Dinac Plus Injection

NSAID with a local anaesthetic (injection or gel) for:

• Injection (IM): acute severe pain — renal/biliary colic, acute gout, musculoskeletal pain, post-operative pain (lidocaine reduces injection pain)
• Gel: local muscle and joint pain, sprains, strains

Injection (diclofenac 75 mg + lidocaine 20 mg/2 ml): 1 ampoule deep IM into the upper outer buttock once daily (twice daily in severe cases, at least 12 hours apart), for a maximum of 2 days, then switch to tablets if needed. Maximum diclofenac 150 mg/day. Not for IV use. Health professional only.

Gel: apply 2–4 g to the painful area 3–4 times daily, up to 14 days; wash hands after use.

• Not for children (injection).

• Allergy to diclofenac, aspirin/NSAIDs, or amide local anaesthetics
• Active peptic ulcer or bleeding; severe heart failure, ischaemic heart disease, cerebrovascular disease, peripheral arterial disease
• Severe kidney or liver impairment
• Last 3 months of pregnancy
• Injection: heart block, bleeding disorders, anticoagulant therapy (IM injection risk)

Common: pain or hardening at the injection site, nausea, indigestion, abdominal pain, dizziness, headache; gel: skin irritation, rash.

Rare but serious: injection-site abscess or tissue necrosis (Nicolau syndrome), severe allergic reactions/anaphylaxis, stomach bleeding, kidney injury, heart attack/stroke, lidocaine effects (dizziness, numbness of lips, seizures) if injected into a vessel.

• Give deep IM with careful technique; observe for allergic reactions after the injection.
• Heart disease, hypertension, asthma, kidney/liver disease, elderly: caution.
• Do not combine with other NSAIDs.
• Gel: avoid broken skin, eyes; do not use with sun exposure on treated area (photosensitivity possible).

Avoid in the first 6 months unless advised; contraindicated in the last 3 months. Short-term use while breastfeeding is generally acceptable.

• Other NSAIDs, aspirin, steroids (stomach bleeding)
• Anticoagulants, antiplatelets, SSRIs (bleeding)
• ACE inhibitors, ARBs, diuretics (kidney injury)
• Lithium, methotrexate, digoxin (toxicity)
• Antiarrhythmics (lidocaine additive effects)

Vomiting, stomach pain, drowsiness, seizures, kidney failure; lidocaine toxicity (perioral numbness, dizziness, convulsions, arrhythmia). Emergency care.

Store below 30°C, protected from light.