GENERIC NAME: Diclofenac

COMMON BRANDS: Cataflam, Voltaren, Dyloject, Cambia, Zipsor, Zorvolex

Diclofenac is a prescription drug and over-the-counter. It is from the class of drugs known as a Non-steroidal anti-inflammatory (NSAID). Like other NSAID the exact mechanism of action of the drug is not clear it may Inhibit cyclooxygenase (COX-1 and COX-2), thereby inhibiting prostaglandin synthesis. Diclofenac is available in its generic form. Generic drugs usually cost less. In some cases, the drug might not be available in every strength or form as the brand. Consult your doctor/physician to see if the generic will work for you.

What are the uses of Diclofenac?

This drug is used to relieve pain associated with conditions such as Gout, Rheumatoid Arthritis, Migraine, sprains of muscles and joints and in some case to treat mild to moderate fever.

If you are using for a chronic condition like arthritis, consult your doctor/physician about non-drug treatment or using other medications for treating your pain and swelling (inflammation). See also Warning section.

How to use Diclofenac?

Read the Medication Guide carefully provided by your pharmacist before you taking diclofenac and whenever you get a refill. If you have any query, ask your doctor/physician/pharmacist.

Take this medication orally with a full glass of water (8 ounces/240 ml) unless your doctor/physician directs you otherwise. Do not lie down immediately just after taking this drug, wait at least for 10 minutes. If you feel stomach upset with this medication, you may take it along with milk, food, or an antacid. However, this may slow down the absorption of drug and delay pain relief, mainly if you are not using this drug regularly.

Swallow this medication whole. Do not crush/chew/break the tablets, doing so can destroy the special coating on the tablet and may increase the side effects.

The dose of the drug depends on your medical condition, response to treatment, and other medications you may be using. Ensure to inform your doctor/physician/pharmacist about all the products you use (prescription drugs, nonprescription drugs, and herbal products). To minimize the risk of side effects (like stomach bleeding), take this medication at lowe dose for the shorter duration. Do not change/increase your dose or use it more frequently than prescribed. For chronic conditions like arthritis, continue taking it as directed by your doctor/physician. Seek advice regarding the risks and benefits from your doctor/physician/pharmacist.

For certain conditions (like arthritis), it may take up to 2 weeks to get the full benefit, if this drug is taken regularly.

If you are using this drug on “as needed” basis (not on a regular basis), use on the occurrence of the first sign of pain, as the pain medications work best if they are used immediately on the first onset of pain. If you use this drug after the pain has worsened, the medicine may not work well. Inform your doctor/physician if your condition worsens.

What are the side effects of Diclofenac?

See also Warning section.

Nausea, heartburn, stomach upset, diarrhea, constipation, gas, headache, drowsiness, and dizziness may happen. If any of these effects remain or worsen, inform your doctor/physician/pharmacist promptly.

Remember that your doctor/physician has prescribed this medicine because your doctor/physician has found that the benefits are higher than the risk of side effects. Several people using this medication do not have severe side effects.

This medication may increase your blood pressure. Monitor your blood pressure frequently and inform your doctor/physician if the results are high.

Inform your doctor/physician right away if any of these strange but severe side effects occur such as hearing changes (like ringing in the ears), mental/mood changes, difficult/painful swallowing, symptoms of heart failure (like swelling ankles/feet, unusual/sudden weight gain, unusual tiredness).

Seek medical assistance right away if any of these rare but very severe side effects occur such as signs of kidney problems (like a change in the amount of urine), unexplained stiff neck.

This drug very rarely causes a serious (possibly fatal) liver disease. Get medical help promptly if you have any symptoms of liver damage, like persistent nausea/vomiting/loss of appetite, stomach/abdominal pain, dark urine, yellowing eyes or skin.

A severe allergic reaction to this drug is uncommon. However, get medical assistance immediately if you observe any symptoms of a severe allergic reaction such as rash, itching/swelling (especially of the face/tongue/throat), trouble breathing, severe dizziness.

This is not a full record of all possible side effects. If you mark other effects not listed above, contact your doctor/physician or pharmacist.

What are the precautions while using Diclofenac?

See also Warning section.

Before using diclofenac, inform your doctor/physician/pharmacist if you are allergic to it or aspirin or other NSAIDs (like ibuprofen, naproxen, celecoxib) or if you have any other allergies. This product may contain inactive ingredients, that may cause allergic reactions or other problems. Discuss with your pharmacist for further details.

Before using this medication, inform your doctor/physician/pharmacist about your medical history, especially of asthma (like a history of worsening breathing after taking aspirin or other NSAIDs), bleeding or clotting problems, heart disease (like previous heart attack), high blood pressure, liver disease, growths in the nose (nasal polyps), stomach/intestinal/esophagus problems (like bleeding, ulcers, recurring heartburn), stroke.

Sometimes kidney problems can occur with the use of NSAID medications, including diclofenac. Problems are more likely to happen if you are dehydrated, have kidney disease or heart failure, are an older adult, or if you use certain medications (see also Drug Interactions section). Take plenty of fluids as directed by your doctor/physician to prevent dehydration and inform your doctor/physician right away if you observe the change in the amount of urine.

This drug can cause stomach bleeding. Regular use of alcohol and tobacco, especially when combined with this drug, may raise your risk for stomach bleeding. Avoid alcohol and stop smoking. Consult your doctor/physician/pharmacist for further information.

This medication may make you sensitive to the sun. Avoid sun exposure and tanning booths and sunlamps. Wear sunscreen and protective clothing when outdoors. Inform your doctor/physician right away if you get sunburned or have skin blisters/redness.

Older adults are more sensitive to the side effects of this drug, especially stomach/intestinal bleeding, kidney problems, and worsening heart problems.

Before taking this drug, women of childbearing age should discuss with their doctor’s about the benefits and risks (like miscarriage, trouble in getting pregnant). Inform your doctor/physician if you are pregnant or if you are planning a pregnancy. In pregnancy, this medication should be used only when needed. It is not recommended to use this medicine during the first and last three months of pregnancy as it may harm fetus and interference with normal labour/delivery.

This drug may pass into breast milk. As far as there are no reports of harm to nursing infants, check with your doctor/physician before breastfeeding.

What are the drug Interactions of Diclofenac?

Drug interactions may alter how your drug works or may enhance your risk for serious side effects. This list does not consist of all possible drug interactions. Keep a record of all the products you are using including prescription/nonprescription drugs and herbal products and inform your doctor/ pharmacist. Don’t start, stop, or alter the dosage of any medicines without your doctor’s consent.

Some products may interact with this drug such as aliskiren, ACE inhibitors (like captopril, lisinopril), angiotensin II receptor blockers (like valsartan, losartan), corticosteroids (like prednisone), cidofovir, lithium, methotrexate, “water pills” (diuretics like furosemide).

This medication may enhance the risk of bleeding when taken with other drugs that can also cause bleeding. For example anti-platelet drugs like clopidogrel, “blood thinners” like dabigatran/enoxaparin/warfarin, among others.

Read all prescription and nonprescription drugs labels carefully as many medicines contain pain relievers/fever reducers (NSAIDs like celecoxib, ibuprofen, ketorolac and aspirin). These drugs related to diclofenac and may increase the risk of side effects if taken along with this drug. However, if your doctor/physician has instructed to take low-dose of aspirin to prevent heart attack or stroke (usually at a dose of 81-325 mg/day), you should continue taking the aspirin unless your doctor/physician advises you otherwise. Discuss with your doctor/physician/pharmacist for more details.

WARNINGS:

Diclofenac and all other NSAIDs can increase the risk of heart attack, heart failure, or stroke. The risk of heart disease might be higher if you use diclofenac for a longer duration or at high doses. You are more prone to this side effect if you have heart disease or conditions like high blood pressure and diabetes.  Inform your doctor about your heart disease, before taking diclofenac. Do not take diclofenac before surgery, especially before heart bypass surgery. Inform to your doctor if you use diclofenac and will have surgery soon. NSAIDs such as diclofenac can increase your risk of severe side effects, including stomach bleeding or ulcers.

Stop taking diclofenac and get medical assistance right away if you notice any of the following rare but severe side effects like bloody or black stools, continue stomach/abdominal pain, vomit that looks like coffee grounds, chest pain radiating to left arm/jaw, breathlessness, weakness on one side of the body,  unusual sweating, slurred speech, sudden vision changes.

Discuss with your doctor/pharmacist about the risks and benefits of this drug.

What are the forms and strengths for Diclofenac?

Brand: Cataflam
Form: Tablet as potassium
Strengths: 50mg

Form: Tablet delayed release as sodium
Strengths: 25mg, 50mg, 75mg

Brand: Voltaren XR
Form: Tablet, extended-release
Strengths: 100mg

Brand: Zorvolex
Form: Capsule
Strengths: 18mg

Brand: Zipsor
Form: Capsule
Strengths: 25mg

Brand: Zorvolex
Form: Capsule
Strengths: 35mg

Brand: Cambia
Form: Powder packet for oral solution
Strengths: 50mg packet

Brand: Dyloject
Form: Solution for IV injection
Strengths: 37.5mg/mL

What is the dosage of Diclofenac?

For Rheumatoid Arthritis:

Adults (18 to 64 years):

Diclofenac potassium: 50mg orally every 8-12 hour.
Diclofenac sodium: 50mg orally every 8hr or 75mg orally every 12 hours.
Extended-release: 100mg orally once per day; may be increased to 100mg orally every 12 hours.

For Osteoarthritis:

Diclofenac potassium: 50mg orally every 8-12 hour.
Diclofenac sodium: 50mg orally every 8hr or 75mg orally every 12 hours.
Extended-release: 100mg orally once daily; may be increased to 100mg orally every 12 hours.
Zorvolex: 35mg orally 3 times daily.

For Ankylosing Spondylitis:

Diclofenac sodium: 25mg orally 4 or 5 times daily.
Diclofenac potassium: 50mg orally every 12 hours.

For Dysmenorrhea:

Cataflam (Immediate-release): 100mg orally once, then 50mg orally every 8 hours as needed.

For mild to moderate for acute pain:

Cataflam (Immediate-release tab): 100mg orally once, then 50 mg orally every 8 hours as needed.

Zipsor: 25mg orally 4 times daily as needed.

Zorvolex: 18mg or 35mg orally 3 times daily.

For Pain (IV administration):

Indicated for management of mild to moderate pain and moderate to severe pain alone or in combination with opioid analgesics.
37.5mg IV bolus injection infused over 15 seconds every 6hr as needed, not to exceed 150mg/day.
To avoid the risk of renal adverse reactions, patients must be well hydrated before IV administration

For Acute Migraine:

Not for prophylaxis.

Oral solution: 50mg (1 packet) in 30-60mL of water, mixed well and take right away.

Pediatric:

Children (3-16 years)

Juvenile Idiopathic arthritis (Off-label)
Safety and efficacy not established although the drug is used safely in a limited number of children (3-16 years) with juvenile rheumatoid arthritis.

Children (below 3 years):

Safety and efficacy have not been established and above 3 years dose of 2-3mg/kg/day for up to 4 weeks.

Note:

Take with food or 8-12oz of water to avoid GI adverse effects.

Zorvolex: Take on the empty stomach as food decreases its absorption.

Oral solution: Use only water to reconstitute; foods decrease the effectiveness.

Disclaimer

TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.