ISSUE 1484
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The FDA has approved Dyloject (Hospira), an IV formulation of the NSAID diclofenac sodium, for use in adults. It can be administered alone for treatment of mild to moderate pain or in combination with opioid analgesics for moderate to severe pain. Dyloject is the first injectable formulation of diclofenac to become available in the US.
NONOPIOIDS FOR PAIN — Use of an NSAID in addition to an opioid analgesic for management of postoperative pain has been shown to reduce opioid use and the incidence of opioid-related adverse effects.1 Administration of an oral drug may not be possible during or immediately after surgery. Injectable formulations of ketorolac and ibuprofen (Caldolor)2 are approved for treatment of pain; IV ibuprofen must be infused over 30 minutes. Use of ketorolac is limited to 5 days because of
... more- E Maund et al. Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs for the reduction in morphine-related side-effects after major surgery: a systematic review. Br J Anaesth 2011; 106:292.
- Intravenous ibuprofen (Caldolor). Med Lett Drugs Ther 2010; 52:3.
- Intravenous acetaminophen (Ofirmev). Med Lett Drugs Ther 2011; 53:26.
- F Mermelstein et al. Single-dose and multiple-dose pharmacokinetics and dose proportionality of intravenous and intramuscular HPßCD-diclofenac (Dyloject) compared with other diclofenac formulations. Pharmacotherapy 2013; 33:1012.
- TJ Gan et al. A novel injectable formulation of diclofenac compared with intravenous ketorolac or placebo for acute moderate-to-severe pain after abdominal or pelvic surgery: a multicenter, double-blind, randomized, multiple-dose study. Anesth Analg 2012; 115:1212.
- S Daniels et al. Analgesic efficacy and safety of a novel injectable formulation of diclofenac compared with intravenous ketorolac and placebo after orthopedic surgery: a multicenter, randomized, double-blinded, multiple-dose trial. Clin J Pain 2013; 29:655.
- Drugs for pain. Treat Guidel Med Lett 2013; 11:31.
- Inhibitors and inducers of CYP enzymes and P-glycoprotein. Med Lett Drugs Ther 2013; 55:e44.
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