DUOFLAM PLUS is indicated for mild to moderate pain associated with inflammation.

DUOFLAM PLUS is to be advocated with caution in liver & kidney damage, elderly, patients requiring surgery, anemia, bronchial asthma, stomatitis, compromised cardiac function, heart failure, pre-existing edema, systemic lupus erythematosus.

Safe use of DUOFLAM PLUS in pregnancy and lactation has not been established. DUOFLAM PLUS should not be preferably coadministered with other NSAIDs, corticosteroids, hypoglycemics, digoxin, lithium, methotrexate, cyclosporine, coagulants & anticoagulants, bone marrow suppressants as well as probenecid.

Abrupt stoppage of caffeine-containing products (such as DUOFLAM PLUS) is not advisable since it could cause withdrawal symptoms such as headache, anxiety, or muscle tension within 12 to 18 hours.

The adverse reactions due to ibuprofen (in DUOFLAM PLUS) include cardiovascular manifestations (tachycardia, flushing & increase in blood pressure), GI complaints (particularly epigastric discomfort, ulceration & perforation), skin changes, hypersensitivity reactions, renal affections, aphthous stomatitis, gingival ulcerations, vision abnormalities, change in hearing, epistaxis, pancreatitis, hepatitis and hematological disturbances.

Side effects of paracetamol (in DUOFLAM PLUS) are rare, and usually mild. Skin rashes and other hypersensitivity reactions could occur, and, on rare occasions, paracetamol could cause hematological changes.

Caffeine (in DUOFLAM PLUS) could cause digestive side effects, restlessness, nervousness, tremor, headache, lightheadedness, dry skin, rash, and kidney dysfunction. Larger doses can lead aggravate ulcers, cause frequent urination, flushing, twitch, irritability, clotting abnormalities leading to hemorrhage and acidosis.

Corticosteroids along with ibuprofen can enhance GI damage. Anticoagulants, heparin or thrombolytic agents are dangerous during DUOFLAM PLUS intake in view of ibuprofen's potential to cause GI ulceration / bleeding. Ibuprofen (in DUOFLAM PLUS) can increase the hypoglycemic action of oral antidiabetics and insulin. When given along with antihypertensives or agents with potential to suppress bone marrow (like some cephalosporins), ibuprofen can increase risk of edema and hematopoietic disturbances respectively. Ibuprofen (in DUOFLAM PLUS) can increase plasma concentrations of digoxin, cyclosporine, lithium and methotrexate.

Absorption of paracetamol from DUOFLAM PLUS is increased by concomitant metoclopramide, and such other agents. Probenecid can decrease it clearance and thereby increase paracetamol's plasma half-life when given along with DUOFLAM PLUS.