Diclofenac Sodium: Gastrointestinal disorders including epigastric pain, eructation, nausea and vomiting may occur. Peptic ulceration and GI bleeding have been reported. Other side effects include vertigo, headache, skin rashes, pruritus, tinnitus, depression, drowsiness, nervousness, insomnia, irritability, agitation, minor hearing disorders, edema, palpitations, blurred vision and other ocular reactions.
Hypersensitivity reactions may occur and include fever and rashes.
Diclofenac sodium may cause cystitis and haematuria as well as acute renal failure, interstitial nephritis and nephrotic syndrome.
Other adverse effects include anaemia, thrombocytopenia, neutropenia, eosinophilia, agranulocytosis and abnormalities in liver function tests.
Patients with congestive heart failure, cirrhosis, diuretic-induced volume depletion or renal insufficiency are at greater risk of developing renal dysfunction.
Paracetamol: Skin rashes and other allergic reactions may occur occasionally. The rash is usually erythematous or urticarial but sometimes more serious and may be accompanied by drug fever and mucosal lesions.
In few cases, the use of paracetamol has been associated with the occurrence of thrombocytopaenia, neutropaenia, pancytopaenia, leucopaenia and agranulocytosis. The dose should be reduced in renal functional impairment.
Prolonged excessive use may cause irreversible kidney damage.
Chlorzoxazone: Occasionally, patients may develop GI disturbances. It is possible, in rare instances, that chlorzoxazone may have been associated with GI bleeding.
Drowsiness, nausea, dizziness, lightheadedness, malaise or overstimulation may be noted by an occasional patient.
Rarely, allergic-type skin rashes, petechiae or ecchymoses may develop during treatment. Angioneurotic oedema and anaphylactic reactions are extremely rare. Rarely, a patient may note discolouration of the urine resulting from a phenolic metabolite of chlorzoxazone.
It should be used with caution in patients with known allergies or with a history of allergic reactions to medicines. If a sensitivity reaction occurs eg, urticaria, redness or itching of the skin, the medicines should be stopped. If any signs or symptoms suggestive of liver dysfunction are observed, Lobak should be discontinued.