diclofenac sodium suppository / Generic mfg. - LARVOL DELTA

Comparative Effectiveness of Rectal Indomethacin and Other Prophylactic Strategies for Post-ERCP Pancreatitis: A Systematic Review and Network Meta-Analysis (ACG 2026) - "Fourteen RCTs (3,913 patients; 338 PEP events) were included-5 PD stent, 5 indomethacin, and 4 diclofenac trials. Versus control, PD stenting (RR 0.32, 95% CI 0.16 - 0.63) and rectal diclofenac (RR 0.37, 0.18 - 0.78) each significantly reduced PEP, whereas rectal indomethacin did not (RR 0.63, 0.38 - 1.05). By P-score, PD stenting ranked highest (0.85), followed by diclofenac (0.75) and indomethacin (0.38)."

HEOR • Retrospective data • Review • Pancreatitis

Short-Term Safety of Rectal Indomethacin in Adults Aged 80 Years or Older Undergoing ERCP (ACG 2026) - "Patients receiving rectal indomethacin on the ERCP date and no peri-procedural rectal diclofenac were matched 1:1 to patients with no rectal indomethacin or diclofenac recorded from 1 day before through 1 day after ERCP... After matching, 2,948 indomethacin-exposed patients were compared with 2,948 patients without peri-procedural rectal indomethacin or diclofenac. Net AEs were similar (11.1% vs 11.0%; risk ratio [RR], 1.006; 95% CI, 0.871 to 1.163; P=0.9). Acute pancreatitis incidence did not differ statistically (1.4% vs 0.9%; RR, 1.538; 95% CI, 0.941 to 2.514; P=0.083)."

Clinical • Acute Kidney Injury • Gastroenterology • Nephrology • Pancreatitis • Renal Disease

Rectal Diclofenac Versus Indomethacin for Prevention of Post-ERCP Pancreatitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (ACG 2026) - "Two RCTs comprising 1,450 patients met inclusion criteria (724 diclofenac, 726 indomethacin). PEP occurred in 8.0% of patients receiving diclofenac and 6.1% receiving indomethacin. Diclofenac was not associated with reduced PEP risk compared with indomethacin (RR 1.32, 95% CI 0.91â1.93; I²=28.5%)."

Retrospective data • Review • Pancreatitis

TacroProph: Tacrolimus as Prophylaxis of Post-ERCP Pancreatitis (clinicaltrials.gov) - P4 | N=520 | Not yet recruiting | Sponsor: Amsterdam UMC, location VUmc

New P4 trial • Pancreatitis

Recovery quality after periumbilical infiltration with liposomal bupivacaine vs ropivacaine in gynecologic single-port laparoscopic surgery, a double blind randomized controlled trial. (PubMed, Eur J Obstet Gynecol Reprod Biol) - "In patients undergoing gynecologic single-port laparoscopic surgery within a multimodal analgesic regimen, umbilical infiltration with liposomal bupivacaine did not improve the quality of recovery at 48 h, postoperative pain scores, or opioid consumption compared to ropivacaine."

Clinical • Journal • Pain

Comparative Efficacy of Rectal Diclofenac and Rectal Indomethacin in Preventing Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Systematic Review. (PubMed, Cureus) - "The findings indicate that both rectal diclofenac and rectal indomethacin are effective prophylactic agents and significantly reduce the incidence of PEP. In conclusion, the available evidence supports the routine use of either rectal diclofenac or rectal indomethacin to prevent post-ERCP pancreatitis."

Journal • Review • Pancreatitis

Nebulized Dexmedetomidine or Lidocaine for Treatment of Post Dural Puncture Headache in Parturients Undergoing Elective Cesarean Section Under Spinal Anesthesia (clinicaltrials.gov) - P1 | N=114 | Completed | Sponsor: Minia University | Recruiting ➔ Completed

Trial completion • Anesthesia • Pain

Therapeutic ERCP is safe in patients above 80 years of age when Imaging, biochemical and symptomatic profile fulfils the criteria (BSG 2026) - "Median dose of midazolam and fentanyl administered were 1.25mg (IQ range 1-1.25), 25mcg (IQ range 25-37.5), respectively...97.8% of patients received rectal diclofenac...Conclusion Outcomes of this study indicate that ERCP is safe in this age group for sepsis and decompressing of the biliary system, when two out of three pre-requisition criteria are met and safe sedation practices are followed. When compared to national metrics there is no difference in complication rates in those over the age of 80."

Clinical • Biliary Cancer • Gastrointestinal Disorder • Hepatology • Infectious Disease • Pancreatitis • Septic Shock • Solid Tumor

Transpancreatic biliary sphincterotomy at ERCP for biliary access is safe and effective: a UK tertiary centre experience (BSG 2026) - "85/88 patients had per rectal diclofenac immediately prior to ERCP...Conclusions TPBS is an effective technique to achieve biliary cannulation when standard cannulation techniques fail. When combined with prophylactic PD stenting and pre-procedure per rectal NSAIDs, TPBS appears safe, with an acceptable rate of adverse events in a tertiary-centre setting."

Pancreatitis • Solid Tumor

Analgesic Efficacy of Shangdiao Music Combined with Diclofenac Sodium Suppositories after Mixed Haemorrhoid Surgery. (PubMed, Noise Health) - "The integration of Shangdiao music with diclofenac sodium suppositories remarkably enhances analgesia, accelerates the recovery of urinary/defecatory functions, mitigates negative psychological states and improves the quality of life of patients following mixed haemorrhoid surgery."

Journal • Retrospective data • CNS Disorders • Constipation • Depression • Gastroenterology • Gastrointestinal Disorder • Pain • Psychiatry

Comparison of Nebulized Neostigmine/Atropine Versus Lignocaine in Treating Acute Post-dural Puncture Headache Following Subarachnoid Block in Parturient Undergoing Elective Cesarean Section. A Randomized, Clinical Trial. (clinicaltrials.gov) - P1 | N=111 | Recruiting | Sponsor: Minia University | Not yet recruiting ➔ Recruiting

Enrollment open • Pain

Incidence of Complications and Parental Satisfaction Following Pain Relief Methods in Paediatric Herniotomy: Caudal Block Versus Pre-incisional Field Block and Diclofenac Suppository Approach. (PubMed, J West Afr Coll Surg) - "Both caudal block with plain bupivacaine and pre-incisional field block with plain bupivacaine plus diclofenac suppository showed comparable efficacy in the incidence of minimal complications. No parent was either dissatisfied or extremely dissatisfied with the techniques."

Clinical • Journal • Anesthesia • Hypotension • Pain • Pediatrics

Prophylactic use of rectal diclofenac in mitigating post endoscopic retrograde cholangiopancreatography pancreatitis risk and severity: low- vs high-dose efficacy and timing strategies— a meta-analysis. (PubMed, Med Glas (Zenica)) - "High-dose rectal diclofenac administered before ERCP procedure is effective in reducing the prevalence and severity of PEP, and is well tolerated with favourable safety profile."

Clinical • Journal • Retrospective data • Pancreatitis

Nebulized Dexmedetomidine or Lidocaine for Treatment of Post Dural Puncture Headache in Parturients Undergoing Elective Cesarean Section Under Spinal Anesthesia (clinicaltrials.gov) - P1 | N=114 | Recruiting | Sponsor: Minia University | Trial completion date: Oct 2026 ➔ Jun 2026 | Trial primary completion date: Oct 2026 ➔ Jun 2026

Trial completion date • Trial primary completion date • Anesthesia • Pain

Nebulized Dexmedetomidine or Lidocaine for Treatment of Post Dural Puncture Headache in Parturients Undergoing Elective Cesarean Section Under Spinal Anesthesia (clinicaltrials.gov) - P1 | N=114 | Recruiting | Sponsor: Minia University | Not yet recruiting ➔ Recruiting | Trial completion date: Oct 2025 ➔ Oct 2026 | Trial primary completion date: Oct 2025 ➔ Oct 2026

Enrollment open • Trial completion date • Trial primary completion date • Anesthesia • Pain

Risk Factors for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis in Patients With Post-Endoscopic Sphincterotomy Papillae. (PubMed, DEN Open) - "Prophylactic rectal diclofenac or intravenous nafamostat mesilate was administered at the operator's discretion. The effectiveness of pharmacologic prophylaxis may differ from that in treatment-naïve papillae and warrants prospective evaluation. N/A."

Journal • Hepatology • Pancreatitis

Comparative Clinical Study to Evaluate the Possible Efficacy and Safety of Oral N-Acetyl Cysteine Versus Rectal Diclofenac in the Prevention of Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis (clinicaltrials.gov) - P1/2 | N=46 | Completed | Sponsor: Tanta University | Recruiting ➔ Completed

Trial completion • Pancreatitis

Intramuscular Versus Rectal Diclofenac for Pain Relief After Cesarean Section in Women (clinicaltrials.gov) - P4 | N=60 | Completed | Sponsor: CMH Multan Institute of Medical Sciences

New P4 trial • Pain

Comparison of topical diltiazem, diclofenac suppository and periprostatic nerve block with periprostatic nerve block alone for pain control during transrectal ultrasonography-guided prostate biopsy: An RCT (EAU 2026) - No abstract available

Biopsy • Pain

Comparison of oral versus rectal NSAIDs for perioperative analgesia in pediatric circumcision using a disposable circumcision suture device: a randomized controlled trial. (PubMed, BMC Anesthesiol) - "Rectal diclofenac sodium suppositories are an effective and well-tolerated option for perioperative analgesia in pediatric circumcision using DCSD, providing improved comfort, sleep quality, and caregiver satisfaction compared to oral ibuprofen. However, due to the study's single-center design, short follow-up period, and the use of different NSAIDs between groups, the results should be interpreted with caution. Larger multicenter trials are necessary to confirm these findings and inform broader clinical application."

Journal • Anesthesia • Pain • Pediatrics

Rectal Diclofenac Versus Indomethacin in Preventing Post-ERCP Pancreatitis: A Systematic Review and Meta-Analysis. (PubMed, Dig Dis Sci) - "Diclofenac and indomethacin demonstrate equivalent efficacy and safety, allowing cost and availability to inform the choice of PEP prophylaxis."

Journal • Retrospective data • Review • Pancreatitis

Precise Endoscopic Application of Nitroglycerin in Preventing Post-ERCP Pancreatitis (clinicaltrials.gov) - P4 | N=440 | Recruiting | Sponsor: National Cheng-Kung University Hospital | Not yet recruiting ➔ Recruiting

Enrollment open • Pancreatitis

Comparison of Rectal Indomethacin and Diclofenac for post ERCP Pancreatitis Prophylaxis: A Single Center Study. (PubMed, Clin Res Hepatol Gastroenterol) - "This study suggests that rectal diclofenac may offer a slight advantage over indomethacin in preventing PEP, particularly in high-risk groups, such as patients undergoing sphincterotomy; which was not previously published in the existing literature."

Journal • Pancreatitis

Ultrasound-Guided Transversus Abdominis Plane Block with Dexmedetomidine Combined with Ropivacaine Plus Diclofenac Sodium Suppository for Post-Cesarean Section Analgesia: A Non-Inferiority Randomized Controlled Trial (ChiCTR) - P=N/A | N=120 | Not yet recruiting | Sponsor: Hanzhong Central Hospital; Hanzhong Central Hospital

Head-to-Head • New trial • Pain

Effectiveness of Rectal Versus Oral Diclofenac for Perineal Pain Relief following Episiotomy Repair at a Tertiary Hospital in Port Harcourt, Nigeria: A randomized controlled study. (PubMed, Niger Med J) - "The mean time interval (hours) between drug administration and the first urine void was similar in both groups (3.19±3.13 vs. 3.29±3.11, t=0.29, p=0.74), and there was no difference in the requirement for additional analgesia (12.1% vs. 9.1%, χ2=0.32, p=0.57). Diclofenac suppository was more effective in management of perineal pain following episiotomy repair and the participants in the rectal route group expressed more satisfaction than their counterparts who received the oral drug."

Journal • Pain