salicylates and Sprains-and-Strains

Diflunisal is a salicylic acid derivative with analgesic and anti-inflammatory activity. It has been studied in osteoarthritis, pain resulting from musculoskeketal sprains and strains and from minor surgery and cancer. The duration of its analgesic effect is longer than that of aspirin and diflunisal is effective when given twice daily. Diflunisal is not metabolised to salicylic acid and has a lesser effect than aspirin on platelet function in vivo. In osteoarthritis, diflunisal appears comparable in efficacy to moderate doses of aspirin (2 to 3g daily), but is better tolerated. It has not been compared with the most active phenylalkanoic acid derivatives such as naproxen in adequate numbers of patients. Diflunisal is comparable with glafenine in pain and with propoxyphene/paracetamol combinations and oxyphenbutazone in pain and in musculoskeletal strains and sprains. As with other non-steroidal agents, gastrointestinal complaints are the most frequently reported side effects.

Topics: Diflunisal; Drug Interactions; Humans; Kinetics; Osteoarthritis; Pain; Salicylates; Sprains and Strains

An occlusive patch formulation containing 10% methyl salicylate and 3% l-menthol was recently approved by the US Food and Drug Administration for the treatment of mild to moderate pain. Despite widespread use of counterirritants, including methyl salicylate and menthol, for topical pain relief, published efficacy and safety data regarding the use of the agents alone or in combination are limited.. The goal of this study was to determine the efficacy and safety profile of a patch containing 10% methyl salicylate and 3% l-menthol compared with a placebo patch in adult patients with mild to moderate muscle strain.. Eligible patients were men or women aged >or=18 years with a clinical diagnosis of mild to moderate muscle strain. Patients were randomly assigned to receive either 1 active patch or 1 placebo patch applied to the skin at the affected area (ie, shoulder, upper back, upper arm, neck, calf, thigh, forearm, abdomen). Pain intensity was assessed on a 100-mm visual analog scale while at rest and with movement for 12 hours after patch application. The primary efficacy end point was the summed pain intensity difference score through 8 hours (SPID8) with movement. Analyses included use of descriptive statistics and an ANOVA model. Safety data, including adverse events, and secondary efficacy end points were also evaluated.. A total of 208 patients (104 men, 104 women; age range, 18-78 years) were randomized to 1 of 2 study groups (105 in the active-patch group [mean age, 37.3 years], 103 in the placebo-patch group [mean age, 38.1 years]). The primary efficacy analysis (SPID8 with movement) indicated that patients receiving the active patch experienced significantly greater pain relief (approximately 40%) than those patients receiving a placebo patch (mean [SD], 182.6 [131.2] vs 130.1 [144.1]; P = 0.005). Analysis of the per-protocol population also found significantly more relief (P = 0.024) in the active-patch group (176.2 [131.4]; n = 92) versus the placebo-patch group (130.2 [144.0]; n = 96). Statistical analysis of secondary efficacy measures supported the primary end-point results. The number of patients experiencing any type of adverse event was comparable between study groups (active patch, 6.7% [7 events]; placebo patch, 5.8% [6 events]). No serious adverse events were reported during the study.. A single, 8-hour application of a patch containing methyl salicylate and l-menthol provided significant relief of pain associated with mild to moderate muscle strain in these adult patients compared with patients receiving a placebo patch.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Antipruritics; Antirheumatic Agents; Double-Blind Method; Female; Humans; Male; Menthol; Middle Aged; Muscle, Skeletal; Pain Measurement; Placebos; Salicylates; Severity of Illness Index; Sprains and Strains; Treatment Outcome; Young Adult

Fifty patients with acute ankle sprains/strains were treated with either 100 mg flurbiprofen or 500 mg diflunisal twice daily in a double-blind fashion for 18 days or until symptoms of the injury resolved. Tolerability of the drugs was evaluated by recording the occurrence of adverse drug reactions and monitoring laboratory parameters. Efficacy measurements were performed at enrollment and at Visit 2-Day 7, Visit 3-Day 14 and Visit 4-Day 21 to determine relief of symptoms and return to normal activities. Patients in both treatment groups exhibited marked improvement by Visit 2-Day 7 with almost complete recovery by Visit 3-Day 14. Flurbiprofen patients had a significantly shorter duration of therapy. Results from three of the six physician assessments were marginally to significantly superior for patients in the flurbiprofen group. The only reported adverse event was mild gastro-intestinal intolerance in a patient receiving diflunisal. Flurbiprofen and diflunisal appear to be effective and well-tolerated medications for the treatment of acute ankle sprains and strains.

Topics: Adolescent; Adult; Ankle Injuries; Diflunisal; Double-Blind Method; Female; Flurbiprofen; Humans; Male; Middle Aged; Propionates; Salicylates; Sprains and Strains

The efficacy of Mobilat ointment (100 g contain: Extract. suprarenale 1.0 g, Mucopolysaccharide-polysulfate 0.2 g, salicylic acid 2.0 g) in the treatment of acute lateral distortions of the ankle was tested in a randomised, placebo-controlled, double blind study. The criteria used for the assessment of the progress of healing were the pressure distribution during walking, the swelling of the injured region and the evaluation of pain using a visual analogue scale. During the period of treatment and observation lasting 2 weeks, all the assessment criteria showed a more rapid regression in the symptoms and signs of the disorder on treatment with the active product. The differences were statistically significant for all the criteria assessed.

Topics: Administration, Topical; Adolescent; Adult; Ankle Injuries; Anti-Inflammatory Agents; Drug Combinations; Female; Glycosaminoglycans; Humans; Male; Middle Aged; Ointments; Random Allocation; Salicylates; Salicylic Acid; Sprains and Strains; Tissue Extracts

Acute soft tissue injuries create pain and limitation of function. Treatment requires analgesia and time for full recovery. Acetaminophen with codeine (650 mg plus 60 mg, respectively, every 4 to 6 hours) is used frequently as the analgesic of choice. Diflunisal (1,000 mg initially then 500 mg twice a day) vs acetaminophen with codeine was prospectively studied in the treatment of acute mild to moderate pain from soft tissue injuries. Thirty-five patients with acute strains, sprains, or low back pain were randomized to treatment (17 acetaminophen with codeine vs 18 diflunisal). Both groups were similar in the amount of pain and type of injury at initiation of therapy. Patient pain rating went from 3.3 +/- 0.6 to 1.6 +/- 1.5 for acetaminophen with codeine and from 3.3 +/- 0.6 to 1.3 +/- 1.1 for diflunisal. However, 65 percent of acetaminophen with codeine patients experienced side effects, with 35 percent of these patients stopping the medication because of intolerable side effects. In the diflunisal group, 28 percent of the patients experienced side effects and 5 percent had to stop the medication early. Diflunisal was found to be an effective analgesic in mild to moderate pain of acute soft tissue injuries, and caused fewer and more tolerable side effects than did acetaminophen with codeine.

Topics: Acetaminophen; Acute Disease; Adult; Back Pain; Clinical Trials as Topic; Codeine; Diflunisal; Drug Combinations; Drug Tolerance; Female; Humans; Male; Pain; Prospective Studies; Random Allocation; Salicylates; Sprains and Strains

Fifty-six patients entered into an open-label, randomized study to compare the efficacy and tolerability of diflunisal and naproxen in the treatment of mild to moderate pain associated with acute low back strain. Thirty-three patients completed the two-week study. No patients withdrew because of side effects, and both drugs were well tolerated. Results showed that diflunisal was more effective than naproxen (81% versus 41%) in relieving pain. Of the 16 patients taking diflunisal, 13 rated its efficacy as very good or excellent; six (35%) of 17 patients taking naproxen rated their drug similarly. Overall, diflunisal rated slightly better in efficacy and tolerability and in improving limitation of function and motion. In addition, diflunisal has a longer duration of action and thus requires less frequent dosing than naproxen.

Topics: Acute Disease; Adult; Back Pain; Clinical Trials as Topic; Diflunisal; Drug Tolerance; Female; Humans; Male; Naproxen; Random Allocation; Salicylates; Sprains and Strains

Effective pain relief and patient tolerance and acceptance are essential in outpatient management of mild to moderate pain of acute low back strain. This study evaluated the efficacy, tolerability, and acceptability of diflunisal and acetaminophen with codeine in patients with mild to moderate pain after an initial or recurrent acute low back strain. Both drugs demonstrated equipotent analgesic efficacy; however, diflunisal was superior to acetaminophen with codeine for patient tolerability and acceptability. The results demonstrated that the study drugs were effective in treating mild to moderate pain caused by acute low back strain in an ambulatory care setting.

Topics: Acetaminophen; Adult; Back Pain; Clinical Trials as Topic; Codeine; Diflunisal; Drug Combinations; Drug Tolerance; Humans; Middle Aged; Random Allocation; Recurrence; Salicylates; Sprains and Strains

The emergency physician treats many patients with mild to moderate pain due to musculoskeletal injury. The physician must consider the extent of injury, the patient's medication history, and the potential for abuse when prescribing an oral analgesic. A study was designed to compare the efficacy of two oral analgesics, one containing a narcotic and one nonnarcotic, in relieving mild to moderate pain associated with grade 2 ankle sprain. Forty patients were enrolled--all with moderate pain--and were randomly allocated to treatment with either diflunisal or acetaminophen with codeine. Both analgesic agents were equally effective in relieving the pain. Side effects were experienced by six patients, all of whom were receiving acetaminophen with codeine; none of the patients given diflunisal noted side effects. Global assessments of the efficacy and tolerability of the study drugs showed that 89% of 19 patients given diflunisal and 43% of 21 patients given acetaminophen with codeine considered their respective analgesics excellent or very good.

Topics: Acetaminophen; Adult; Ankle Injuries; Codeine; Diflunisal; Drug Combinations; Edema; Female; Humans; Male; Middle Aged; Pain; Prospective Studies; Random Allocation; Salicylates; Sprains and Strains

Fifty college athletes with acute sprains and strains from football-related activities were randomly assigned to treatment with either diflunisal or acetaminophen with codeine for seven days. Additional treatment in both groups included rest, elevation, local application of cold or heat, splinting, and physical therapy, as indicated. Both treatment groups exhibited clinically significant improvements in pain, tenderness, and swelling. The results of this study show that diflunisal, a peripherally acting nonnarcotic nonsteroidal anti-inflammatory agent with analgesic properties, was as effective as acetaminophen with codeine in relieving mild to moderate pain due to musculo-skeletal sprains and strains. The long duration of action of diflunisal permits less frequent dosing, an important consideration when prescribing medication for active young adults.

Topics: Acetaminophen; Adolescent; Adult; Athletic Injuries; Clinical Trials as Topic; Codeine; Diflunisal; Drug Combinations; Humans; Male; Pain; Random Allocation; Salicylates; Sprains and Strains

In a prospective open study over 2 years with 197 out-patients (150 men, 47 women, mean age 31 years) the efficacy and skin compatibility of a sportgel were investigated. Conditions of admission of a patient to the study were covered sport injuries according to their degree of severity of scaling 1-4 (0 = no complaints; 1 = slight complaints; 2 = slight to moderate complaints; 3 = moderate to severe complaints; 4 = severe complaints). Exclusion criteria were severe sport injuries older than three days and patients treated with medicaments others than with sportgel. 109 patients were treated who had muscle injuries and damages as a result of overstrain, 75 patients with joint injuries and damages from overstrain, and 13 patients with repeated injuries and damages from repeated overstrain in the muscular, tendon, and joint apparatus. Criterion of efficacy was the comparison of situation of ailment between treated and untreated patients in historic control. The descriptive evaluation of the results showed that under sportgel treatment the time of resumption of sporting activity is shortened generally by 2-6 days with damages of degrees of severity 1-4. During the two years' study none of the 197 patients showed any signs of skin incompatibility.

Topics: Adult; Athletic Injuries; Drug Combinations; Female; Gels; Heparin; Humans; Male; Menthol; Prospective Studies; Salicylates; Sprains and Strains; Time Factors

Topics: Administration, Topical; Adolescent; Adult; Ankle Injuries; Ankle Joint; Anti-Inflammatory Agents; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Female; Gels; Heparin; Humans; Hydrocortisone; Male; Middle Aged; Movement; Physical Therapy Modalities; Salicylates; Sprains and Strains; Time Factors

In a randomized double-blind study efficacy and tolerance of diflunisal, 375 mg twice daily, and oxyphenbutazone, 200 mg twice daily, were compared in 40 patients (aged 21 to 70 years, average 38 years), with moderate or severe complaints after spraining or dislocating ankle or wrist. The drugs were given for five days. Both proved to be highly efficacious, diflunisal slightly more so. Among the 20 patients in the diflunisal group one developed diarrhoea, another gastritis; in the oxyphenbutazone group one developed gastritis, another herpetiform pustules. There were no clinically significant abnormalities in routine biochemical tests.

Topics: Adult; Aged; Ankle Joint; Anti-Inflammatory Agents, Non-Steroidal; Clinical Trials as Topic; Diarrhea; Double-Blind Method; Drug Tolerance; Female; Gastritis; Humans; Joint Dislocations; Male; Middle Aged; Oxyphenbutazone; Salicylates; Skin Diseases; Sprains and Strains; Wrist Injuries

Topics: Adult; Ankle Joint; Diethylamines; Drug Combinations; Escin; Heparin; Humans; Joints; Salicylates; Saponins; Sprains and Strains; Wounds and Injuries

Topics: Adrenal Glands; Adult; Ankle Joint; Edema; Female; Glycosaminoglycans; Hematoma; Humans; Joint Diseases; Male; Salicylates; Sprains and Strains; Tissue Extracts

Topics: Adrenal Glands; Contusions; Female; Gels; Glycosaminoglycans; Humans; Male; Rheumatic Diseases; Salicylates; Sprains and Strains; Sulfuric Acids; Tissue Extracts; Wounds and Injuries

Topics: Adrenal Glands; Ambulatory Care; Heparinoids; Humans; Ointments; Salicylates; Skin Absorption; Sprains and Strains; Tissue Extracts; Wounds and Injuries