Knee Pain Inflammation

Dyloject is a new form of the treatment diclofenac, which is a popular treatment for reducing pain.  It is a non-steroidal anti-inflammatory (NSAID) drug that works to inhibit certain pathways associated with pain such as COX.

Dyloject’s superior release mechanism gives it more rapid pain relief action than the existing form.  It is designed to be delivered by injection or intravenously with greater ease.

The condition

A wide variety of situations create pain, a sensation which is hard to define, but that almost everyone has experienced.

After surgery, there is an especially high amount of pain, or acute pain.  Treatment of this pain quickly and effectively is essential to minimize discomfort and make the patient’s life a lot more bearable.

How it works

Dyloject is an NSAID, which are one of the most commonly used pain killers.  They work by inhibiting important pathways in the generation of pain, including prostaglandins and COX.  These mechanisms prevent the body from sending as strong a pain signal.

The advantages

Dyloject is a new formulation of diclofenac, an extremely commonly used pain killer, with more than 8 million prescriptions filled in 2007 in the United Kingdom alone.

Importantly, it is chemically modified so that Dyloject starts relieving pain faster.  Additionally, the modifications mean that it also takes less time to prepare for infusion, and that it might have less issues with local, venous irritation.

In one study, at 15 minutes 52% of those on Dyloject reported a 30% reduction in pain.  This is compared to just 21% of those on regular diclofenac who reported a 30% reduction in pain.

How well does it work?

It works pretty well.  In one study, 50-60% of those taking Dyloject reported a 50% reduction in pain over 4 to 6 hours.

Diclofenac, the active ingredient of Dyloject, has been compared to other NSAIDs for efficacy.  One analysis showed that it has equal efficacy to naproxen, is more effective than paracetamol and worse efficacy than rofecoxib.

Another analysis from the respected Cochrane Review compared diclofenac in 34 trials with a large amount of patients to ibuprofen.  There, the conclusion was that there was no significant difference between the two.

What are the side effects?

According to the SIDER side effect database, the following are the most common side effects from diclofenac:

21% report abdominal pain

19% report diarrhea

14% report dyspepsia

11% report nausea

9% report flatulence

Because of the injection route, it is possible that there will be irritation at the site of administration.

And there have been reports of pruritus and dermatitis among others.  This list is not comprehensive.

In general, NSAIDs have the concern for the potential to cause bleeding in the stomach and possibly heart issues.  Fortunately, in general, these side effects are associated with long term use.  Since Dyloject is more of a short term drug, it is likely to have less of those issues.

Sources:

1) Single dose oral diclofenac for acute postoperative pain in adults (Review)
2) Dyloject, a Novel Injectable Diclofenac Formulation, Offers Greater Safety and Efficacy Than Voltarol for Postoperative Dental Pain
3) Single dose oral ibuprofen and diclofenac for postoperative pain.