Diacerein; Uses, Dosage, Side Effects, Interactions, Pregnancy

Last updated: February 7, 2026Reviewed date: February 7, 2026Reading time: 5 min read

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Article Summary

Diacerein is a prodrug which is metabolized to rhein. It is currently approved in France for the treatment of osteoarthritis although the use of diacerein is restricted due to the side effects including severe diarrhea. Diacerein is under investigation for the treatment of Insulin Resistance, Diabetes Mellitus (Type 2), and Diabetes-Related Complications. Diacerein also is known as diacetylrhein, is a slow-acting medicine of the class anthraquinone used to treat joint diseases such as...

Key Takeaways

This article explains Mechanism of action of Diacerein in simple medical language.
This article explains Indications of Diacerein in simple medical language.
This article explains Contra-Indications of Diacerein in simple medical language.
This article explains Dosage of Diacerein in simple medical language.

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Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
New weakness, severe pain, high fever, or symptoms after a serious injury.
Any symptom that feels urgent, unusual, or unsafe for the patient.

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Definition

Diacerein is a prodrug which is metabolized to rhein. It is currently approved in France for the treatment of pain and stiffness. সহজ বাংলা: বয়স/ক্ষয়ের কারণে জয়েন্টের ব্যথা।" data-rx-term="osteoarthritis" data-rx-definition="Osteoarthritis is wear-and-tear joint disease causing pain and stiffness. সহজ বাংলা: বয়স/ক্ষয়ের কারণে জয়েন্টের ব্যথা।">osteoarthritis although the use of diacerein is restricted due to the side effects including severe diarrhea. Diacerein is under investigation for the treatment of Insulin Resistance, Diabetes Mellitus (Type 2), and Diabetes-Related Complications.

Diacerein also is known as diacetylrhein, is a slow-acting medicine of the class anthraquinone used to treat joint diseases such as pain and stiffness. সহজ বাংলা: বয়স/ক্ষয়ের কারণে জয়েন্টের ব্যথা।" data-rx-term="osteoarthritis" data-rx-definition="Osteoarthritis is wear-and-tear joint disease causing pain and stiffness. সহজ বাংলা: বয়স/ক্ষয়ের কারণে জয়েন্টের ব্যথা।">osteoarthritis (swelling and pain in the joints). It works by inhibiting interleukin-1 beta. An updated 2014 Cochrane review found diacerein had a small beneficial effect on pain. It is used to relieve pain and swelling associated with Osteoarthritis. This medicine is slow acting and is used as a long-term treatment option for osteoarthritis.

Mechanism of action of Diacerein

Diacerein’s active metabolite rhein reduces cartilage destruction by decreasing expression of matrix metalloproteinase (MMP)-1 and -3 as well as upregulating tissue inhibitor of matrix metalloproteinases which serve to reduce the activity of several MMPs.This compound belongs to the class of organic compounds known as anthracene carboxylic acids. These are organic compounds containing a carboxylic acid group attached to an anthracene ring system. The infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।" data-rx-term="anti-inflammatory" data-rx-definition="Anti-inflammatory means reducing inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।">anti-inflammatory action of rhein reduces the level of interleukin-1beta activity which plays a large role in the reduction of extracellular matrix production, MMP activity, and continued inflammation. Rhein reduces abnormal osteoblast synthetic activity through an unknown mechanism

Indications of Diacerein

For the treatment of osteoarthritis affecting the hip or knee .
Diacerein is a symptomatic slow acting drug in osteoarthritis.
Osteoarthritis
Cervical spondylosis
Backpain
Lumbergo
PLID
Fibromyelgia
Glaucoma
Weight loss
Degeneration of cartigage
Road Traffic accident,
Post oparetive joint injury
Interstitial cystitis, a bladder condition
Joint pain, such as knee pain
Multiple sclerosis (MS)

Contra-Indications of Diacerein

The patient should not take this medicine if he has hypersensitivity of Diacerein or any other active ingredient in the medicine

Dosage of Diacerein

The recommended starting dose is 50 mg once daily with the evening meal for the first 2 to 4 weeks of treatment, after which the recommended daily dose is 50mg twice daily. The treatment should be taken with food, one with breakfast and the other with the evening meal. The capsules must be swallowed intact, without opening them, together with a glass of water.

Diacerein’s dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
50 to 50 mg	50 (50)	12 hourly	PO	Take with food. If CrCl is less then 30ml/min then reduce the dose to 25mg per day.
Paedriatic Dosage (20kg)
No data regarding the Paedriatic dosage details of Diacerein is available.
Neonatal Dosage (3kg)
No data regarding the neonatal dosage details of Diacerein is available.

Side Effects of Diacerein

Diacerein may cause some unwanted effects too. In such cases, you must seek medical attention immediately.

Yellow colouration of urine
Diarrhea
Stomach discomfort and pain
Nausea ,Vomiting
Yellowing of skin and eyes
Intense yellow urine
Increase in liver enzyme levelsE
Allergic skin reaction

Observed in a small fraction of the population

Drug Interactions of Diacerein

Ask your doctor about whether diacerein is safe for you if you’re taking any of the following

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
Drugs that stop platelets from sticking together, such as clopidogrel and prasugrel
Blood thinners, such as warfarin, heparin,
Medications for depression like citalopram and venlafaxine
Cancer chemotherapy drugs, such as etoposide and doxorubicin
insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।" data-rx-term="diabetes" data-rx-definition="Diabetes is a condition where blood sugar stays too high because insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।">Diabetes medications, such as pioglitazone , rosiglitazone , and insulin

Pregnancy & Lactation of Diacerein

FDA pregnancy Category B

Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1^st trimester (and there is no evidence of a risk in later trimesters).

Pregnancy

The use of Diacerein is not recommended in women attempting to conceive. No clinical data on exposed pregnancies are available for Diacerein. The potential for human risk in pregnancy is unknown.

Lactation
Pharmacokinetics of Diacerein has not been studied in lactating women and its administration is not recommended.

References

Diacerein; Uses, Dosage, Side Effects, Interactions, Pregnancy

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

Write when the problem started and how it changed.
Bring old prescriptions, investigation reports, and current medicines.
Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

What is the most likely cause of my symptoms?
Which danger signs mean I should go to hospital quickly?
Which tests are necessary now, and which can wait?
How should I take medicines safely and what side effects should I watch for?
When should I come for follow-up?

Tests to discuss

Vital signs: temperature, pulse, blood pressure, oxygen saturation
Basic physical examination by a clinician
CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

Avoid heavy lifting, sudden bending, and prolonged bed rest.
Use comfortable posture and gentle movement as tolerated.
Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

Do not start antibiotics without a proper medical decision.
Do not use steroid tablets or injections casually for quick relief.
Do not delay emergency care because of home remedies.

Get urgent help if

Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.

Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider

Tests to discuss with doctor

Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
Relevant blood, urine, imaging, or specialist tests only after clinical assessment

Questions to ask

What is the most likely cause of my symptoms?
Which warning signs mean I should go to emergency care?
Which tests are really needed now?
Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Go to emergency care if you notice:

Severe or rapidly worsening symptoms
Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration

Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.

Step 1
Check danger signs first

If danger signs are present, seek emergency care and do not wait for online information.
Step 2
Record the symptom story

Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.
Step 3
Visit a qualified clinician

A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.
Step 4
Do only useful tests

Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.
Step 5
Follow up and return early if worse

If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips

Take a written symptom diary and all previous prescriptions/test reports.
Do not hide medicines already taken, even herbal or over-the-counter medicines.
Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

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