Airtal
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Here is a complete overview of Airtal (Aceclofenac):
Airtal (Aceclofenac)
Drug class: Non-steroidal anti-inflammatory drug (NSAID)
Manufacturer: Almirall (Spain) - available globally under the brand name Airtal and other generics
Mechanism of Action
Aceclofenac works primarily by inhibiting the cyclooxygenase (COX) enzyme - both COX-1 and COX-2 - thereby blocking the synthesis of prostaglandins. Prostaglandins are key mediators of pain, fever, and inflammation. By reducing prostaglandin production, aceclofenac provides analgesic, anti-inflammatory, and antipyretic effects.
It is structurally and pharmacologically related to diclofenac, with some studies suggesting it may show slightly greater COX-2 selectivity than non-selective NSAIDs, though it is not classified as a selective COX-2 inhibitor.
Indications (Uses)
- Osteoarthritis - joint pain and inflammation
- Rheumatoid arthritis
- Ankylosing spondylitis
- Acute musculoskeletal pain (back pain, shoulder pain, sprains)
- Dental pain
- Post-operative pain and soft tissue injuries
- Dysmenorrhea (painful periods)
Dosage
| Form | Dose | Frequency |
|---|---|---|
| Tablet (100 mg) | 100 mg | Twice daily (with food) |
| Maximum daily dose | 200 mg/day | - |
Tablets should be taken with or after food to reduce GI upset.
Pharmacokinetics
- Absorption: Rapidly and completely absorbed after oral administration; peak plasma levels in ~1.25-3 hours
- Protein binding: >99% (highly protein-bound - can displace other highly bound drugs like warfarin)
- Metabolism: Hepatic - partially converted to diclofenac, a pharmacologically active metabolite
- Excretion: Primarily renal (~70%) and biliary (~20%)
- Half-life: ~4 hours
Side Effects
Common:
- GI upset, nausea, dyspepsia, abdominal pain
- Diarrhea or constipation
- Headache, dizziness
Serious (less common):
- Peptic ulcer / GI bleeding (lower risk compared to older NSAIDs, but still possible)
- Elevated liver enzymes / hepatotoxicity
- Renal impairment, especially in pre-existing kidney disease
- Fluid retention / edema
- Cardiovascular: increased risk of thrombotic events (MI, stroke) with prolonged use
- Hypersensitivity/skin reactions (including rare drug-induced Sweet syndrome, as noted in dermatology references)
- Exacerbation of asthma (especially in patients with the nasal polyp/rhinitis/asthma triad)
Contraindications
- Active peptic ulcer or GI bleeding
- Severe hepatic impairment
- Severe renal impairment
- Known hypersensitivity to aceclofenac, aspirin, or other NSAIDs
- Third trimester of pregnancy
- Severe heart failure
- History of asthma triggered by NSAIDs
Key Drug Interactions
| Drug | Interaction |
|---|---|
| Warfarin / anticoagulants | Increased bleeding risk (displaces from protein binding) |
| Lithium | Increases lithium plasma levels |
| Methotrexate | Reduces methotrexate clearance - toxicity risk |
| Diuretics / ACE inhibitors | Reduced antihypertensive effect; increased renal risk |
| Other NSAIDs / aspirin | Increased GI and renal side effects |
| SSRIs | Increased GI bleeding risk |
Special Precautions
- Elderly patients: Use with caution - higher risk of GI and renal adverse effects
- Pregnancy: Avoid in 3rd trimester; use with caution in 1st and 2nd trimester
- Renal/hepatic impairment: Reduce dose or avoid; monitor closely
- Cardiovascular disease: Prolonged use may increase cardiovascular event risk
Compared to Diclofenac
Aceclofenac is often positioned as having a somewhat better GI tolerability profile than diclofenac, though both carry similar overall NSAID risks. Some studies (including a multicenter double-blind study referenced in Yamada's Textbook of Gastroenterology) have evaluated its GI safety, showing it is manageable at 100 mg twice daily with appropriate gastroprotection when needed.
Bottom line: Airtal (aceclofenac) is a widely used NSAID for inflammatory and painful conditions. It should always be taken at the lowest effective dose for the shortest duration, with food, and with a proton pump inhibitor (e.g., omeprazole) if GI risk is a concern.
Disclaimer: This is for informational purposes only. Always follow your prescriber's instructions and read the full product information leaflet for your specific country's formulation.
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