NSAID, acetic acid derivative, COX-1/COX-2 inhibitor
ATC code: M01AB16 (Aceclofenac)
An acetic acid derivative related to diclofenac. Inhibits COX-1 and COX-2 with preferential COX-2 activity in vitro – less GI toxicity than diclofenac. Reduces prostaglandin synthesis at inflammation sites. Metabolized to 4-hydroxyaceclofenac and further to diclofenac – part of the effect is mediated by this metabolite. Half-life 4 hours. In Spain widely prescribed under the Airtal brand by Almirall.
Second line
Symptomatic treatment of knee and hip osteoarthritis with marked pain. 2019 and 2023 set topical NSAIDs and paracetamol as first-line pharmacotherapy; oral NSAIDs including aceclofenac are second-line with shortest possible duration.
Second line
Used in acute pain (dental, postoperative, musculoskeletal) in courses up to 7 days. Dose 100 mg twice daily. Effective in dysmenorrhea.
Second line
Used for symptomatic relief in rheumatoid arthritis as an NSAID alternative. Dose 100 mg twice daily. Does not modify disease – 2022 builds treatment on DMARDs (methotrexate, sulfasalazine, leflunomide). Patel 2011 meta-analysis showed efficacy comparable to diclofenac with fewer GI side effects.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Aceclofenac is a nonsteroidal anti-inflammatory drug (NSAID). It is prescribed in short courses for osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis (AEMPS Ficha Técnica). In anti-aging regimens, aceclofenac is positioned as a safer diclofenac for long-term use in age-related joint pain. Long-term NSAID use in people without a confirmed inflammatory disease is not justified: 2020 and 2023 recommend non-pharmacological approaches (weight loss, exercise, physiotherapy) as the basis of osteoarthritis care, with NSAIDs reserved for short flare courses. The drug carries serious risks on chronic use: gastrointestinal bleeding, blood-pressure elevation, acute kidney injury, and cardiovascular events. If aceclofenac was prescribed for age-related pain as long-term therapy, consider seeking a second opinion.
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Contraindicated in T3 – risk of premature ductus arteriosus closure, oligohydramnios. T1 and T2 not recommended without clear indication. For musculoskeletal inflammation in pregnancy, paracetamol is first-line.
Ibuprofen with more data is preferred during lactation.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Aceclofenac is evaluated for the following indications with varying evidence strength: Knee osteoarthritis (evidence tier A), Rheumatoid arthritis (evidence tier B), Acute mild-to-moderate pain (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Aceclofenac (≥ 1 in 100): Dyspepsia, nausea, Abdominal pain, Diarrhea or constipation, Headache, Dizziness, Elevated liver enzymes. See the Safety section for uncommon and serious reactions.
FDA category C. Contraindicated in T3 – risk of premature ductus arteriosus closure, oligohydramnios. T1 and T2 not recommended without clear indication. For musculoskeletal inflammation in pregnancy, paracetamol is first-line.
Ibuprofen with more data is preferred during lactation.
Aceclofenac is contraindicated in: Hypersensitivity to aceclofenac, diclofenac, or other NSAIDs; Active peptic ulcer, GI bleeding; Inflammatory bowel disease; Severe hepatic impairment; Severe renal impairment (eGFR under 30). Full list in the Safety section.