MILITARY PHARMACY AND MEDICINE

© Military Pharmacy and Medicine • 2012 • 4 • 41 – 50Ophthalmic diclofenac preparations include:Dicloabak (Thea; bottle of 10 mL), Difadol 0.1%(Polfa Warsaw; bottle of 5 ml), Naclof (Novartis;bottle of 5 mL) — all products contain diclofenacsodium (0.1% ophthalmic drops;1 mg/mL).Dicloabak does contain no preservatives (it isdistributed in a multi-dose bottle with 0.2 μmfilter membrane to protect contamination uponuse); the remaining two products, i.e. Difadol 0.1%and Naclof contain the preservative — benzalkoniumchloride.Other substances present in the aforementioneddrugs: Dicloabak — castor oil, tromethamine(also known as tromethamol or Tris, i.e. tris(hydroxymethyl) aminomethane), boric acid;Difadol 0.1% — polysorbate-80, boric acid, borax;Naclof — polyoxyethylenated castor oil-35, tromethamine,boric acid, sorbic acid (2 mg/mL),sodium edetate (1 mg/mL) — composition identicalto that of Voltaren Ophthalmic.Indications (accd. toPharmindex — Okulistyka, 2012):Dicloabak — inhibition of miosis during cataractsurgeries prevention of inflammation in thesurgeries of cataract and anterior ocular segment;relief of ocular pain due to photorefractivekeratectomy within 24 hours after the procedure.Difadol 0.1% — inflammation following cataractsurgery or other surgical procedures; fightingsymptoms of eye pain and photophobia, inhibitionof miosis in the course of cataract surgery,prevention of cystoid macular edema followingcataract surgery with lens implantation.Naclof — post-operative inflammatory conditionsafter removal of cataract and other surgicalprocedures, prevention of cystoid macular edemafollowing cataract surgery with lens implantation,post-traumatic inflammation in injuries withoutperforation of the eyeball; inhibition of miosis,fighting symptoms of eye pain and photophobia.Although the three aforementioned productsslightly differ in formal therapeutic indications,there are no rational premises capable of shakingan opinion that the three compounds can be usedinterchangeably, as they are practically identical.Jerzy Z. Nowak: Non-steroidal anti-inflammatory drugs (NSAIDs) in …Dicloabac:••Inhibition of miosis during cataract surgeryand prevention of inflammation in cataractsurgeries and the surgeries of the anteriorocular segment: before surgery — 1 drop up to5x within 3 h before the surgery; after surgery— 1 drop 3x immediately after surgery, andnext 1 drop 3-5x/day, for as long as required.••Fighting ocular pain in photorefractive keratectomywithin the first 24 h after the surgery:before surgery — 2 drops within 1 h beforesurgery; after surgery — 2 drops within 1 hafter the surgery followed by 4 drops within24 h after the surgery.Difadol 0,1%:••Ocular surgery and complications: before asurgical procedure — 1 drop 5x within 3 h;after surgical procedure — 1 drop 3x duringthe surgery and then 1 drop 3-5x per day, foras long as required.••Pain and photophobia: 1 drop every 4-6 h.••Prevention of pain associated with surgicalprocedures — 1-2 drops within 1 h before theprocedure, 1-2 drops within 15 min. after theprocedure and then 1 drop every 4-6 hoursover the following 3 days.Naclof:••Ocular surgery and complications: before asurgical procedure — 1 drop 5x within 3 h;after surgical procedure — 1 drop 3x duringthe day after the surgery and 1 drop 3-5x perday over the following days, for as long asrequired.••Pain and photophobia: 1 drop every 4-6 h.••Pain resulting from surgical procedures — 1-2drops within 1 h before the surgery, 1-2 dropswithin 15 min after the surgery and 1 every4-6 h over 3 days after the surgery.As in the case of therapeutic indications of theaforementioned drugs, which should be identicaldue to the similarity of products, also thedosage of individual products in particular situationsshould be identical. Diverse summariesof therapeutic indications and dosage results inintroduction of unnecessary confusion, implyingthat the products are used for different purposes,which is not true.Dosage (accd. toPharmindex — Okulistyka, 2012):http://military.isl-journals.comAs mentioned above, diclofenac is the originalproduct by Ciba-Geigy (currently Novartis),41