- Dosages
- Side effects in children
- Warnings & precautions in children
- Contra-indications in children
-
Interactions - PK
- Renal impairment
- References
Pharmacokinetics in children
No information is present at this moment.
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dose recommendation of formulary compared to licensed use (on-label versus off-label)
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Available formulations
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Dosages
| Verschluss des Ductus arteriosus |
|---|
|
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Renal impaiment in children > 3 months
Adjustment in renal impairment as specified:
GFR 50-80 ml/min/1.73 m2
When diclofenac is prescribed to children at risk: verify renal function prior to the start and within the first week after starting.Consider whether the use of an NSAID is justified.
GFR 30-50 ml/min/1.73 m2
When diclofenac is prescribed to children at risk: verify renal function prior to the start and within the first week after starting.Consider whether the use of an NSAID is justified.
GFR 10-30 ml/min/1.73 m2
When diclofenac is prescribed to children at risk: verify renal function prior to the start and within the first week after starting.Consider whether the use of an NSAID is justified.
GFR < 10 ml/min/1.73 m2
A general recommendation is not given.Clinical consequences
Risk-factors are: heart failure, liver cirrhosis, nephrotic syndrome, chronic kidney disease, causes leading to dehydration (e.g. summer heat), use of other drugs decreasing renal function, like diuretics or RAAS inhibitors.
NSAIDs (including COX-2 inhibitors) can cause acute renal failure by decreasing renal perfusion (by hypovolaemia). Normally, an increased prostaglandin synthesis in the kidneys prevents a rapid decrease in renal perfusion; however, NSAIDs disturb this compensating mechanism. Decreased renal perfusion also leads to water and salt retention, resulting in the occurrence or worsening of hypertension and heart failure.
Patients on dialysis
Haemodialysis / continuous venovenous haemodialysis or haemo(dia)filtration:
- residual kidney function (urine production) PRESENT: avoid use to save residual kidney function
- residual kidney function (urine production) NOT PRESENT: avoidance is not necessary
Patients undergoing dialysis have a higher bleeding risk, probably related to an abnormal platelet function. The bleeding risk can be increased by the use of low molecular weight heparines at the start of haemodialysis to prevent coagulation in the extracorporeal circulation.
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The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Side effects in children
The safetyprofile in children does not differ from the safetyprofile in adults.
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The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here
Contra-indications
No information available on specific contra indications in children.
The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here
Warnings & precautions
No information available on specific warnings and precautions in children.
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Interactions
The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here
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| Adrenergic and dopaminergic agents | ||
|---|---|---|
| C01CA24 | ||
| C01CA07 | ||
| C01CA04 | ||
| C01CA26 | ||
| C01CA02 | ||
| C01CA17 | ||
| C01CA03 | ||
| C01CA06 | ||
| Phosphodiesterase inhibitors | ||
|---|---|---|
| C01CE02 | ||
| Other cardiac stimulants | ||
|---|---|---|
| C01CX08 | ||
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References
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Changes
Changes
