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	<title>Cancer Treatment Today &#187; analgesics</title>
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	<link>http://cancertreatmenttoday.org</link>
	<description>Knowledge is Power</description>
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		<title>Flector patch for painful metastases &#8211; pro</title>
		<link>http://cancertreatmenttoday.org/10831/</link>
		<comments>http://cancertreatmenttoday.org/10831/#comments</comments>
		<pubDate>Fri, 08 Mar 2013 12:43:04 +0000</pubDate>
		<dc:creator>M Levin, MD</dc:creator>
				<category><![CDATA[Professional]]></category>
		<category><![CDATA[analgesics]]></category>
		<category><![CDATA[cancer pain]]></category>
		<category><![CDATA[dicolfenac]]></category>
		<category><![CDATA[Flector]]></category>
		<category><![CDATA[hepatotoxicity]]></category>
		<category><![CDATA[metastases]]></category>
		<category><![CDATA[morphine]]></category>
		<category><![CDATA[Pain control. pain treatment]]></category>

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		<description><![CDATA[Flector Patch(diclofenac) is a topical  non-steroidal(NSAID) drug diclofenac. Diclofenac has anti-inflammatory, analgesic, and antipyretic properties by inhibiting the enzyme cyclooxegenase (COX) and decreasing the formation of prostaglandins, thromboxanes, and prostacyclin. The oral version is Voltaren. Each FLECTOR® Patch measures approximately 4 inches by 5.5 inches and contains 180-mg of diclofenac epolamine. The recommended dose of [...]]]></description>
			<content:encoded><![CDATA[<p>Flector Patch(diclofenac) is a topical  non-steroidal(NSAID) drug diclofenac. Diclofenac has anti-inflammatory, analgesic, and antipyretic properties by inhibiting the enzyme cyclooxegenase (COX) and decreasing the formation of prostaglandins, thromboxanes, and prostacyclin. The oral version is Voltaren. Each FLECTOR® Patch measures approximately 4 inches by 5.5 inches and contains 180-mg of diclofenac epolamine. The recommended dose of FLECTOR® Patch is one patch to the most painful area twice a day (12 hours at a time). FLECTOR® Patch should be applied to intact or non-damaged skin.</p>
<p>A meta-analysis in 2004 by Mason et al. showed topical NSAIDs to be effective and safe in treating acute painful conditions for 1 week. Whether this is also true of the patch is not known. This systemic review of 26 double-blind, placebo-controlled trials showed clinically significant efficacy in 19 of 26 trials, with a pooled relative benefit of 1.6 and number needed to treat of 3.8 vs. placebo to achieve an outcome of approximately 50% reduction in pain at 7 days. It is also well studied for ostearthritis and localized pain of rheumatic conditions.</p>
<p>Flector has not been adequately studied for pain of metastatic cancer. Oral doclofenac has  a morphine sparing effect, as do other NSAID. It can cause liver damage. How well it works locally has not been studied.  It is not a completely benign drug, especially for a debilitated cancer patient susceptible to side effects of NSAID or ir with known or undiagnosed liver metastases.</p>
<p>Flector® Patch (diclofenac epolamine 1.3%). Prescribing information. August 2011. King Pharmaceuticals, Inc.<br />
Bristol, TN 37620. <a href="http://www.flectorpatch.com/">www.flectorpatch.com</a>.</p>
<p>The Medical Letter on Drugs and Therapeutics,  1277a January 14, 2008(50): 1-2</p>
<p>Mason L, Moore RA, Edwards JE, Derry S, McQuay HJ. Topical NSAIDs for acute pain: a meta-analysis. BMC Fam Pract. 2004;5:10–9.</p>
<p>R. Björkman, A. Ullman, J. Hedne Morphine-sparing effect of diclofenac in cancer pain European Journal of Clinical Pharmacology January 1993, Volume 44, Issue 1, pp 1-5<br />
 For Lay version see <span style="color: #ff0000;">here</span></p>
<p><a title="Lidoderm for cancer pain syndromes – pro" href="http://cancertreatmenttoday.org/lidoderm-for-cancer-pain-syndromes-pro/"><span style="color: #ff0000;">More on patches in pain management</span></a> - Lidoderm</p>
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