[e-drug] Diclofenac and the WHO Essential Medicines List

E-DRUG: Diclofenac and the WHO Essential Medicines List
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Friends at E-drug,

I am interested in knowing as to why diclofenac has not been included in the list of Essential Medicines by WHO. Any substantial reason for it?
Again why is that standard text books of pharmacology do not mention about its intramuscular route of administration. I find that in India it is most routinely used.

[Please note that the WHO EML has one NSAID (and the most safe one ibuprofen) as the model substance. Each country is free to decide what they prefer. Diclofenac does not have the best risk/safety profile:
http://www.emea.europa.eu/pdfs/human/opiniongen/nsaids.pdf
http://www.npc.co.uk/ebt/merec/pain/musculo/merec_monthly_no2.htm
http://www.npc.co.uk/ebt/merec/cardio/cdrisk/merec_extra_no30.htm

Diclofenac can give serious hypersensitivity reactions; they are more serious when drugs are injected - and injections are expensive. Hence im injections is not a good idea. Moderator]

From
Dr Gopal Dabade,
57, Tejaswinagar,
Dharwad 580 002
INDIA
Tel 0836-2461722
Cell (0)9448862270
www.jagruti.org
www.aidanindia.org
www.daf-k.cjb.net
dabadedr@yahoo.com

E-DRUG: Diclofenac and the WHO Essential Medicines List (2)
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Dear colleagues,

As the moderator has mentioned diclofenac causes a wide range of side
effects and certainly is not the best choice. There is a parenteral form,
which has limited use as an alternative to pethidine in renal colic. But
what really amazed me is its popularity in India because its widespread use in veterinary medicine in that country has been the main cause of the high mortality in raptors, particularly vultures, with disastrous indirect
consequences for public health (garbage and offal removal etc.). Naproxen is probably a better choice despite some negative influence on cardiovascular events.

Dr. Leo Offerhaus, Bussum, the Netherlands.
offerhausl@euronet.nl