Diclofenac, sold under the brand name Voltaren, among others, is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammatory diseases such as gout. It is taken by mouth or rectally in a suppository, used by injection, or applied to the skin. Improvements in pain last for as much as eight hours. It is also available in combination with misoprostol in an effort to decrease stomach problems.Common side effects include abdominal pain, gastrointestinal bleeding, nausea, dizziness, headache, and swelling. Serious side effects may include heart disease, stroke, kidney problems, and stomach ulceration. Use is not recommended in the third trimester of pregnancy. It is likely safe during breastfeeding. It is believed to work by decreasing the production of prostaglandin. It blocks both COX-1 (like aspirin) and COX-2 (like celecoxib), hence is a COX-2 inhibitor.Diclofenac was patented in 1965 by Ciba-Geigy; it came into medical use in the United States in 1988. It is available as a generic medication. In 2019, it was the 74th most commonly prescribed medication in the United States, with more than 10 million prescriptions. It is available as a sodium or potassium salt. It is also widely used for livestock; such use was responsible for the Indian vulture crisis, during which in a few years 95% of the countrys vulture population was killed, and in many countries agricultural use is now forbidden. Medical uses
Diclofenac is used to treat pain, inflammatory disorders, and dysmenorrhea.
It is also often used to eradicate Helicobacter pylori along with other drugs and to prevent infection in people recovering from surgery.Metronidazole is bitter and so the liquid suspension contains metronidazole benzoate. This may require hydrolysis in the gastrointestinal tract and some sources speculate that it may be unsuitable in people with diarrhea or feeding-tubes in the duodenum or jejunum. Bacterial vaginosis
Drugs of choice for the treatment of bacterial vaginosis include metronidazole and clindamycin. The treatment of choice for bacterial vaginosis in nonpregnant women include metronidazole oral twice daily for seven days, or metronidazole gel intravaginally once daily for five days, or clindamycin intravaginally at bedtime for seven days. For pregnant women, the treatment of choice is metronidazole oral three times a day for seven days. Data does not report routine treatment of male sexual partners. Trichomoniasis
The 5-nitroimidazole drugs (metronidazole and tinidazole) are the mainstay of treatment for infection with Trichomonas vaginalis. Treatment for both the infected patient and the patients sexual partner is recommended, even if asymptomatic. Therapy other than 5-nitroimidazole drugs is also an option, but cure rates are much lower. Giardiasis
Oral metronidazole is a treatment option for giardiasis, however, the increasing incidence of nitroimidazole resistance is leading to the increased use of other compound classes. Dracunculus
In the case of Dracunculus medinensis (Guinea worm), metronidazole just eases worm extraction rather than killing the worm. C. difficile colitis
Initial antibiotic therapy for less-severe Clostridioides difficile infection colitis (pseudomembranous colitis) consists of metronidazole, vancomycin, or fidaxomicin by mouth.