticoagulants, other NSAIDs, diuretics, corticosteroids, lithium, and methotrexate.

Q7: What precautions should be taken when prescribing this drug to elderly patients?

A: Lower doses may be necessary due to decreased renal and hepatic function. Close monitoring is required.

Q8: Can patients consume alcohol while taking this medication?

A: Alcohol should be avoided as it can increase the risk of gastrointestinal side effects and liver damage.

Q9: How does serratiopeptidase contribute to the effectiveness of this combination?

A: Serratiopeptidase acts as a proteolytic enzyme, breaking down fibrin and reducing inflammation and swelling.

Q10: What should a patient do if they miss a dose?

A: If a dose is missed, it should be taken as soon as remembered unless it’s close to the next scheduled dose. Double dosing should be avoided.