Generic Name: diclofenac (dye KLOE fen ak)
Brand Names: Cambia, Cataflam, Voltaren, Voltaren-XR, Zipsor, Zorvolex

What is Cambia?

Cambia (diclofenac) is a nonsteroidal anti-inflammatory drug (NSAID). Diclofenac works by reducing substances in the body that cause pain and inflammation.

Cambia is used to treat a migraine headache attacks, with or without aura, in adults 18 years of age and older. It is not used to prevent migraine headaches. Do not use Cambia to treat a cluster headache.

Cambia will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Diclofenac may also be used for purposes not listed in this medication guide.

Important information

You should not use Cambia if you have a history of allergic reaction to aspirin or NSAIDs (non-steroidal anti-inflammatory drugs).

Cambia may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Slideshow: Living with Your Migraines: Tips for Treatment and Prevention

Cambia may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking Cambia.

Before taking this medicine

You should not use Cambia if you have a history of allergic reaction to aspirin or NSAIDs (non-steroidal anti-inflammatory drugs).

Cambia may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Cambia may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking Cambia.

To make sure Cambia is safe for you, tell your doctor if you have:

  • heart disease, high blood pressure, or history of heart attack, stroke, or blood clot;

  • a history of stomach ulcers or bleeding;

  • liver or kidney disease,

  • asthma;

  • polyps in your nose;

  • a bleeding or blood clotting disorder; or

  • if you smoke.

FDA pregnancy category D. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking Cambia during the last 3 months of pregnancy may harm the unborn baby. Do not take Cambia during pregnancy unless your doctor has told you to.

See also: Pregnancy and breastfeeding warnings (in more detail)

It is not known whether diclofenac passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Do not give this medicine to a child younger than 18 years old without medical advice.

How should I take Cambia?

Take Cambia exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take diclofenac in larger or smaller amounts or for longer than recommended.

If you switch brands of diclofenac, your dose needs may change. Follow your doctor's instructions about how much medicine to take.

Dissolve the diclofenac powder (Cambia) with 1 to 2 ounces of water. Do not use any other type of liquid. Stir this mixture and drink all of it right away. Cambia works best if you take it on an empty stomach.

Call your doctor if your headache does not completely go away after taking Cambia. Do not take a second dose without your doctor's advice.

If you use Cambia long-term, your liver function will need to be checked with frequent blood tests. Visit your doctor regularly.

Store Cambia at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

Ask a doctor or pharmacist before using any cold, allergy, or pain medication. Many medicines available over the counter contain aspirin or other medicines similar to diclofenac. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid exposure to sunlight or tanning beds. Diclofenac can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Cambia side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Cambia: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Cambia and call your doctor at once if you have:

  • sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;

  • chest pain, sudden cough, wheezing, rapid breathing;

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • little or no urinating;

  • swelling, rapid weight gain;

  • nausea, upper stomach pain, itching, diarrhea, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • bruising, severe tingling, numbness, pain, muscle weakness;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • fever, neck stiffness, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions); or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Cambia side effects may include:

  • upset stomach, mild heartburn or stomach pain, bloating, gas;

  • mild diarrhea, constipation;

  • dizziness, mild headache;

  • mild skin rash; or

  • ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Cambia dosing information

Usual Adult Dose for Migraine:

For acute treatment of migraine without aura:

Cambia for oral solution packets: Mix one packet (50 mg) with 1 to 2 ounces (30 to 60 mL) water in a cup and drink immediately.

What other drugs will affect Cambia?

Ask your doctor before using Cambia if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Cambia, especially:

  • cyclosporine;

  • lithium;

  • methotrexate;

  • rifampin;

  • antifungal medication--fluconazole, voriconazole;

  • a blood thinner (warfarin, Coumadin);

  • a diuretic or "water pill";

  • heart or blood pressure medication--amiodarone, benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril; or

  • other NSAIDs--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with diclofenac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about Cambia.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Cambia only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 13.03. Revision Date: 2013-11-18, 4:19:13 PM.

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