Drug Class: Non-Steroidal Anti-Inflammatory Drug (NSAID) | Form: Intramuscular (IM) Injection | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Dicloran 75mg Injection?
Dicloran 75mg Injection contains Diclofenac Sodium 75mg in a sterile solution for intramuscular (IM) injection — the injectable formulation of Diclofenac designed for situations where fast, powerful pain and inflammation relief is required and oral administration is not possible, not practical, or not fast enough to meet the clinical need.
When Diclofenac is injected directly into muscle tissue, it is absorbed rapidly into the bloodstream — bypassing the digestive system entirely and achieving therapeutic blood levels significantly faster than any oral tablet or dispersible formulation. This makes Dicloran 75mg Injection the preferred choice in acute clinical situations where rapid, reliable pain control is the immediate priority — such as sudden severe back pain, acute renal or biliary colic, post-operative pain, severe acute gout, and other conditions involving intense, sudden-onset pain (شدید اور اچانک درد) that requires immediate medical intervention.
Dicloran 75mg Injection is strictly a clinical and hospital setting medicine. It must be administered exclusively by a qualified doctor or nurse as a deep intramuscular injection into a large muscle — typically the upper outer quadrant of the buttock. It is not for self-administration, repeated long-term use, or intravenous injection. The injectable route is intended for short-term use only — typically one to two days — with transition to oral Diclofenac as soon as the patient can tolerate it.
What is Dicloran 75mg Injection Used For?
Dicloran 75mg Injection is approved for the short-term treatment of the following acute painful conditions:
- Acute severe back pain — sudden-onset lower back pain with severe muscle spasm and inflammation (کمر کا شدید اچانک درد) — one of the most common clinical uses in Pakistan
- Renal colic — intense, severe pain caused by kidney stones passing through the ureter (گردے کی پتھری کا درد) — Diclofenac injection is a first-line analgesic for renal colic in many guidelines
- Biliary colic — sudden severe right-sided upper abdominal pain caused by gallstones obstructing the bile duct (پتے کی پتھری کا درد)
- Post-operative pain — rapid relief of moderate to severe pain immediately following surgical procedures when oral intake is not yet possible
- Acute gout attack — sudden intensely painful joint inflammation caused by uric acid crystals (گاؤٹ کا شدید حملہ) — injectable form provides faster relief during severe acute attacks
- Acute musculoskeletal pain — severe sprains, strains, and soft tissue injuries with significant inflammation and pain
- Post-traumatic pain — pain and inflammation following significant injuries, fractures, or dislocations
- Severe menstrual cramps (dysmenorrhoea) — when oral medicines have not provided adequate relief for severe menstrual pain (شدید ماہواری درد)
- Acute arthritis flares — sudden severe exacerbations of osteoarthritis or rheumatoid arthritis requiring immediate injectable anti-inflammatory treatment
- Dental and orofacial pain — severe acute dental pain when oral administration is temporarily not possible
How Does Dicloran 75mg Injection Work?
Diclofenac Sodium works by blocking COX-1 and COX-2 (cyclo-oxygenase) enzymes — the enzymes responsible for synthesising prostaglandins throughout the body. Prostaglandins are the key chemical mediators of pain, inflammation, swelling, and fever — sensitising pain receptors, causing tissue swelling, and driving the inflammatory response that underlies most acute painful conditions.
By inhibiting COX enzymes and reducing prostaglandin production, Dicloran 75mg Injection delivers three simultaneous therapeutic effects:
Powerful analgesic action — prostaglandins lower the activation threshold of pain receptors (nociceptors) in tissues, making them fire more easily and intensely. By reducing prostaglandin levels, Diclofenac raises the pain threshold — making pain receptors significantly less sensitive and dramatically reducing the intensity of pain signals reaching the brain
Anti-inflammatory action — directly interrupts the prostaglandin-driven inflammatory cascade at the site of tissue injury, disease, or obstruction — reducing swelling, heat, and redness in affected joints, muscles, and soft tissues
Antipyretic action — reduces fever by blocking prostaglandin production in the hypothalamus — the brain's temperature regulation centre
The Injectable Advantage for Acute Pain:
The intramuscular injection route delivers Diclofenac directly into highly vascular muscle tissue, from which it is absorbed rapidly and completely into the bloodstream:
- Faster onset — therapeutic blood levels are achieved within 20 to 30 minutes of injection, compared to 45 to 60 minutes for oral tablets — critical in severe acute pain situations where every minute of suffering matters
- Guaranteed absorption — the full 75mg dose is absorbed reliably regardless of gut function, nausea, vomiting, or post-operative digestive disruption
- Higher initial blood concentrations — achieves higher peak blood levels more quickly, providing more powerful acute pain control than equivalent oral doses in the initial treatment period
- Bypasses first-pass metabolism — avoids partial breakdown of the drug in the gut and liver before it reaches systemic circulation, resulting in more efficient drug delivery
Dosage and Administration
⚠️ Dicloran 75mg Injection must be administered only by a qualified doctor or nurse as a deep intramuscular injection. It is never given intravenously or subcutaneously. Never attempt self-injection. For short-term use only — maximum 2 days of IM injections.
Indication Dose Frequency Maximum Duration
Acute severe back pain
75mg (1 ampoule)
Once daily or every 12 hours
Maximum 2 days
Renal / biliary colic
75mg (1 ampoule)
Once — repeat after 30 min if needed (max 150mg in 24hrs)
1 – 2 days
Post-operative pain
75mg (1 ampoule)
Every 12 hours
Maximum 2 days
Acute gout attack
75mg (1 ampoule)
Once daily
1 – 2 days then switch to oral
Acute musculoskeletal pain
75mg (1 ampoule)
Once daily
Maximum 2 days
Severe menstrual cramps
75mg (1 ampoule)
Once daily
1 – 2 days
Maximum daily IM dose
150mg
In divided doses
Never exceed
Critical Administration Rules:
- Administer as a deep IM injection into the upper outer quadrant of the buttock only — this specific site reduces the risk of accidental injection near the sciatic nerve, which can cause permanent nerve damage
- Never inject into the arm, thigh, or any other muscle site for this formulation — the upper outer buttock is the only appropriate IM site for Diclofenac injection
- Never administer intravenously (IV) — Diclofenac injection solution is not formulated for IV use and IV administration can cause serious cardiovascular complications including thromboembolism
- Never administer subcutaneously (under the skin)
- If two injections are required in 24 hours, administer into alternating sides — do not inject into the same site twice in succession
- Transition to oral Diclofenac tablets or Disperlet as soon as the patient's condition allows — do not continue IM injections beyond 2 days
- The IM injection must be given slowly and deliberately into deep muscle tissue
Active Ingredient
Ingredient Strength per Ampoule
Diclofenac Sodium
75mg
Volume per ampoule
3ml
Concentration
25mg per ml
Who Should NOT Receive Dicloran 75mg Injection?
Do not administer this injection if the patient:
- Is allergic to Diclofenac, Aspirin, or any other NSAID
- Has experienced asthma, hives, or severe allergic reaction after taking Aspirin or any NSAID
- Has or has previously had a stomach ulcer, gastrointestinal bleeding, or bowel perforation
- Has severe heart failure, established ischaemic heart disease (angina or previous heart attack), peripheral arterial disease, or cerebrovascular disease (previous stroke or TIA)
- Has severe kidney failure or severe liver failure
- Is in the last 3 months (third trimester) of pregnancy
- Is a child or adolescent under 18 years of age
- Has a bleeding disorder or is receiving anticoagulant therapy — IM injections can cause significant haematoma (blood collection) at the injection site in patients with clotting problems
- Has porphyria — a rare metabolic disorder in which NSAIDs can trigger an acute attack
Always inform the treating doctor before administration if the patient has any of the following:
- History of stomach ulcers, gastrointestinal bleeding, or inflammatory bowel disease
- High blood pressure or any cardiovascular risk factors
- Any degree of kidney or liver disease
- Asthma — particularly aspirin-sensitive asthma
- Diabetes — NSAIDs can impair kidney function
- Local infection or skin conditions at the injection site — do not inject into infected, inflamed, or damaged skin
- Are aged 65 or over — higher risk of serious NSAID side effects and injection-site complications
- Are pregnant (first or second trimester) or breastfeeding
Side Effects
Dicloran 75mg Injection is generally well tolerated when used correctly for the short duration intended. The injection route introduces additional site-specific risks alongside the standard NSAID systemic side effect profile.
Common Side Effects:
- Injection site pain, redness, swelling, or tenderness — the most common side effect; localised discomfort at the injection site is expected and usually resolves within 24 to 48 hours
- Nausea or stomach discomfort
- Mild headache or dizziness
- Heartburn or mild gastrointestinal upset
- Mild skin rash or itching
Injection Site-Specific Serious Complications:
- Sciatic nerve injury — if the injection is not administered into the correct upper outer quadrant of the buttock, the needle can inadvertently damage the sciatic nerve — causing immediate severe pain, numbness, tingling, or weakness running down the leg. This is a serious and potentially permanent complication that requires immediate medical evaluation — it is why correct injection site selection is absolutely critical
- Sterile abscess — a localised pus-filled swelling at the injection site not caused by infection, but by tissue reaction to the medicine — more common if the injection is too superficial or repeated at the same site
- Haematoma — blood pooling under the skin at the injection site — particularly in patients with clotting problems or those on blood thinners
- Tissue necrosis — rare but serious localised tissue death if the injection is incorrectly placed into fatty rather than deep muscle tissue
Serious Systemic Side Effects — Seek Emergency Medical Attention Immediately:
- Gastrointestinal bleeding or ulceration — dark or black tarry stools, vomiting blood, or severe sudden stomach pain — even with short-term injectable use, this risk exists
- Severe allergic reaction — sudden widespread rash, hives, swelling of the face, lips, tongue or throat, difficulty breathing, or circulatory collapse (یہ طبی ہنگامی صورتحال ہے)
- Cardiovascular events — chest pain, sudden breathlessness, or neurological symptoms suggesting stroke
- Acute kidney injury — significantly reduced urination, rapid swelling — particularly in volume-depleted or hypovolaemic patients receiving NSAID injection
- Severe liver reaction — jaundice, severe abdominal pain, extreme fatigue
- Severe skin reactions — widespread blistering or peeling skin — stop immediately and seek emergency help
- Bronchospasm — sudden severe wheezing or breathing difficulty — particularly in aspirin-sensitive asthmatic patients
If any serious side effect occurs during or after injection, the medical team must be informed immediately and emergency treatment initiated without delay.
Drug Interactions
The treating doctor and pharmacist must be fully informed of all medicines the patient is receiving before Dicloran 75mg Injection is administered.
Medicine / Substance Possible Interaction
Other NSAIDs or Aspirin (above 75mg)
Markedly increased gastrointestinal bleeding risk — never combine with another NSAID
Low-dose Aspirin (75mg — cardiac protection)
Diclofenac may reduce Aspirin's antiplatelet protective effect — inform the cardiologist; administer Aspirin before Diclofenac
Blood thinners (e.g., Warfarin, Heparin, Clopidogrel)
Major bleeding risk — both systemic and at injection site haematoma; avoid unless under specialist supervision
Antihypertensives (ACE inhibitors, ARBs, Beta-blockers, diuretics)
Diclofenac reduces their effectiveness; worsens blood pressure control; increases kidney stress
Methotrexate
Diclofenac significantly increases Methotrexate toxicity — potentially life-threatening; specialist supervision required
Cyclosporine and Tacrolimus
Increased serious kidney damage risk
Lithium
Diclofenac raises Lithium blood levels — risk of toxicity
SSRIs / antidepressants (e.g., Fluoxetine, Sertraline)
Increased gastrointestinal bleeding risk
Digoxin
Diclofenac may raise Digoxin levels — toxicity risk; monitoring required
Corticosteroids (e.g., Prednisolone)
Greatly increased gastrointestinal bleeding and ulceration risk
Quinolone antibiotics (e.g., Ciprofloxacin)
Combined use may increase seizure risk
Oral hypoglycaemics and Insulin
Monitor blood glucose — NSAIDs affect kidney function and glucose control in diabetic patients
Alcohol (شراب)
Increases gastrointestinal bleeding and stomach irritation risk — avoid completely
Storage Instructions
- Store unopened ampoules below 25°C in a cool, dry place
- Protect from direct sunlight and heat — Diclofenac solution is sensitive to light and heat exposure
- Keep in the original packaging until immediately before use
- Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں)
- Do not freeze — freezing can cause precipitation of the solution, rendering it unsafe for injection
- Inspect every ampoule before use — the solution must be clear and free of visible particles or discolouration; discard immediately if the ampoule is cracked, leaking, or the solution appears cloudy, discoloured, or contains particles
- Use immediately once the ampoule is opened — do not store a partially used or opened ampoule for later use
- Dispose of used ampoules and needles according to clinical sharps disposal protocols
- Do not use after the expiry date printed on the ampoule or outer carton
Frequently Asked Questions
Why is Dicloran 75mg Injection used for renal colic — is it as effective as an opioid painkiller?
Yes — multiple clinical studies and international pain management guidelines confirm that Diclofenac injection is at least as effective as opioid analgesics (such as Pethidine) for the treatment of acute renal colic, and in many studies it provides superior relief with significantly fewer side effects. Renal colic pain is largely driven by prostaglandin-mediated ureteral spasm and inflammation — making it highly responsive to NSAID treatment. Diclofenac also reduces ureteral spasm, potentially facilitating stone passage. For this reason, it has become one of the first-line treatments for renal colic in emergency departments across Pakistan and worldwide.
Why must Dicloran 75mg Injection only be given into the upper outer buttock?
The upper outer quadrant of the buttock is the only safe IM injection site for Diclofenac because it is the area farthest from the sciatic nerve — the large nerve running through the buttock and down the leg. If the injection is placed incorrectly — particularly in the inner or lower portions of the buttock — the needle can strike or cause chemical irritation to the sciatic nerve, resulting in immediate severe pain, and potentially causing permanent nerve damage including lasting weakness, numbness, or chronic pain in the leg. Correct site selection is therefore not a minor technical detail — it is a critical patient safety requirement.
Can Dicloran 75mg Injection be given intravenously for faster effect?
No — Dicloran 75mg Injection must never be given intravenously under any circumstances. The formulation is specifically prepared for intramuscular use only. Intravenous injection of IM-formulated Diclofenac can cause serious cardiovascular complications including thromboembolism — blood clots in the veins. Separate IV Diclofenac formulations exist for intravenous use in specific clinical settings — but the IM ampoule must never be substituted for an IV preparation. Always confirm the intended route before administration.
How long can Dicloran 75mg Injection be used continuously?
Dicloran 75mg Injection is strictly for short-term use only — a maximum of 2 consecutive days of IM injections. Beyond this period, the risk of serious injection-site complications including sterile abscess, tissue damage, and sciatic nerve injury increases significantly with repeated injections. Additionally, the systemic NSAID risks — gastrointestinal bleeding, kidney damage, and cardiovascular effects — accumulate with continued use. As soon as the acute pain is controlled and the patient can tolerate oral medicines, the doctor should transition to oral Diclofenac tablets or Disperlet to complete any further treatment course required.
Can Dicloran 75mg Injection be combined with Paracetamol for better pain relief?
Yes — combining Diclofenac injection with Paracetamol (either IV or oral, depending on the clinical situation) is a well-established and widely practised multimodal analgesia strategy in post-operative and acute pain management. Because Diclofenac and Paracetamol work through different pain pathways — Diclofenac peripherally through COX inhibition and Paracetamol centrally through the brain — their combination provides additive and often superior pain relief compared to either medicine alone. This combination also reduces the total dose of each individual medicine needed, which can reduce the risk of dose-dependent side effects. Your doctor will determine whether this combination is appropriate for your specific situation.
Is Dicloran 75mg Injection safe for elderly patients?
Elderly patients can receive Diclofenac injection when there is a clear clinical need — such as acute renal colic or severe post-operative pain — but with significant additional precautions. Older patients are at considerably higher risk of NSAID-related gastrointestinal bleeding, acute kidney injury, and cardiovascular complications, particularly if they have existing heart disease, kidney impairment, or are on blood-thinning medicines. The injection site must also be chosen more carefully in elderly patients — loss of muscle mass with age means deep muscle tissue may be less accessible, increasing the risk of superficial or incorrectly placed injections. The treating doctor will assess whether the injectable NSAID benefit outweighs the elevated risk in each individual elderly patient.
⚕️ Medical Disclaimer: This product description is provided for general informational purposes only and does not replace professional medical advice, diagnosis, or treatment. Dicloran 75mg Injection is a prescription-only medicine that must be administered exclusively by a qualified healthcare professional as a deep intramuscular injection into the upper outer quadrant of the buttock only. Never administer intravenously. For short-term use only — maximum 2 days. Any adverse reactions must be reported to the medical team immediately.
DRAP Registered | Prescription Required (Rx) | Deep IM injection into upper outer buttock only — never IV — short-term use maximum 2 days — administer under strict medical supervision only