Aceclofenac (Preservex): updated cardiovascular advice in line with diclofenac and COX-2 inhibitors
Aceclofenac is now contraindicated in patients with certain established cardiovascular diseases.
When using aceclofenac to relieve pain and inflammation in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, you should:
- consider that aceclofenac is now contraindicated in patients with established:
- ischaemic heart disease
- peripheral arterial disease
- cerebrovascular disease
- congestive heart failure (New York Heart Association, NYHA, classification II-IV)
- switch patients with these conditions to an alternative treatment at their next routine appointment
- only start aceclofenac treatment after careful consideration of any significant risk factors for cardiovascular events, eg
- hypertension
- hyperlipidaemia
- diabetes mellitus
- smoking
Aceclofenac (Preservex) is a non-steroidal anti-inflammatory drug (NSAID) licensed for the relief of pain and inflammation in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Aceclofenac has little pharmacological activity itself; its main mode of action is through its metabolites which include diclofenac and 4바카라 사이트™-hydroxy diclofenac.
In June 2013 we told you about the for diclofenac. This was after a review by European regulators concluded that the risk of arterial thrombotic events (myocardial infarction; stroke) with diclofenac is greater than with other non-selective NSAIDs and similar to the COX-2 inhibitors.
There are limited data available regarding the arterial thrombotic effects of aceclofenac. The treatment advice for aceclofenac has been updated in line with diclofenac and COX-2 inhibitors. This was based on aceclofenac바카라 사이트™s structural similarity to diclofenac and its metabolism to diclofenac.
Reminder of advice for all NSAIDs
Base the an NSAID on an assessment of each patient바카라 사이트™s individual risk factors including any history of cardiovascular and gastrointestinal illness.
Use the lowest effective dose for the shortest duration necessary to control symptoms. Periodically re-evaluate the patient바카라 사이트™s need for symptomatic relief and response to treatment.
Article citation: Drug Safety Update volume 8 issue 6 January 2015: 5