Warfarin, other anticoagulants, ACE inhibitors , diuretics, tacrolimus, antihypertensives, cyclosporin, fluconazole, Rifampicin, phenytoin, carbamazepine, corticosteroids, dextromethorphan, flecainamide, Lithium, propafenone, metoprolol, methotrexate, Substrates of CYP2D6, or 2C19, Ketoconazole Cigarette smoking, Aspirin, opioid analgesics

Short term treatment of post operative pain

Hypotension, hypertension, back pain, peripheral odema, oliguria, hypoaesthesia, alveolar osteltis, dyspepsia, flatulance, GI ulcer, bleeding, perforation( possible )

Hepatic or renal effects, raised creatinine,hyokalemia, agitation, insomnia, post operative anaemia, Pharyngitis, respiratory insufficiency, priritus, Serious skin conditions, discontinue immediately

Severe hepatic impairment Hypersensitivity to sulphonamides Aspirin/NSAIDs - induced allergy

Active peptic ulcer or GI bleding, inflamationary bowel disease

Moderate to severe congestive heart failure, ischaemic heart disease

Peripheral artery disease Coronary by pass surgery

Pregnancy - women trying to conceive Lacation

Short term treatment of post operative pain

Dosage-

40mg i.v. or i.m. injection then 20mg or 40mg every 6 -12 hours as required Max. 80mg daily Elderly females less than 50kg Moderate hepatic impairment 20mg Patients under 18 years not recommened

Contraindicated for use during pregnancy in women trying to conceive and lactation Observe caution if required to be administered