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Diclofenac

 

1. Generic Name & Brand Names

  • Generic Name: Diclofenac

  • Common Brand Names (Varies Globally):

    • Oral: Voltaren® (SR/tablets), Cataflam® (immediate-release)

    • Topical: Voltaren® Emulgel/Ge (gel), Pennsaid® (liquid solution), Flector® (patch)

    • Injectable: Dyloject® (IV), generic formulations

    • Generic/Store Brands: Diclofenac Sodium/Potassium (e.g., Zorvolex®, Cambia®)

2. Dosage Forms

  • Tablets (Immediate/Sustained-Release)

  • Capsules

  • Topical Gel/Cream (1% OTC; higher Rx)

  • Transdermal Patch

  • Liquid Solution (for topical or oral use)

  • Suppositories

  • Intravenous/Intramuscular Injection (hospital use)

  • Powder for Oral Solution (e.g., Cambia®)

3. Drug Class

  • NSAID (Non-Steroidal Anti-Inflammatory Drug)

  • Analgesic (Pain Reliever)

  • Anti-inflammatory

  • Antipyretic (Fever Reducer)

4. Uses

  • Inflammatory Pain: Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis.

  • Acute Pain: Migraines (oral powder), dental/surgical pain, menstrual cramps (primary dysmenorrhea).

  • Localized Pain: Sprains, strains (via topical gel/patch).

  • Gout Flare-Ups (short-term use).

5. Side Effects

  • Common:

    • Stomach upset, heartburn, nausea

    • Diarrhea/constipation

    • Dizziness, headache

    • Mild skin irritation (topical use)

  • Serious (Seek Immediate Help):

    • GI Bleeding/Ulcers: Black stools, vomit with blood/coffee grounds.

    • Heart Attack/Stroke: Chest pain, sudden weakness/slurred speech (↑ risk with long-term/high-dose use).

    • Kidney Damage: Swollen ankles, reduced urine output, fatigue.

    • Severe Allergic Reactions: Rash, blisters (SJS/TEN), throat swelling, wheezing.

    • Liver Toxicity: Jaundice (yellow skin/eyes), dark urine.

    • Hypertension (High Blood Pressure).

6. Warnings Before Taking

  • Black Box Warning (USA): ↑ Risk of cardiovascular events (heart attack/stroke) and GI bleeding/ulcers.

  • Contraindications:

    • Allergy to NSAIDs/aspirin.

    • History of asthma/urticaria after NSAIDs.

    • Coronary artery bypass graft (CABG) surgery pain.

    • 3rd trimester pregnancy.

  • Use with Extreme Caution If:

    • History of heart/kidney/liver disease, ulcers, IBD, or stroke.

    • Over 65 years old.

    • Taking blood thinners (warfarin), SSRIs (e.g., fluoxetine), or steroids.

  • Pregnancy: Avoid in 3rd trimester; consult doctor in 1st/2nd trimesters.

7. How to Take It

  • Oral: Take with food/milk. Swallow whole (do not crush SR tablets).

  • Topical Gel: Apply thin layer to clean skin (4x daily max); avoid bandaging. Wash hands after.

  • Patch: Apply once daily to dry, intact skin.

  • Dosing (Adults):

    • Oral: 50mg 2–3x daily (max 150mg/day) for pain/inflammation.

    • Topical (OTC gel): 4g per joint (e.g., knee) up to 4x daily.

  • Never exceed prescribed dose!

8. Uses in Adults

  • Short-term pain (e.g., sprains, dental pain).

  • Chronic inflammatory conditions (e.g., arthritis) under strict medical supervision.

9. Missed Dose

  • Scheduled Dosing: Skip if close to next dose. Never double dose.

  • As-Needed Use: Take when required (wait ≥4–6 hours between doses).

10. Overdose Symptoms & Action

  • Symptoms: Severe vomiting, stomach pain, drowsiness, seizures, kidney failure.

  • Emergency: Call poison control (1-800-222-1222) or seek ER immediately.

11. Avoid While Taking

  • Other NSAIDs: Ibuprofen, naproxen, aspirin (↑ bleeding/ulcer risk).

  • Alcohol: ↑ GI bleeding risk.

  • ACE Inhibitors/Diuretics: May reduce kidney function (e.g., lisinopril, furosemide).

  • Lithium/Methotrexate: Diclofenac ↑ toxicity risk.

12. Storage

  • Oral/Suppositories: Room temperature (20–25°C); avoid moisture.

  • Topical Gel/Patches: Below 30°C; do not freeze.

  • Keep all forms away from children/pets.

Critical Safety Notes:

⚠️ Cardiovascular Risk: Higher than some NSAIDs; avoid in heart disease/uncontrolled hypertension.
⚠️ Topical vs. Systemic: Gel/patch have lower systemic absorption but never combine with oral diclofenac/other NSAIDs.
⚠️ Short-Term Use: Minimize dose/duration to reduce risks (especially for chronic conditions).

Consult your doctor/pharmacist before use—especially if you have existing health conditions or take other medications.

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