1,519
Views
53
CrossRef citations to date
0
Altmetric
Review

Review of the pharmaceutical properties and clinical effects of the topical NSAID formulation, diclofenac epolamine

, &
Pages 2967-2992 | Accepted 25 Jul 2008, Published online: 02 Oct 2008

References

  • Dromgoole SH. Topical nonsteroidal anti-inflammatory drugs in skin diseases and musculoskeletal disorders. In: Lewis AJ, Furst DE, ed. Nonsteroidal anti-inflammatory drugs. Mechanisms and clinical uses, 2nd edn. New York: Marcel Dekker, 1994, pp.71-95
  • Bolin DJ. Transdermal approaches to pain in sports injury management. Curr Sports Med Rep 2003;2:303-9
  • Kvien TK, Viktil K. Pharmacotherapy for regional musculoskeletal pain. Best Pract Res Clin Rheumatol 2003;17:137-50
  • McCleane G. Pharmacological management of neuropathic pain. CNS Drugs 2003;17:1031-43
  • Schalnus R. Topical nonsteroidal anti-inflammatory therapy in ophthalmology. Ophthalmologica 2003;217:89-98
  • Blumstein H, Gorevic PD. Rheumatologic illnesses: treatment strategies for older adults. Geriatrics 2005;60:28-35
  • Gotzsche PC. Musculoskeletal disorders. Non-steroidal anti-inflammatory drugs. Clin Evid 2005;14:1498-505
  • Sullivan WJ, Panagos A, Foye PM,. et al. Industrial medicine and acute musculoskeletal rehabilitation. 2. Medications for the treatment of acute musculoskeletal pain. Arch Phys Med Rehabil 2007;88:S10-3
  • Mason L, Moore RA, Edwards JE,. et al. Topical NSAIDs for chronic musculoskeletal pain: systematic review and meta-analysis. BMC Musculoskelet Disord 2004a;5:28
  • Evans JMM, McMahon AD, McGilcrist MM,. et al. Topical non-steroidal anti-inflammatory drugs and admission to hospital for upper gastrointestinal bleeding and perforation: a record linkage case-control study. Br Med J 1995;311:22-6
  • Rainsford KD, ed. Aspirin and related drugs. London: Taylor & Francis, 2004.
  • Mason L, Moore RA, Edwards JE,. et al. Systematic review of efficacy of topical rubefacients containing salicylates for the treatment of acute and chronic pain. Br Med J 2004;328:995
  • Sengupta Ch, Aféche P, Meyer-Brunot HG, et al. Diclofenac sodium. In: Rainsford K, ed. Anti-inflammatory and anti-rheumatic drugs, volume II: newer anti-inflammatory drugs. Boca Raton (FL): CRC Press, 1985, pp.49-63
  • Evans D, Williamson WRN, eds. Anti-inflammatory compounds. New York: Marcel Dekker, 1987, pp.193-302.
  • Liauw L, Mascaritola JD, Burcher J. Diclofenac. In: Lewis AJ, Furst D, eds. Nonsteroidal anti-inflammatory drugs. Mechanisms and clinical use. New York: Marcel Dekker, 1987, pp.329-47
  • Rainsford KD. Mode of action, uses, and side-effects of anti-rheumatic drugs. In: Rainsford K, ed. Advances in anti-rheumatic therapy. Boca Raton (Fl): CRC Press, 1996, pp.59-111
  • Rainsford KD. Inhibitors of eicosanoids. In: Curtis-Prior, ed. The eicosanoids. Chichester: John Wiley, 2004, pp.189-210
  • Henry D, Dobson A, Turner C. Variability in the risk of major GI complications from non-aspirin non-steroidal anti-inflammatory drugs. Gastroenterology 1993;105:1078-88
  • Henry D, Drew A, Beuzeville S. Adverse drug reactions in the gastrointestinal system attributed to ibuprofen. In: Rainsford KD, Powanda M, ed. Safety and efficacy of non-prescription (OTC) analgesics and NSAIDs. Dordrecht: Kluwer Academic Publishers, 1998, pp.19-45
  • Potts RO, Bommannan DB, Guy RH. Percutaneous absorption. In: Muktar H, ed. Pharmacology of the skin. Boca Raton (Fl): CRC Press, 1992, pp.13-27
  • Banakar UV. Transport percutané de médicaments. In: Flector EP Tissugel – Diclofénac épolamine. Un nouveau système de libération continue de médicament. Rapports du Symposium, Lugano, Palais des Congrès, CH – juin 1994. Editor: G. Mautone. Lugano: Lugano, Institut Biochimique SA, 1995, pp.11-8.
  • Roberts MS, Cross SE. Percutaneous absorption of topically applied NSAIDs and other compounds. Role of solute properties, skin physiology and delivery systems. Inflammopharmacology 1999;7:339-50
  • Fox LP, Merk HF, Bickers DR. Dermatological pharmacology. In: Brunton LL, Lazo JS, Parker K, eds. Goodman and Gillman's. The pharmacological basis of therapeutics, 11th edn. New York: McGraw Hill, 2006, pp.1679-80
  • Lever WF, Schaumburg-Lever G, eds. Histopathology of the skin. Philadelphia: Lippincott, 1983.
  • Flynn GL. Physicochemical determinants of skin absorption. In: Gerity TR, Henry CJ, eds. Principles of route to route extrapolation for risk assessment. New York: Elsevier, 1990, pp. 93-127
  • Roberts MS, Pugh WJ, Hadgraft J,. et al. Epidermal permeability penetrant structure relationships. I. An analysis of methods of predicting penetration of monofunctional solutes from aqueous solutions. Int J Pharm 1995;126:219-33
  • Pugh WJ, Degim IT, Hadgraft J. Epidermal penetrant structure relationships. IV. Quantitative structure activity relationships of permeant diffusion across human stratum corneum in terms of molecular weight, H bonding, and electronic charge. Int J Pharm 2000;197:203-11
  • Değim T, Hadgraft J, İlbasmiş S,. et al. Prediction of skin penetration using artificial neural network (ANN) modeling. J Pharm Sci 2003;92:656-64
  • Cordero JA, Alarcon L, Escribano E,. et al. A comparative study of the transdermal penetration of a series of nonsteroidal antiinflammatory drugs. J Pharm Sci 1997;86:503-8
  • Cordero JA, Camacho M, Obach R,. et al. In vitro based index of topical anti-inflammatory activity to compare a series of NSAIDs. Eur J Pharm Biopharm 2001;61:135-42
  • Srinivasa Roa G, Anbu J, Dhanaraju MD,. et al. Biopharmaceutical and pharmacodynamic studies on topically applied diclofenac gel available on the Indian market. Boll Chim Farm 2004;143:208-10
  • Hui X, Anigbogu A, Singh P,. et al. Pharmacokinetics and local distribution of [14C] sodium diclofenac following iontophoresis and systemic administration in rabbits. J Pharm Sci 2001;90: 1269-76
  • Lee CM, Maibach HI. Deep percutaneous penetration into muscles and joints. J Pharm Sci 2006;95:1405-13
  • Riess W, Schmid K, Botta L,. et al. The percutaneous absorption of diclofenac [in German]. Arzneimittelforsch 1986;36:1092-6
  • Assandri A, Canali S, Giachetti C. Local tolerability and pharmacokinetic profile of a new transdermal delivery system, diclofenac hydroxyethylpyrrolidine plaster. Drugs Exptl Clin Res 1993; 19(3): 89-95
  • Seth BL. Comparative pharmacokinetics and bioavailability study of percutaneous absorption of diclofenac from 2 topical formulations containing drug as a solution gel or as an emulsion gel. Arzneimittelforsch 1992;42:120-2
  • Neubert R, Winter K, Bendas B. Evaluation of the drug availability from commercial topical formulations using multilayer membrane system. Pharmazie 1993;48:54-6
  • Friedman DI, Schwarz JS, Weisspapir M. Submicron emulsion vehicle for enhanced transdermal delivery of steroidal and nonsteroidal antiinflammatory drugs. J Pharm Sci 1995;84:324-9
  • Daffonchio L, Bestetti A, Clavenna G,. et al. Effects of a new foam formulation of ketoprofen lysine salt in experimental models of inflammation and hyperalgesia. Arzneimittelforsch 1995;45:590-4
  • Parra JL, Coderch L, Yuste I de la Maza A. Incorporation of non-steroidal anti-inflammatory drugs into specific monophasic formulations. Coll Surf A – Physicochem Eng Asp 1997;123: 115-23
  • Vincent CM, Laugel C, Marty JP. In vitro delivery of non-steroidal anti-inflammatory drugs. Arzneimittelforsch 1999; 49: 509-13
  • Calpena AC, Escribano E, San Martin H,. et al. Influence of the formulation on the in vitro transdermal penetration of sodium diclofenac – Evaluation of the topical and systemic anti-inflammatory in the rat. Arzneimittelforsch 1999;49:1012-7
  • Csoka G, Marton S, Zelko R,. et al. Stability of diclofenac sodium and piroxicam in new transdermal ‘soft-patch’ type gel systems. STP Pharma Sci 2000;10:415-8
  • Hendradi E, Obata Y, Isowa K,. et al. Effect of micelle formulations including terpenes on the transdermal delivery of diclofenac. Biol Pharm Bull 2003;26:1739-43
  • Mohammed FA. Topical permeation characteristics of diclofenac sodium from NaCMC gels in comparison with conventional gel formulation. Drug Dev Ind Pharm 2001;27:1083-97
  • Parsee S, Sarbolouki MN, Parnianpour M. In-vitro release of diclofenac diethylammonium from lipid-based formulations. Int J Pharm 2002;241:185-90
  • Djordjevic L, Primorac M, Stupar M,. et al. Characterization of caproyl macroglycerides based microemulsion drug delivery systems for an amphiphylic drug. Int J Pharm 2004;271:11-9
  • Conte A, Ronca G, Perini M,. et al. Effect of lecithin on the epicutaneous absorption of diclofenac epolamine. Drugs Exp Clin Res 2002;28:249-55
  • Burian M, Tegeder I, Seegek M,. et al. Peripheral and central antihyperalgesic effects of diclofenac in a model of human inflammatory pain. Clin Pharmacol Ther 2003;74:113-20
  • Escribano E, Calpena AC, Queralt J,. et al. Assessment of diclofenac permeation with different formulations: anti-inflammatory study of a selected formula. Eur J Pharm Sci 2003;19:203-10
  • Bionpally RR, Zhou SL, Poondru S,. et al. Lecithin vesicles for topical delivery of diclofenac. Eur J Pharm Biopharm 2003;56: 389-92
  • Dehghanyar P, Mayer BX, Namiranian K,. et al. Topical penetration of diclofenac after single- and multiple-dose application. Int J Clin Pharmacol Ther 2004;42:353-9
  • Kahlig H, Valenta C, Dampfhart U,. et al. Rheology and NMR self-diffusion experiments as well as skin permeation of diclofenac-sodium and cyproterone acetate of new gel preparations. J Pharm Sci 2005;94:288-96
  • Djordjevic L, Primorac M, Stupar M. In vitro release of diclofenac diethylamine from caprylocaproyl macrogolglycerides based microemulsions. Int J Pharm 2005;296:73-9
  • Gschwend MH, Martin W, Arnold P,. et al. Determination of the transdermal bioavailability of a newly developed diclofenac sodium patch in comparison with a reference preparation. Arzneimittelforsch 2005;55:403-13
  • Kantarci G, Ozgungey I, Karasulu HY,. et al. In vitro permeation of diclofenac sodium from novel microemulsion formulations through rabbit skin. Drug Dev Res 2005; 65:17-25
  • Brunner M, Dehghanyar P, Siegfried B,. et al. Favourable dermal preparation of diclofenac after administration to the skin using a novel spray gel formulation. Br J Clin Pharmacol 2005;60:573-7
  • Sintov AC, Botner S. Transdermal drug-delivery using microemulsion and aqueous systems; influence of skin storage conditions on the in vitro permeability of diclofenac from aqueous vehicle systems. Int J Pharm 2006;311:55-62
  • Kogan A, Garti N. Microemulsions as transdermal drug delivery vehicles. Adv Colloid Interface Sci 2006;123:369-85
  • Minghetti P, Cilurzo F, Casiraghi A,. et al. Ex vivo study of transdermal permeation of four diclofenac salts from different vehicles. J Pharm Sci 2007;96:814-23
  • Zimmerman J, Siguencia J, Tsvang E. Upper gastrointestinal hemorrhage associated with cutaneous application of diclofenac gel. Am J Gastroenterol 1995;90:2032-4
  • Heyneman CA, Lawless-Liday C. Oral versus NSAIDs in rheumatic diseases – a comparison. Drugs 2000;60:555-74
  • Dreiser RL. Expert's report on the clinical documentation of Flector Tissugel®, IBSA ( October. 2002). IBSA internal report.
  • Fini A, Fazio G, Orienti I,. et al. Chemical properties-dissolution relationship. IV. Behaviour in solution of the diclofenac/N-(2-hydroxyethyl) pyrrolidine salt (DHEP). Pharm Acta Helv 1991;66:201-3
  • Fini A, Fazio G, Orienti I,. et al. Chemical properties, dissolution relationships of NSAIDs. Release of diclofenac N-(2-hydroxyethyl) pyrrolidine salt (DHEP) from monoliths. Eur J Biopharm 1992;38:66-72
  • Fini A, Fazio G, Rapaport I. Diclofenac/N-(2-hydroxyethyl)pyrrolidine: a new salt for an old drug. Drugs Exp Clin Res 1993; 19:81-8
  • Fini A, Fazio G. L’importance de la forme chimique dans la liberation du diclofénac. In: Flector EP Tissugel, ed. Diclofénac épolamine Un nouveau système de libération continue de médicament. Rapports du Symposium, Lugano, Palais des Congrès, CH – juin 1994. Editor: G. Mautone. Lugano: Lugano, Institut Biochimique SA 1995, pp.18-20.
  • Fini A, Fazio G, Gonzalez-Rodriguez M,. et al. Formation of ion-pairs in aqueous solutions of diclofenac salts. Int J Pharm 1999; 187:163-73
  • Fini A, Fazio G, Rosetti F,. et al. Diclofenac salts. III 2005;94: 2416-31
  • Castellari C, Sabatino P. Anti-inflammatory drugs: 1-(2-hydroxyethyl) pyrrolidinium salt of diclofenac. Acta Crystallogr C 1994;50:1723-6
  • Hiramatsu Y, Akita S, Salamin PA,. et al. Assessment of topical non-steroidal anti-inflammatory drugs in animal models. Arzneimittelforsch 1990;40:1117-24
  • Gallacchi G, Marcolongo R. Pharmacokinetics of diclofenac hydroxyethylpyrrolidine (DHEP) plasters in patients with monolateral knee joint effusion. Drugs Exp Clin Res 1993; 19:95-7
  • Buchanan WW, Kean WF. Osteoarthritis IV. Clinical therapeutic trials and treatment. Inflammopharmacology 2002;10:79-155
  • Kean WF, Buchanan WW. The use of NSAIDs in rheumatic disorders 2005: a global perspective. Inflammopharmacology 2005;13:343-70
  • Elliott, AM, Smith BH, Penny KI,. et al. The epidemiology of chronic pain in the community. Lancet 1999;354:1248-52
  • Laine L. Gastrointestinal effects of NSAIDs and Coxibs. J Pain Symptom Manage 2003;25 (Suppl):S32-40
  • Wolfe MM, Lichtenstein DR, Singh G. Gastrointestinal toxicity from nonsteroidal anti-inflammatory drugs. N Engl J Med 1999; 340:1888-99
  • Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications. Am J Med 1999;106:13S-24
  • Pope JE, Anderson JJ, Felson DT. A meta-analysis of the effects of nonsteroidal anti-inflammatory drugs on blood pressure. Arch Intern Med 1993;153:477-84
  • Hirschowitz BI. Nonsteroidal antiinflammatory drugs and the gastrointestinal tract. Gastroenterologist 1994;2:207-23
  • Singh G, Ramey DR. NSAID Induced gastrointestinal complications: the ARAMIS perspective – 1997. J Rheumatol. 1998;25 (Suppl 51):8-16
  • Langman MJ, Jensen DM, Watson DJ,. et al. Adverse upper gastrointestinal effects of rofecoxib with NSAIDs. J Am Med Assoc 1999;282:1929-33
  • Buttgereit F, Burmester GR, Simon LS. Gastrointestinal toxic side effects of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2-specific inhibitors. Am J Med 2001; 110 (Suppl 3A):13S-9
  • Hawkey C, Talley NJ, Yeomans ND,. et al. and NASA1 SPACE1 Study Group. Improvements with esomeprazole in patients with upper gastrointestinal symptoms taking non-steroidal antiinflammatory drugs, including selective COX-2 inhibitors. Am J Gastroenterol 2005;100:1028-36
  • Hawkey CJ, Talley NJ, Scheiman JM,. et al. and NASA/SPACE author group Maintenance treatment with esomeprazole following initial relief of non-steroidal anti-inflammatory drug-associated upper gastrointestinal symptoms: the NASA2 and SPACE2 studies. Arthritis Res Ther 2007;9:R17
  • Gercez-Simon E, Kean WF. Methods for application of topical nonsteroidal antiinflammatory drugs (TNSAIDs) in clinical trials. Inflammopharmacology 1999;7:329
  • McQuay H, Moore A. (Eds) Topically applied non-steroidal anti-inflammatory drugs. An evidenced-based resource for pain relief 1999. Oxford: Oxford University Press, pp.102-17
  • Vaile JH, Davis P. Topical NSAIDs for musculoskeletal conditions. A review of the literature, Drugs 1998;56:783-99
  • Gercez-Simon E, Kean WF. Efficacy and safety of topical nonsteroidal anti-inflammatory drugs (TNSAIDs) in musculoskeletal disorders. Inflammopharmacology 1999;7:330-1
  • McQuay H, Moore A. Paracetamol with or without codeine in acute pain. In: McQuay H, Moore A, eds. An evidenced based resource for pain relief 1999. Oxford: Oxford University Press, pp.58-77
  • McQuay H, Moore A. Oral tramadol versus placebo, codeine, and combination analgesics. In: McQuay H, Moore A, eds. An evidenced based resource for pain relief 1999. Oxford: Oxford University Press, pp.138-46
  • Hosie G. The topical NSAID, felbinac, versus ibuprofen: a comparison of efficacy in the treatment of lower back injury. Br J Clin Res 1993;4:5-17
  • Gebhardt M, Wollina U. Cutaneous side-effects of nonsteroidal anti-inflammatory drugs (NSAID) [in German]. Z Rheumatol 1995;54:405-12
  • Grace D, Rogers J, Skeith K,. et al. Topical diclofenac versus placebo: a double blind randomized clinical trial in patients with osteoarthritis of the knee. J Rheumatol 1999; 26:2659-83
  • Zacher J, Burger KJ, Färber L,. et al. Topisches Diclofenac Emulgel versus orales Ibuprofen in der Therapie der aktivierten Arthrose der Fingergelke (Heberden- und/order Bouchard-Arthrose). Akt Rheumatol 2001;26:7-14
  • Mattara L, Trotta F, Biasi D,. et al. Evaluation of the efficacy and tolerability of a new locally acting preparation of flurbiprofen in scapulohumeral periarthritis. Eur J Rheumatol Inflamm 1994;4:15-20
  • van Haselen RA. Fisher PA. A randomized controlled trial comparing topical piroxicam gel with a homeopathic gel in osteoarthritis of the knee. Rheumatology 2000;39:714-9
  • Mazieres B, Rouanet S, Guillon Y,. et al. Topical ketoprofen patch in the treatment of ankle sprain: a randomized, double blind, placebo controlled study. Am J Sports Med 2005; 33:515-23
  • Mazieres B, Rouanet S, Guillon Y,. et al. Topical ketoprofen patch in the treatment of tendinitis: a randomized, double blind, placebo controlled study. J Rheumatol 2005; 32:1563-70
  • Mason L, Moore RA, Edwards JE,. et al. Topical NSAIDs for acute pain: a meta-analysis. BMC Musculoskelet Disord 2004;5:10
  • Chan TY. Potential dangers from topical preparations containing methylsalicylate. Human Exp Toxicol 1990;15:747-50
  • Candy JM, Morrison C, Paton RD,. et al. Salicylate toxicity masquerading as malignant hypertension. Paediatr Anaesth 1998;8:421-3
  • Yip AS, Chow WH, Tai YT,. et al. Adverse effect of topical methylsalicylate ointment on warfarin anticoagulation: an unrecognized potential hazard. Postgrad Med J 1990; 66:367-9
  • O’Callaghan CA, Andrews PA, Ogg CS. Renal disease and use of topical nonsteroidal anti-inflammatory drugs. Br Med J 1994;308:110-11
  • Zhang WY, Li Wan Po A. The effectiveness of topically applied capsaicin. A metaanalysis Eur J Clin Pharmacol 1994; 46:517-22
  • Deal CL, Schnitzer TJ, Lipstein E,. et al. Treatment of arthritis with topical capsaicin: a double-blind trial. Clin Therapeutics 1991;13:383-95
  • McCarthy GM, McCarty DJ. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J Rheumatol 1992;19:604-17
  • Zacher J, Altman R, Bellamy N,. et al. Topical diclofenac and its role in pain and inflammation: an evidence-based review. Curr Med Res Opin 2008;24:925-50
  • Bookman A, Williams KS, Shainhouse KZ. Effect of a topical diclofenac solution for relieving symptoms of primary osteoarthritis of the knee: a randomized controlled trial. CMAJ 2004; 171:333-8
  • Baer PA, Thomas LM, Shainhouse KZ. Treatment of osteoarthritis of the knee with a topical diclofenac solution: a randomised controlled, 6-week trial. BMC Musculoskel Disord 2005;6:44
  • Niethard FU, Gold MS, Solomon GS,. et al. Efficacy of topical diclofenac diethylamine gel in osteoarthritis of the knee. J Rheumatol 2005;32:2384-92
  • Affaitati G, Vecchiet F, Lerza R,. et al. Effects of topical diclofenac (DHEP plaster) on skin, subcutis and muscle pain thresholds in subjects without spontaneous pain. Drugs Exptl Clin Res 2001;27:69-76
  • Gallacchi G, Mautone G, Lualdi P. Painful inflammatory conditions. Topical treatment with diclofenac hydroxyethylpyrrolidine. Clin Trials J 1990;27:58-63
  • Weinheimer EM, Jemiolo B, Carroll CC,. et al. Resistance exercise and cyclooxygenase (COX) expression in human skeletal muscle: implications for COX-inhibiting drugs and protein synthesis. Am J Physiol Regul Integr Comp Physiol 2007; 292:2241-8
  • Studynkova JT, Kuchen S, Jeisy E,. et al. The expression of cyclooxygenase-1, cyclooxygenase-2 and 5-lipoxygenase in inflammatory muscle tissue of patients with polymyositis and dermatomyositiy. Clin Exp Rheumatol 2004; 22:395-402
  • Dreiser RL, Tisne-Camus M. DHEP plasters as a topical treatment of knee osteoarthritis – a double-blind placebo-controlled study. Drugs Exp Clin Res 1993;19:117-123
  • Brühlmann P, Michel BA. Topical diclofenac patch in patients with knee osteoarthritis: a randomized, double-blind, controlled clinical trial. Clin Exp Rheumatol 2003;21:193-8
  • Brühlmann P, de Vathaire F, Dreiser RL,. et al. Short-term treatment with topical diclofenac epolamine plaster in patients with symptomatic knee osteoarthritis: pooled analysis of two randomised clinical studies. Curr Med Res Opin 2006;22: 2429-38
  • Mahler P, Mahler F, Duruz H,. et al. Double-blind, randomized, controlled study on the efficacy and safety of a novel diclofenac epolamine gel formulated with lecithin for the treatment of sprains, strains and contusions. Drugs Exp Clin Res 2003;29:45-52
  • Saillant G, Auguste P, Boyer C,. et al. Étude comparant l’efficacité et la tolerance de Flector Tissugel® à celles ‘un placebo dans le traitement des entorses bénignes de la cheville. Médicine du Sport 1998;72:1-5
  • Jousselin E. Flector Tissugel® dans le traitement des entorses douloureuses de la cheville. J Traumatol Sport 2003; 20:155-9
  • Galer BS, Rowbotham M, Perander J,. et al. Topical diclofenac patch relieves minor sports injury pain: results of a multicenter controlled clinical trial. J Pain Symptom Management 2000;19: 287-94
  • Rowbotham MC. Efficacy and safety of Flector Tissugel in minor sports injuries. J Traumatol Sport 2003;20:1S15-20
  • Camarri E. Double-blind controlled evaluation (vs. placebo) of the systematic efficacy and tolerability of a nonsteroidal anti-inflammatory drug, Flector EP plaster, in localized rheumatological diseases. IBSA (1992). Internal report.
  • Galeazzi M, Marcolongo R. A placebo-controlled study of the efficacy and tolerability of a nonsteroidal anti-inflammatory drug, DHEP plaster, in inflammatory peri- and extra-articular rheumatological diseases. Drugs Exp Clin Res 1993;19:107-15
  • Rosenthal M, Bahous I. A controlled clinical study on the new topical dosage form of DHEP plasters in patients suffering from localized inflammatory diseases. Drugs Exp Clin Res 1993; 19:99-105
  • Bahous I, Rosenthal M. Controlled study on the safety and efficacy of a new topical dosage form DIEP Plaster in patients with inflammatory symptoms. Clin Trials Meta Analysis 1993; 28:147-56
  • Jenoure P, Segesser B, Luhti U,. et al. A trial with diclofenac HEP plaster as topical treatment in minor sport injuries. Drugs Exp Clin Res 1993;19:129-37
  • Jenoure PJ, Rostan A, Gremion G,. et al. Studio multicentrico controllato in doppio cieco su diclofenac Tissugel plaster in pazienti con epicondilite. Med Sport 1997;50:285-92
  • Polieri T, Saponati G. Minor sport injuries in children: a new, safe, topical preparation containing DHEP (Diclofenac Epolamine). Med Sport 2000;53:275-8
  • Jones CE. A randomized, double-blind, placebo controlled study of the analgesic efficacy and safety of the diclofenac epolamine patch (DEP) in minor soft tissue injury. IBSA (February 2006). Internal report.
  • Aithal GP. Diclofenac-induced liver injury: a paradigm of idiosyncratic drug toxicity. Expert Opin Drug Saf 2004;3:519-23

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.