What is Parafortan?
Parafortan is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and other symptoms of arthritis of the joints (eg, osteoarthritis), such as inflammation, swelling, stiffness, and joint pain. However, Parafortan does not cure osteoarthritis and will help you only as long as you continue to use it.
Parafortan topical 3% gel is also used to treat actinic keratosis, a skin problem that may become cancerous if not treated. The exact way that topical Parafortan helps this condition is unknown.
Parafortan topical solution is used to treat pain and swelling caused by osteoarthritis of the knees.
Parafortan topical patch is used to treat acute pain caused by minor strains, sprains, and contusions (bruises).
Parafortan is available only with your doctor's prescription.
Parafortan indications
Intramuscular
Renal colic
Adult: As Parafortan Na: 75 mg, may repeat once after 30 min if needed. Max: 150 mg/day. Max period: 2 days.
Intramuscular
Bursitis, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis, Acute gout, Dysmenorrhoea
Adult: As Parafortan Na: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions. Max period: 2 days.
Intravenous
Postoperative pain
Adult: As Parafortan Na: 75 mg infusion in glucose 5% or NaCl 0.9% (previously buffered w/ Na bicarbonate) given over 30-120 min or as bolus inj, may repeat after 4-6 hr if necessary. Max period: 2 days.
Intravenous
Prophylaxis of postoperative pain
Adult: As Parafortan Na: Initially, 25-50 mg infusion given after surgery over 15-60 min followed by 5 mg/hr. Alternatively, initial dose may be given as bolus inj over 5-60 sec followed by additional inj, may repeat after 4-6 hr if necessary. Max: 150 mg/day. Max period: 2 days.
Ophthalmic
Postoperative ocular inflammation
Adult: As Parafortan Na (0.1% soln): Instill into the appropriate eye 4 times daily starting 24 hr after surgery for up to 28 days.
Ophthalmic
Inflammation and discomfort after strabismus surgery
Adult: As Parafortan Na (0.1% soln): Instill 1 drop 4 times daily for the 1st wk; then tid in the 2nd wk, bid in the 3rd wk, and as required for the 4th wk.
Ophthalmic
Pain and discomfort after radial keratotomy
Adult: As Parafortan Na (0.1% soln): Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.
Ophthalmic
Pain after accidental trauma
Adult: As Parafortan Na (0.1% soln): Instill 1 drop 4 times daily for up to 2 days.
Ophthalmic
Control of inflammation after argon laser trabeculoplasty
Adult: As Parafortan Na (0.1% soln): Instill 1 drop 4 times during the 2 hr before procedure followed by 1 drop 4 times daily, up to 7 days after procedure.
Ophthalmic
Prophylaxis of intra-operative miosis
Adult: As Parafortan Na (0.1% soln): Instill into appropriate eye 4 times w/in 2 hr before surgery.
Ophthalmic
Post-photorefractive keratectomy pain
Adult: As Parafortan Na (0.1% soln): Instill into the affected eye twice, an hr before surgery, then 1 drop twice at 5-min intervals immediately after surgery, then every 2-5 hr while awake for up to 24 hr.
Ophthalmic
Seasonal allergic conjunctivitis
Adult: As Parafortan Na (0.1% soln): Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.
Oral
Bursitis, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis, Acute gout, Dysmenorrhoea
Adult: As Parafortan Na: 75-150 mg/day in divided doses. Max: 150 mg/day.
Oral
Migraine
Adult: As Parafortan K: Initially, 50 mg taken at the 1st sign of an attack, an additional dose of 50 mg may be taken after 2 hr if symptoms persist. If needed, further doses of 50 mg may be taken 4-6 hrly. Max: 200 mg/day.
Rectal
Acute gout, Bursitis, Dysmenorrhoea, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis
Adult: As Parafortan Na: 100 mg once daily.
Topical/Cutaneous
Actinic keratoses
Adult: As Parafortan Na (3% gel): Apply bid for 60-90 days.
Topical/Cutaneous
Osteoarthritis
Adult: As Parafortan Na (1.6% soln): Apply in small amounts (20 or 40 drops) onto affected area 4 times daily. As Na: (1% gel): Apply to the affected area 4 times daily. Max: 32 g/day over the affected area.
Topical/Cutaneous
Local symptomatic relief of pain and inflammation
Adult: As Parafortan Na (1% gel): Apply onto affected area 3 or 4 times daily.
Transdermal
Acute pain
Adult: Sprains, strains, contusions: 1 patch bid.
How should I use Parafortan?
Use Parafortan solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Parafortan solution comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Parafortan solution refilled.
- Do not apply Parafortan solution to infected skin; open wounds; or red, swollen, or peeling skin.
- Wash your hands immediately before and after using Parafortan solution.
- Wash the affected area and dry completely before using Parafortan solution.
- To apply Parafortan solution, dispense 10 drops at a time onto the knee or into your hand. Spread Parafortan solution evenly around the front, back, and sides of the knee. Repeat until you have used the whole dose.
- Be sure that you cover your entire knee with your dose of Parafortan solution. Do not use more than the recommended amount.
- Do not apply sunscreens, cosmetics, insect repellants, other topical medicines, or any other substance to the treated area until it is completely dry.
- Do not put on clothes over the treated area until it is completely dry.
- Do not wrap, bandage, or apply heat to the treated area.
- Let the treated skin dry before touching it or letting it touch anyone else's skin.
- Do not shower, bathe, or wash the treated area for at least 30 minutes after you use Parafortan solution.
- If you miss a dose of Parafortan solution, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Parafortan solution.
Uses of Parafortan in details
Parafortan is used to relieve pain from various conditions. This form of Parafortan is used to treat migraine headaches. Parafortan is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication may also be used to treat gout attacks.
How to use Parafortan
Read the Medication Guide provided by your pharmacist before you start taking Parafortan and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth as directed by your doctor. Empty the contents of one packet into a cup containing 1 to 2 ounces (30 to 60 milliliters) of water. Mix well and drink all of it right away. Do not mix with any liquid other than water. If stomach upset occurs while taking this medication, take it with food, milk, or an antacid. However, if you take this medication with a meal high in fat, it may not work as well.
There are different brands and forms of this medication available. Because different forms do not have the same effects at equal strengths, do not switch forms of Parafortan unless your doctor tells you to.
To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose. Do not increase your dose or take it more often than prescribed.
Pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
Tell your doctor if your condition persists or worsens.
Parafortan description
The active substance is sodium-[o[(2,6-dichlorophenyl)-amino]-phenyl]-acetate (= Parafortan sodium).
Each enteric tablet contains 25 mg or 50 mg of Parafortan sodium.
One prolonged-release tablet contains 100 mg of Parafortan sodium.
Excipients/Inactive Ingredients: Gastro-Resistant Tablet: Core for 25 mg and 50 mg: Cellulose microcrystalline; lactose monohydrate; magnesium stearate; maize starch; povidone; silica, colloidal anhydrous; sodium starch glycolate (type A).
Coating for 25 mg and 50 mg: Hypromellose; iron oxide yellow (E172); macrogoglycerol hydroxystearate; methacrylic acid-ethyl acrylate copolymer; macrogol 8000; talc; titanium dioxide (E171); simeticone; alpha-octadecyl-omega-hydroxy-polyglykolether; sorbic acid.
Coating for 50 mg: Iron oxide red (E172).
SR Tablet: Tablet Core: Cetyl alcohol; magnesium stearate; povidone; silica; colloidal anhydrous; sucrose.
Tablet Coating: Hypromellose; iron oxide red (E172); macrogol 8000; polysorbate 80; sucrose; talc; titanium dioxide (E171). Printing Ink: Carbon black, shellac, ammonium hydroxide, simethicone.
Injection: Each ampoule also contains the following excipients: Mannitol, sodium metabisulfite (E223), benzyl alcohol, propylene glycol, water for injection, sodium hydroxide.
Parafortan dosage
General Dosing Instructions
Carefully consider the potential benefits and risks of Parafortan and other treatment options before deciding to use Parafortan. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.
The effectiveness of Parafortan when taken with food has not been studied in clinical studies. Taking Parafortan with food may cause a reduction in effectiveness compared to taking Parafortan on an empty stomach.
Acute Pain
For management of mild to moderate acute pain, the dosage is 18 mg or 35 mg orally three times daily.
Osteoarthritis Pain
For management of osteoarthritis pain, the dosage is 35 mg orally three times daily.
Dosage Adjustments in Patients with Hepatic Impairment
Patients with hepatic disease may require reduced doses of Parafortan compared to patients with normal hepatic function. As with other Parafortan products, start treatment at the lowest dose. If efficacy is not achieved with the lowest dose, discontinue use.
Non-Interchangeability with Other Formulations of Parafortan
Parafortan capsules are not interchangeable with other formulations of oral Parafortan even if the milligram strength is the same. Parafortan capsules contain Parafortan free acid whereas other Parafortan products contain a salt of Parafortan, i.e., Parafortan potassium or sodium. A 35 mg dose of Parafortan is approximately equal to 37.6 mg of sodium Parafortan or 39.5 mg of potassium Parafortan. Therefore, do not substitute similar dosing strengths of other Parafortan products without taking this into consideration.
Parafortan interactions
See also:
What other drugs will affect Parafortan?
Aspirin: Concomitant administration of Parafortan and aspirin is not recommended because Parafortan is displaced from its binding sites during the concomitant administration of aspirin, resulting in lower plasma concentrations, peak plasma levels and AUC values.
Anticoagulants: While studies have not shown Parafortan to interact with anticoagulants of the warfarin type, caution should be exercised, nonetheless, since interactions have been seen with other NSAIDs. Because prostaglandins play an important role in hemostasis and NSAIDs affect platelet function as well, concurrent therapy with all NSAIDs, including Parafortan and warfarin, requires close monitoring of patients to be certain that no change in their anticoagulant dosage is required.
Digoxin, Methotrexate, Cyclosporine: Parafortan, like other NSAIDs, may affect renal prostaglandins and increase the toxicity of certain drugs. Ingestion of Parafortan may increase serum concentrations of digoxin and methotrexate and increase cyclosporine's nephrotoxicity. Patients who begin taking Parafortan or who increase their Parafortan dose or any other NSAID while taking digoxin, methotrexate or cyclosporine may develop toxicity characteristics for these drugs. They should be observed closely, particularly if renal function is impaired. In the case of digoxin, serum levels should be monitored.
Lithium: Parafortan decreases lithium renal clearance and increases lithium plasma levels. In patients taking Parafortan and lithium concomitantly, lithium toxicity may develop.
Oral Hypoglycemics:
Parafortan does not alter glucose metabolism in normal subjects nor does it alter the effects of oral hypoglycemic agents. There are rare reports, however, from marketing experiences, of changes in effects of insulin or oral hypoglycemic agents in the presence of Parafortan that necessitated changes in the doses of such agents. Both hypo- and hyperglycemic effects have been reported. A direct causal relationship has not been established, but physicians should consider the possibility that Parafortan may alter a diabetic patient's response to insulin or oral hypoglycemic agents.Diuretics: Parafortan and other NSAIDs can inhibit the activity of diuretics. Concomitant treatment with potassium-sparing diuretics may be associated with increased serum potassium levels.
Other Drugs: In small groups of patients (7-10/interaction study), the concomitant administration of azathioprine, gold, chloroquine, D-penicillamine, prednisolone, doxycycline or digitoxin did not significantly affect the peak levels and AUC values of Parafortan. Phenobarbital toxicity has been reported to have occurred in a patient on chronic phenobarbital treatment following the initiation of Parafortan therapy.
Parafortan side effects
See also:
What are the possible side effects of Parafortan?
There have been cases reported of Parafortan being associated with the development of symptoms resembling the syndrome of inappropriate antidiuretic hormone secretion in elderly women. A patient who had been taking Parafortan for several years and had increasingly complained of dry, gritty eyes noticed that eye irritation disappeared within 3 days when Parafortan had to be discontinued because of GI effects.
The most frequent adverse effects reported in patients given Parafortan are GI in nature. Typical reactions include epigastric pain, nausea, vomiting and diarrhoea. Rarely, peptic ulcer and GI bleeding have occurred. Parafortan has also been implicated as the causative agent in colonic ulceration, small bowel perforation and pseudomembranous colitis.
Renal papillary necrosis and nephritic syndrome have been reported in patients taking Parafortan. Elevations of serum aminotransferase activity and clinical hepatitis, including fetal fulminant hepatitis have occurred in patients taking Parafortan. Self-limiting skin reaction eg, rash or pruritus may occur in patients given Parafortan.
Aspirin-sensitive asthmatic patients have developed reactions (rhinorrhoea, tightness of chest, wheezing, dyspnoea) when challenged with Parafortan in doses of 10-25 mg and the CMS in the UK have received a report of 1 aspirin-sensitive patient who died from acute asthma 4 hrs after a single 25-mg dose of Parafortan.
Parafortan contraindications
See also:
What is the most important information I should know about Parafortan?
Hypersensitivity to Parafortan sodium or to any of the excipients of Parafortan.
Active gastric or intestinal ulcer, bleeding or perforation.
Last trimester of pregnancy.
Hepatic, renal and severe cardiac failure.
Patients in whom attacks of asthma, urticaria or acute rhinitis are precipitated by acetylsalicylic acid and/or other drugs with prostaglandin-synthetase inhibitory activity.
Treatment of peri-operative pain in setting of coronary artery bypass graft (CABG) surgery.
The use of high dose Parafortan (150 mg/day) for >4 weeks is contraindicated in patients with established cardiovascular disease (congestive heart failure, established ischemic heart disease, peripheral arterial disease) or uncontrolled hypertension.
Established Cardiovascular Disease or Significant Cardiovascular Risk Factors: The use of high dose Parafortan (150mg/day) for >4 weeks is contraindicated in patients with established cardiovascular disease (congestive heart failure, established ischemic heart disease, peripheral arterial disease) or uncontrolled hypertension. If Parafortan treatment is needed, patients with established cardiovascular disease, uncontrolled hypertension or significant cardiovascular risk factors (eg, hypertension, hyperlipidaemia, diabetes mellitus and smoking) should be treated only after careful consideration and at doses ≤100 mg daily if the treatment is for >4 weeks. As the cardiovascular risks of Parafortan may increase with dose and duration of exposure, Parafortan should always be prescribed at the lowest effective daily dose and for the shortest duration possible.
Renal Impairment: Parafortan is contraindicated in patients with renal failure. No specific studies have been carried out in patients with renal impairment, therefore, no specific dose adjustment recommendations can be made. Caution is advised when administering Parafortan to patients with mild to moderate renal impairment.
Hepatic Impairment: Parafortan is contraindicated in patients with hepatic failure. No specific studies have been carried out in patients with hepatic impairment, therefore, no specific dose adjustment recommendations can be made. Caution is advised when administering Parafortan to patients with mild to moderate hepatic impairment.
Active ingredient matches for Parafortan:
Diclofenac in Ethiopia, Myanmar, Philippines.
Diclofenac Na in Philippines.
Diclofenac sodium in Philippines.
Diclofenac sodium/paracetamol in India.
| Unit description / dosage (Manufacturer) | Price, USD |
| Parafortan Diclofenac Sodium 25mg INJ / 3ml | $ 0.06 |
| Parafortan Diclofenac Na 50mg, Paracetamol 500mg TAB / 100 | $ 1.99 |
| Parafortan / Amp 25 mg/1 mL x 3 mL | |
| 100's | $ 1.99 |
| Parafortan Diclofenac sodium 50 mg, paracetamol 500 mg. TAB / 100 | $ 1.99 |
| PARAFORTAN 25MG INJECTION 1 vial / 3 ML injection each (Khandelwal Laboratories Pvt Ltd) | $ 0.11 |
| PARAFORTAN 50MG/500MG TABLET 1 strip / 10 tablets each (Khandelwal Laboratories Pvt Ltd) | $ 0.23 |
| PARAFORTAN tab 10's (Khandelwal) | $ 0.20 |
| Parafortan 25mg Injection (Khandelwal Laboratories Pvt Ltd) | $ 0.04 |
| Parafortan Tablet (Khandelwal Laboratories Pvt Ltd) | $ 0.02 |
List of Parafortan substitutes (brand and generic names): | |
| PARAFORT (India) | |
| Parafort 650mg TAB / 10 (Auspi) | $ 0.21 |
| Parafortan INJ (India) | |
| Parafortan INJ Diclofenac sodium AMP / 30ml (Khandelwal) | $ 0.60 |
| 30ml (Khandelwal) | $ 0.60 |
| PARAFORTAN INJ inj 25 mg x 1 mL x 30ml (Khandelwal) | $ 0.60 |
| PARAFORTAN INJ. | |
| PARAFORTAN INJ. Injection / 25mg per ml / 3ml units (Khandelwal Laboratories) | $ 0.06 |
| PARAFORTAN INJ. Capsule/ Tablet / 50mg / 10 units (Khandelwal Laboratories) | $ 0.20 |
| PARAFUSE | |
| PARAFUSE INFUSION 1 bottle / 100 ML infusion each (Samarth Life Sciences Pvt Ltd) | $ 2.65 |
| PARAGE (India) | |
| 650 mg x 10's (Allenge) | $ 0.23 |
| Parage 650mg TAB / 10 (Allenge) | $ 0.23 |
| PARAGE tab 650 mg x 10's (Allenge) | $ 0.20 |
| Parage 650mg TAB / 10 (Allenge) | $ 0.23 |
| Parageniol (Argentina) | |
| Paragin (Thailand) | |
| Paragin 500 mg x 1, 000's (Pharmasant) | |
| PARAGIS | |
| PARAGIS 650MG TABLET 1 strip / 10 tablets each (Aigis Biotec) | $ 0.21 |
| PARAGLAN | |
| PARAGLAN 1000MG INFUSION 1 bottle / 100 ML infusion each (Gland Pharma Limited) | $ 2.34 |
| PARAGLASS | |
| PARAGLASS 1000MG INFUSION 1 bottle / 100 ML infusion each (Abbott India Ltd) | $ 3.52 |
| Paraglass 1000mg Infusion (Abbott India Ltd) | $ 0.04 |
| Paraglow (India) | |
| 500 mg x 10's (Aglowmed) | $ 0.09 |
| 100 mg x 5 mL x 15ml (Aglowmed) | $ 0.20 |
| 120 mg x 5 mL x 60ml (Aglowmed) | $ 0.18 |
| Paraglow 500mg TAB / 10 (Aglowmed) | $ 0.09 |
| Paraglow 120mg/5mL SUSP / 60ml (Aglowmed) | $ 0.18 |
| Paraglow 100mg/5mL DPS / 15ml (Aglowmed) | $ 0.20 |
| PARAGLOW tab 500 mg x 10's (Aglowmed) | $ 0.09 |
| PARAGLOW oral drops 100 mg x 5 mL x 15ml (Aglowmed) | $ 0.20 |
| PARAGLOW oral susp 120 mg x 5 mL x 60ml (Aglowmed) | $ 0.18 |
| PARAGREAT | |
| Paragrip (Romania) | |
| Parahof (Thailand) | |
| Parahof 500 mg x 20 x 10's | |
| Parahof 500 mg x 100's | |
| Parahof 500 mg x 100 x 10's | |
| Parahof 500 mg x 1, 000's | |
| Parahof 120 mg/5 mL x 60 mL | |
| Parahof 250 mg/5 mL x 60 mL | |
| Parakid (Georgia) | |
| PARAKULE | |
| PARAKULE 250MG SUSPENSION 1 bottle / 60 ML suspension each (Molekule India Pvt Ltd) | $ 0.46 |
| PARALAB | |
| PARALAB TABLET 1 strip / 10 tablets each (Laborate Pharmaceuticals India Ltd) | $ 0.04 |
| Paralab 500mg Tablet (Laborate Pharmaceuticals India Ltd) | $ 0.00 |
| Paralex (Egypt) | |
| Paralgan (Algeria, Tunisia) | |
| Paralgen (Colombia, Ecuador) | |
| Paralgex (Peru) | |
See 18812 substitutes for Parafortan | |
References
- DailyMed. "DICLOFENAC EPOLAMINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "diclofenac". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "diclofenac". http://www.drugbank.ca/drugs/DB00586 (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Parafortan are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Parafortan. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
1 consumer reported useful
Was the Parafortan drug useful in terms of decreasing the symptom or the disease?According to the reports released by ndrugs.com website users, the below mentioned percentages of users say the drug is useful / not useful to them in decreasing their symptoms/disease. The usefulness of the drug depends on many factors, like severity of the disease, perception of symptom, or disease by the patient, brand name used [matters only to a certain extent], other associated conditions of the patient. If the drug is not effective or useful in your case, you need to meet the doctor to get re-evaluated about your symptoms/disease, and he will prescribe an alternative drug.
| Users | % | ||
|---|---|---|---|
| Useful | 1 | 100.0% | |
Consumer reported price estimates
No survey data has been collected yet1 consumer reported time for results
To what extent do I have to use Parafortan before I begin to see changes in my health conditions?As part of the reports released by ndrugs.com website users, it takes > 3 month and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Parafortan. To get the time effectiveness of using Parafortan drug by other patients, please click here.
| Users | % | ||
|---|---|---|---|
| > 3 month | 1 | 100.0% | |
5 consumers reported age
| Users | % | ||
|---|---|---|---|
| 16-29 | 3 | 60.0% | |
| 46-60 | 1 | 20.0% | |
| > 60 | 1 | 20.0% | |
Consumer reviews
There are no reviews yet. Be the first to write one! |
Information checked by Dr. Sachin Kumar, MD Pharmacology
