Econac suppositories (diclofenac)

How does it work?

Econac suppositories contain the active ingredient diclofenac sodium, which is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are used to relieve pain and inflammation. (NB. Diclofenac is also available without a brand name, ie as the generic medicine.)

Diclofenac works by blocking the action of a substance in the body called cyclo-oxygenase (COX). Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced by the body in response to injury and certain diseases and conditions, and cause pain, swelling and inflammation. Diclofenac blocks the production of these prostaglandins and is therefore effective at reducing inflammation and pain.

Diclofenac is used to relieve pain and inflammation in a wide range of musculoskeletal conditions, including various forms of arthritis, gout, sprains, fractures, dislocations, back pain, tendinitis and frozen shoulder. It is also used to relieve pain and inflammation following dental, orthopaedic (bone) and other minor surgery.

Econac suppositories may be especially useful for people who can't take diclofenac by mouth, for example because they feel or are being sick, or have just had an operation. The suppositories melt in the rectum and the diclofenac is then absorbed into the bloodstream through the rich supply of blood vessels found in this area.

What is it used for?

Econac suppositories are used to relieve pain and inflammation in a wide range of conditions in adults, including those listed below.

Rheumatoid arthritis.

Osteoarthritis.

A form of arthritis affecting the joints of the spine (ankylosing spondylitis).

Acute gout.

Acute disorders of the muscles and skeleton, such as frozen shoulder (periarthritis), tendon inflammation (tendinitis), tenosynovitis, bursitis.

Painful conditions due to accidents, such as sprains, strains, dislocations, fractures.

Lower back pain.

Pain and inflammation following dental, orthopaedic (bone) and other minor surgery.

Warning!

Econac suppositories are for rectal use only and must not be taken by mouth.

This medicine may cause dizziness, drowsiness or visual disturbances and so may affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

This medicine may mask the signs and symptoms of infection, such as fever and inflammation. This may make you think mistakenly that an infection is getting better when it isn't, or that an infection is less serious than it is. For this reason you should tell your doctor if you get an infection while you are using this medicine.

Your doctor will prescribe you the lowest effective dose of this medicine for the shortest possible time necessary to relieve your symptoms. This is to minimise the chances of any side effects, particularly those mentioned below. It is important not to exceed the prescribed dose.

NSAIDs can occasionally cause serious side effects on the gut, such as ulceration, bleeding or perforation of the stomach or intestinal lining. This type of side effect is more likely to occur in elderly people and in people taking high doses of the medicine. The risk can also be increased by taking certain other medicines (see end of factsheet). It is important that these people, as well as people with a history of disorders affecting the stomach or intestines, are closely monitored by a doctor while using this medicine. If your doctor thinks you are at high risk of side effects on the gut you may be prescribed an additional medicine to help protect your gut. All people having treatment with this medicine should stop using it and consult their doctor immediately if they experience any sign of bleeding from the stomach or intestine, for example vomiting blood and/or passing black/tarry/bloodstained stools.

Studies have suggested that use of diclofenac may be associated with a small increase in the risk of heart attacks and stroke. The risks increase with higher doses and the longer the medicine is used. If you have risk factors for heart disease or stroke, such as diabetes, high blood pressure, high cholesterol or smoking, your doctor will need to assess the overall benefits and risks before deciding if this medicine is suitable for you. You should tell your doctor if you experience shortness of breath, chest pains or ankle swelling while using the medicine. Ask your doctor or pharmacist for further information.

Very rarely, NSAIDS may cause serious blistering or peeling skin reactions (eg Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis). For this reason, you should stop using this medicine and consult your doctor if you get a skin rash or sores inside your mouth while using this medicine. This side effect is very rare, but if it occurs, is most likely to happen in the first month of treatment.

If you have cirrhosis of the liver, heart failure or kidney disease, you are taking diuretic medicines, or you are recovering from major surgery, your kidney function should be assessed before starting and regularly throughout treatment with this medicine.

During long-term treatment with this medicine you should have regular check-ups with your doctor so that you can be monitored for possible side effects of the medicine. This might include routine blood tests to monitor your kidney function, liver function and levels of blood components, particularly if you are elderly.

Use with caution in

Elderly people.

History of disorders affecting the stomach or intestines, such as ulceration or bleeding.

Piles.

Inflammatory bowel disease such as Crohn's disease or ulcerative colitis.

Decreased kidney function.

Decreased liver function.

A type of life long inherited blood disease caused by a defect in the liver (hepatic porphyria).

Heart failure.

Heart disease caused by inadequate blood flow to the heart (ischaemic heart disease), eg angina or history of heart attack.

Disease of the blood vessels in and around the brain (cerebrovascular disease), eg history of stroke or mini-stroke.

Poor circulation in the arteries of the legs or feet (peripheral arterial disease).

History of high blood pressure .

Raised levels of fats such as cholesterol in the blood (hyperlipidaemia).

Diabetes.

Smokers.

History of asthma.

History of allergies.

People with blood clotting disorders or taking anticoagulant medicines.

Diseases affecting connective tissue, eg systemic lupus erythematosus.

Not to be used in

People in whom aspirin or other NSAIDs, eg ibuprofen, cause allergic reactions such as asthma attacks, itchy rash (urticaria), nasal inflammation (rhinitis) or swelling of the lips, tongue and throat (angioedema).

Active peptic ulcer, perforation (hole) or bleeding in the gut.

People who have had recurrent peptic ulcers or bleeding from the gut (two or more episodes).

People who have previously experienced bleeding or perforation of the gut as a result of taking an NSAID.

Severe heart failure.

Severe liver failure.

Severe kidney failure.

Third trimester of pregnancy.

Econac suppositories are not suitable for children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used in the third trimester of pregnancy because it may delay labour, increase the length of labour and cause complications in the newborn baby. It is not recommended for use in the first and second trimesters of pregnancy unless considered essential by your doctor. Some evidence suggests that NSAIDs such as this one should also be avoided by women attempting to conceive, as they may temporarily reduce female fertility during treatment and may also increase the risk of miscarriage or malformations. Seek medical advice from your doctor.

The medicine passes into breast milk in small amounts. At normal doses it is unlikely to harm the baby, however it is important to discuss this with your doctor before using this medicine if you are breastfeeding.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Itching or burning of the rectum.

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting, indigestion or abdominal pain.

Excess gas in the stomach and intestines (flatulence).

Loss of appetite.

Headache.

Dizziness.

Balance disorders involving the inner ear (vertigo).

Skin rashes.

Ulceration of the stomach or intestine.

Bleeding from the stomach or intestine.

Drowsiness.

Anxiety.

Depression.

Difficulty sleeping (insomnia).

Fluid retention (oedema).

Changes in blood pressure.

Sensation of ringing or other noise in the ears (tinnitus).

Allergic reactions such as severe skin rashes, swelling of the lips, tongue and throat (angioedema) or narrowing of the airways (bronchospasm).

Kidney, liver or blood disorders.

Small increased risk of heart attack (myocardial infarction) or stroke, particularly at high doses (150mg daily) and in long-term treatment.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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