Table 8

Diclofenac rectal

Diclofenac rectal
What is it?Non-opioid analgesic
Mechanism of actionNon-steroidal anti-inflammatory selective Cox-2 inhibitor
Starting dose50 mg 8–12 hourly prn
Time to onset of effect30 min17
FormulationRectal suppository
IndicationMild to moderate pain
Common adverse effectsOedema; skin reactions; appetite decreased; diarrhoea; dizziness; gastrointestinal discomfort; gastrointestinal disorders; headache; nausea; rash (discontinue); vertigo; vomiting16
ContraindicationsAllergy to aspirin, cardiovascular disease, gastrointestinal bleeding or history of perforation16
CautionHepatic impairment
Renal failure16
BenefitsAlternative route of administration
RisksDifficult to administer
Cost£1.24 for 10×25 mg or £2.04 for 10×50 mg suppositories