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Clinorel 200 mgClinorel 200 mg is indicated for the symptomatic treatment of- Rheumatoid arthritis Osteoarthritis Ankylosing spondylitis Periarticular inflammatory disorders Acute painful shoulder Acute gouty arthritis Diabetic neuropathy Diabetic retinopathy Theropeutic ClassDrugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Drugs used in Gout, Non-steroidal Anti-inflammatory Drugs (NSAIDs)PharmacologyClinorel 200 mg is a non-steroidal antirheumatic agent possessing anti-inflammatory, analgesic and anti-pyretic properties. Prostaglandin synthetase inhibition is probably the basis of the mechanism of action of non-steroidal anti-inflammatory agents. Following absorption, Clinorel 200 mg undergoes two major transformations. It is oxidised to the sulphone and then reversibly reduced to the sulphide. The sulphide metabolite is the biologically active form which is an inhibitor of prostaglandin synthesis.Dosage & Administration of Clinorel 200 mgThe usual dosage is 100 mg to 200 mg twice a day, although dosages should be optimized for each individual. The maximal daily dose is 400 mg. Therapy for seven days in acute gouty arthritis and for seven to fourteen days in acute painful shoulder is usually sufficient. After a satisfactory response has been achieved, the dosage may be reduced according to the response. Clinorel 200 mg should be taken with foodDosage of Clinorel 200 mgClinorel 200 mg should be administered orally twice a day with food. The maximum dosage is 400 mg per day. Dosages above 400 mg per day are not recommended. In osteoarthritis, rheumatoid arthritis & ankylosing spondylitis, the recommended starting dosage is 150 mg. In acute painful shoulder & acute gouty arthritis the recommended dosage is 200 mg twice a day. The dosage may be lowered or raised depending on the response. After a satisfactory response has been achieved, the dosage may be reduced according to the response. Or, as directed by the registered physicians.Interaction of Clinorel 200 mgClinorel 200 mg and its sulphide metabolite are highly protein bound. Patient should be monitored carefully until it is certain that no chance in their anticoagulant or hypoglycemic dosage is required. Aspirin has been shown to decrease the bioavailability of the active sulfide metabolite of Clinorel 200 mg. Prolonged concurrent use of Paracetamol with Clinorel 200 mg may increase the risk of adverse renal effects. That patient is under close medical supervision while receiving such combined therapy. Probenecid may increase the plasma concentration of Clinorel 200 mg and its sulfone metabolite and slightly decrease the plasma concentration of the active sulfide metabolite.ContraindicationsPatients known to be allergic to Clinorel 200 mg and those in whom acute asthmatic attacks, urticaria or rhinitis have been precipitated by Aspirin or other non-steroidal anti-inflammatory agents. Clinorel 200 mg is also contraindicated in patients with a history of active gastro-intestinal bleeding or peptic ulceration. It should not be given to children, pregnant or lactating women.Side Effects of Clinorel 200 mgGastrointestinal side effects are the most common and consist of abdominal pain, nausea and constipation. Gastrointestinal ulceration and bleeding may also occur. The most frequently reported central nervous system side effects are drowsiness, dizziness, headache and nervousness. Other adverse effects include depression, tinnitus, confusion, light-headedness, insomnia, psychiatric disturbances, syncope, convulsions, coma, peripheral neuropathy, blurred vision and other ocular effects, oedema and mass gain, hypertension, hematuria, skin rashes, pruritus, urticaria, stomatitis, alopecia and hypersensitivity reactions. A hypersensitivity syndrome consisting of fever and chills, skin rashes or other cutaneous manifestations, hepatotoxicity, renal toxicity (including renal failure), leukopenia, thrombocytopenia, eosinophilia, inflammed glands or lymph nodes, and arthralgia have been reported. Leucopenia, purpura, thrombocytopenia, aplastic anaemia, haemolytic anaemia, agranulocytosis, epitaxis, hyperglycaemia, hyperkalaemia and vaginal bleeding have been reported. There have also been reports of hepatitis and jaundice or renal failure.Pregnancy & LactationUse in pregnancy: Clinorel 200 mg should be used during the first two trimesters of pregnancy only if the potential benefit justifies the potential risk to the foetus. Use of Clinorel 200 mg during the third trimester of pregnancy is not recommended. Use in lactation: It is not known whether Clinorel 200 mg is excreted in human milk. So a decision should be made whether to discontinue nursing or discontinue the medicine taking into account the importance of the medicine to the mother.Precautions & WarningsClinorel 200 mg should be administered with caution to patients with impaired renal function and bleeding disorders, epilepsy, parkinsonism or psychiatric disorders. Patient with hepatic impairment the half life of Clinorel 200 mg is prolonged and a reduction of daily dosage may be required. Anemia is some time seen in patients receiving NSAIDs with Clinorel 200 mg.Overdose Effects of Clinorel 200 mgReported symptoms have generally reflected the gastro-intestinal, renal and central nervous system toxicities of Clinorel 200 mg. Treatment is symptomatic and supportive.Storage ConditionsKeep below 25?C temperature, away from light & moisture. Keep out of the reach of children.Use In Special PopulationsPatient with renal impairment: Clinorel 200 mg should be administered with caution to patients with impaired renal function and to those with bleeding disorders, epilepsy, parkinsonism or psychiatric disorders. Patient with hepatic impairment: In the presence of liver function impairment the half life of Clinorel 200 mg is prolonged and a reduction of daily dosage may be required.Drug ClassesDrugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Drugs used in Gout, Non-steroidal Anti-inflammatory Drugs (NSAIDs)Mode Of ActionClinorel 200 mg is a non-steroidal antirheumatic agent possessing anti-inflammatory, analgesic and anti-pyretic properties. Prostaglandin synthetase inhibition is probably the basis of the mechanism of action of non-steroidal anti-inflammatory agents. Following absorption, Clinorel 200 mg undergoes two major transformations. It is oxidised to the sulphone and then reversibly reduced to the sulphide. The sulphide metabolite is the biologically active form which is an inhibitor of prostaglandin synthesis.PregnancyUse in pregnancy: Clinorel 200 mg should be used during the first two trimesters of pregnancy only if the potential benefit justifies the potential risk to the foetus. Use of Clinorel 200 mg during the third trimester of pregnancy is not recommended. Use in lactation: It is not known whether Clinorel 200 mg is excreted in human milk. So a decision should be made whether to discontinue nursing or discontinue the medicine taking into account the importance of the medicine to the mother.Pediatric UsesPatient with renal impairment: Clinorel 200 mg should be administered with caution to patients with impaired renal function and to those with bleeding disorders, epilepsy, parkinsonism or psychiatric disorders. Patient with hepatic impairment: In the presence of liver function impairment the half life of Clinorel 200 mg is prolonged and a reduction of daily dosage may be required.