What is diclofenac?
Diclofenac is an analgesic and anti-inflammatory medicine that belongs to the drug class called nonsteroidal anti-inflammatory drugs. Different types of pain such as dental pain, muscle pain associated with injury or surgery, and migraine can be treated by diclofenac. Redness and swelling caused by injury can also be eased by this drug by blocking the process of inflammation.
Diclofenac is a type of pain reliever that is available as an over-the-counter and prescription medication. Some of its common brands are Cataflam (diclofenac potassium), Cambia (diclofenac potassium), Zipsor (diclofenac potassium), Voltaren (diclofenac sodium), and Zorvolex. This medication is often used for the treatment of pain, swelling, and stiffness that are associated with rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis.
Before using this medicine, the following must be considered:
- Tell your doctor if you have heart disease and hypertension (high blood pressure), including kidney or liver problems.
- Inform your healthcare provider if you have asthma, certain allergies to dyes, foods, or preservatives, or if you have had an allergic reaction to this medicine or any of its ingredients.
- Extra caution may be required when this medication is used by elderly patients since they are more susceptible to developing age-related gastrointestinal and kidney problems.
- Check with your doctor if you are considering taking diclofenac during pregnancy and breastfeeding. Diclofenac should not be taken after the 29th week of pregnancy.
- Anyone who is younger than 18 years old should not take diclofenac.
The dosage of diclofenac may also depend on its specific brand as different brands have different uses and amounts. For this reason, your dosage needs to be adjusted if you switch to other diclofenac brands.
Always follow your healthcare provider's instructions on how to take this medicine. Your doctor may also change your dosage according to the brand you are using to get the best results.
Do not take diclofenac in larger dosages or for a longer duration than recommended. The lowest effective dose must be initially used for the treatment of your condition.
Zorvolex should be taken on an empty stomach at least an hour before or two hours after your meal. Cambia is also more effective when it is taken on an empty stomach. Add Cambia powder to 2 ounces of water. Stir the mixture and drink it right away. Only use water and not other types of liquid when dissolving the powder.
If your headache is not completely relieved after taking Cambia, inform your doctor. It is very important not to take another dose of Cambia without your healthcare provider's advice. Headaches may get worse if migraine headache medications are overused.
Frequent medical tests may also be required if you take diclofenac for a longer duration.
Before using diclofenac and other treatment options, potential benefits and risks must be carefully considered. The lowest effective dose with the shortest duration should be used according to the each patient's required treatment. After the initial dose, the frequency and dosage of this medicine may be adjusted according to the patient's needs.
- For osteoarthritis: Diclofenac may be given 2-3 times a day at 100-150 mg per day in divided doses.
- For rheumatoid arthritis: Given 2-3 or 4 times a day at 150-200 mg per day in divided doses.
- For ankylosing spondylitis: May be administered four times a day at 25 mg with another 25-mg dose before bedtime as needed.
- For migraine: 50-mg oral solution packet of diclofenac potassium taken once a day. (Note: Diclofenac is not meant for migraine (with or without aura) prophylactic therapy or for cluster headaches.)
- For pain: 50-mg diclofenac potassium immediate-release tablets orally given three times a day with an initial dose of 100 mg followed by 50-mg doses. Liquid-filled capsules of diclofenac potassium are orally taken four times a day at 25 mg, while the free acid capsules are orally taken three times a day at 18 mg.
The more common side effects of diclofenac include:
- Weakness or tiredness
- Abdominal pain, bloating, or cramping
- Loss of appetite
- Weight loss
- Feeling of indigestion
- Constipation or diarrhea
- Black, bloody, or tarry stools
- Low urine output
- Cloudy urine
- Coffee ground vomitus (vomit that looks bloody or similar to coffee grounds)
- Pale skin
- Unusual bruising or bleeding
- Prolonged bleeding time
- Itchy skin
- Skin rash
- Difficulty breathing
- Chest pain just below the breastbone
Symptoms of Overdose
Seek immediate medical help if any of the following overdose symptoms occur:
- Unusual drowsiness
- Difficulty sleeping
- Fast or slow heartbeat
- Chest tightness
- Irregular breathing
- Difficulty breathing
- Discomfort or pain in the upper abdominal region, chest, or throat
- Irritability or hostility
- A shift in consciousness
- Blurred vision
- Unable to clearly identify colors, particularly yellow or blue
- Swelling of the face, hands, or ankles
- Muscle twitching
- Rapid weight gain
- Cyanosis (blue skin or lips)
Nonsteroidal anti-inflammatory drugs (NSAIDs) can also cause an increased risk of fatal events, such as stroke and myocardial infarction. Other adverse reactions to this medication include:
- Heart failure
- Serious dermatologic (skin) reactions
- Anaphylactic reactions
- Gastrointestinal bleeding, perforation, and ulceration
- Drug-induced liver damage
- Nephrotoxicity or renal toxicity
- Hematologic Toxicity
Older adults with a previous history of gastrointestinal (GI) bleeding or peptic ulcer disease have an increased risk of fatal GI events.
When nonsteroidal anti-inflammatory drugs such as diclofenac are taken along with antidepressants, easy bruising or bleeding may occur. Before using diclofenac, make sure to inform your healthcare provider if you are taking antidepressants, such as:
The following drugs may also interact with diclofenac. Inform your doctor of all the current medications you are taking, including your past medications.
- Other forms of diclofenac (Voltaren Gel, Pennsaid topical solution, Flector patch, or Solaraze Gel)
- Other NSAIDs such as naproxen (Aleve), ibuprofen (Motrin, Advil), celecoxib (Celebrex), aspirin, meloxicam, and indomethacin, among others.
- Steroid medications (prednisone)
- Blood thinners such as Coumadin, warfarin, or Jantoven
- Antifungal medications
- Blood pressure medications
- Heart disease medications
- Diuretics or water pills
The Bottom Line
Diclofenac is a potent medication used for pain relief. However, this medication is also associated with serious gastrointestinal side effects along with an increased risk of cardiovascular events, such as stroke and heart attack.