Trypsin (48mg) + Bromelain (90mg) + Rutoside (100mg) + Diclofenac (50mg) (Medical Monograph)

Overview

A fixed-dose combination (FDC) of proteolytic enzymes (Trypsin and Bromelain), a bioflavonoid (Rutoside), and a non-steroidal anti-inflammatory drug (NSAID - Diclofenac). This combination is primarily used in India for the management of acute inflammatory conditions, post-operative/traumatic edema, and pain. The enzymes and rutoside are believed to enhance the anti-inflammatory and anti-edema effects of diclofenac, potentially allowing for lower NSAID doses and improved tissue permeability.

Diclofenac provides primary analgesic and anti-inflammatory action via non-selective inhibition of cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis. Trypsin and Bromelain are proteolytic enzymes that may reduce edema by breaking down inflammatory mediators (bradykinin, fibrin), improving microcirculation, and facilitating tissue drainage. Rutoside (a flavonoid) is thought to reduce capillary fragility and permeability through antioxidant activity and inhibition of hyaluronidase, potentially stabilizing capillary walls and reducing swelling. The combination aims for a multi-targeted approach to inflammation, pain, and edema.