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Diclofenac safe and effective for acute pain in children: review

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Although diclofenac is commonly used to treat acute pain in children, it is not licensed for this purpose in all age groups. A new review, however, suggests that perhaps it should be.

As reported in the latest issue of The Cochrane Library, Dr. Imogen Savage, from the University of London, and colleagues searched MEDLINE, EMBASE, and several other databases for studies examining diclofenac as a treatment for acute pain in children 18 years old or younger.

Seven studies examining the efficacy of the drug and 79 looking at its safety were identified, the researchers note.

In the efficacy analysis, the focus was typically on post-operative pain. In this regard, use of diclofenac reduced the need for rescue analgesia by 40% relative to placebo or no treatment. The number needed to treat to benefit was 3.6.

As for safety, the authors found that diclofenac-treated children were 40% less likely to suffer nausea, vomiting, or both compared with patients treated with any non-NSAID agent.

Fewer than 0.24% of children experienced a serious adverse event with diclofenac, and none had bleeding episodes requiring surgical intervention. The serious adverse events observed were similar to those previously reported in adults given the drug.

Dr. Savage told Reuters Health that the message for clinicians is that diclofenac is “a useful drug in pediatrics, and one which is already used quite widely in the UK, although we probably need more ‘child friendly’ formulations.”

Cochrane Database of Systematic Reviews 2009.