diclofenac (Topical route)
dye-KLOE-fen-ak
- CARDIOVASCULAR RISK
- NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.
- Diclofenac patch is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
- GASTROINTESTINAL RISK
- NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events .
NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Diclofenac patch is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs can also cause an increased risk of serious gastrointestinal adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal .
Oral routeTablet, Enteric CoatedTablet, Extended Release- CARDIOVASCULAR RISK
- Non steroidal anti-inflammatory drugs (NSAIDs) may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.
- Diclofenac is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
- GASTROINTESTINAL RISK
- NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events .
NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Diclofenac is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs can also cause an increased risk of serious gastrointestinal adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal .
Topical routeGel/Jelly- CARDIOVASCULAR RISK
- Non steroidal anti-inflammatory drugs (NSAIDs) may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.
- Diclofenac is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
- GASTROINTESTINAL RISK
- NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events .
NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Diclofenac is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs can also cause an increased risk of serious gastrointestinal adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal .
Oral routeTabletCapsule, Liquid Filled- CARDIOVASCULAR RISK
- NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk .
- Diclofenac potassium is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery .
- GASTROINTESTINAL RISK
- NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events .
NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Diclofenac is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs can also cause an increased risk of serious gastrointestinal adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal .
Oral routePowder for Solution- CARDIOVASCULAR RISK
- NSAIDs may increase the risk of serious cardiovascular (CV) thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk .
- Diclofenac potassium is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery .
- GASTROINTESTINAL RISK
- NSAIDs increase the risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events .
NSAIDs may increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Diclofenac potassium is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs can also cause an increased risk of serious gastrointestinal adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal .
Commonly used brand name(s):
In the U.S.
- Flector
- Solaraze
- Voltaren
Available Dosage Forms:
- Patch, Extended Release
- Gel/Jelly
Therapeutic Class: Analgesic
Pharmacologic Class: NSAID
Chemical Class: Acetic Acid (class)
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Uses For diclofenac
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and other symptoms of arthritis of the joints (osteoarthritis), such as inflammation, swelling, and stiffness. However, diclofenac does not cure osteoarthritis and will help you only as long as you continue to take it .
Diclofenac is also used to treat cancer by killing cancer cells. When applied to the skin, diclofenac may be used to treat actinic keratosis, a skin problem that may be cancer or may become cancerous if not treated. The exact way that topical diclofenac helps this condition is unknown.
diclofenac is available only with your doctor's prescription.
Before Using diclofenac
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For diclofenac, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to diclofenac or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies have not been performed on the relationship of age to the effects of diclofenac in the pediatric population. Safety and efficacy have not been established .
Geriatric
Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of diclofenac in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving diclofenac .
Pregnancy
| Pregnancy Category | Explanation |
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Breast Feeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Using diclofenac with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Ketorolac
Using diclofenac with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Ardeparin
- Beta Glucan
- Certoparin
- Dalteparin
- Danaparoid
- Enoxaparin
- Ginkgo
- Methotrexate
- Nadroparin
- Parnaparin
- Pemetrexed
- Reviparin
- Tacrolimus
- Tinzaparin
Using diclofenac with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acetohexamide
- Alacepril
- Amiloride
- Azosemide
- Bemetizide
- Benazepril
- Bendroflumethiazide
- Benzthiazide
- Bumetanide
- Buthiazide
- Candesartan Cilexetil
- Canrenoate
- Captopril
- Chlorothiazide
- Chlorpropamide
- Chlorthalidone
- Cilazapril
- Ciprofloxacin
- Citalopram
- Clopamide
- Clopidogrel
- Clovoxamine
- Cyclopenthiazide
- Cyclosporine
- Cyclothiazide
- Delapril
- Desvenlafaxine
- Duloxetine
- Enalaprilat
- Enalapril Maleate
- Eprosartan
- Escitalopram
- Ethacrynic Acid
- Femoxetine
- Flesinoxan
- Fluoxetine
- Fluvoxamine
- Fosinopril
- Furosemide
- Gliclazide
- Glimepiride
- Glipizide
- Gliquidone
- Glyburide
- Hydrochlorothiazide
- Hydroflumethiazide
- Imidapril
- Indapamide
- Irbesartan
- Lisinopril
- Lithium
- Losartan
- Methyclothiazide
- Metolazone
- Milnacipran
- Moexipril
- Nefazodone
- Olmesartan Medoxomil
- Paroxetine
- Pentopril
- Perindopril
- Piretanide
- Polythiazide
- Quinapril
- Quinethazone
- Ramipril
- Sertraline
- Spirapril
- Spironolactone
- Tasosartan
- Telmisartan
- Temocapril
- Tolazamide
- Tolbutamide
- Torsemide
- Trandolapril
- Triamterene
- Trichlormethiazide
- Valsartan
- Venlafaxine
- Xipamide
- Zimeldine
- Zofenopril
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of diclofenac. Make sure you tell your doctor if you have any other medical problems, especially:
- Anemia or
- Asthma or
- Bleeding problems or
- Blood clots or
- Edema (fluid retention or body swelling) or
- Heart attack, history of or
- Heart disease (e.g., congestive heart failure) or
- High blood pressure or
- Stomach or intestinal ulcers or bleeding or
- Stroke, history of—Use with caution. Diclofenac may make these conditions worse .
- Aspirin sensitivity, history of—diclofenac should not be used in patients with this condition .
- Heart surgery (e.g., coronary artery bypass graft [CABG] surgery)—diclofenac should not be used to relieve pain right before or after the surgery .
- Kidney disease or
- Liver disease—Effects of diclofenac may be increased because of slower removal of the medicine from the body.
Proper Use of diclofenac
Keep using diclofenac for the full time of treatment. However, do not use diclofenac more often or for a longer time than your doctor ordered. Apply enough medicine each time to cover the entire affected area.
Diclofenac may cause redness, soreness, scaling, and peeling of the affected skin. Do not stop using diclofenac without first checking with your doctor. If the reaction is very uncomfortable, check with your doctor.
diclofenac comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions .
Wash your hands before and after using diclofenac .
Apply diclofenac very carefully to clean, dry skin, and avoid getting any in your eyes, nose, or mouth. Do not apply diclofenac to areas with broken skin or open wounds, infection, or severely peeling skin .
Do not use heating pads or cover the treated area with a bandage unless your doctor has told you to. Do not use cosmetics (makeup or sunscreens) or other skin care products on the same skin areas where you have applied diclofenac .
After applying diclofenac, do not shower, bathe, or wash the affected area for at least one hour. Wait at least 10 minutes before covering the treated skin with gloves or clothing .
Dosing
The dose of diclofenac will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of diclofenac. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For topical dosage form (gel):
- For actinic keratosis:
- Adults—Apply to affected skin 2 times a day.
- Children—Use and dose must be determined by your doctor .
- For osteoarthritis of the hands, elbows, or wrists:
- Adults—Apply 2 grams to the affected skin areas 4 times a day (a total of 8 grams each day). However, the total dose should not exceed 32 grams per day over all affected joints.
- Children—Use and dose must be determined by your doctor .
- For osteoarthritis of the knees, ankles, or feet:
- Adults—Apply 4 grams to the affected skin areas 4 times a day (a total of 16 grams each day). However, the total dose should not exceed 32 grams per day over all affected joints.
- Children—Use and dose must be determined by your doctor .
- For actinic keratosis:
Missed Dose
If you miss a dose of diclofenac, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using diclofenac
It is very important that your doctor check your progress at regular visits to make sure that diclofenac is working properly and to check for unwanted effects.
diclofenac may raise your risk of having a heart attack or stroke. This is more likely in people who already have heart disease. People who use diclofenac for a long time might also have a higher risk .
diclofenac may cause bleeding in your stomach or intestines. These problems can happen without warning signs. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, if you are over 60 years old, if you are in poor health, or if you are using certain other medicines (a steroid or a blood thinner) .
Possible warning signs of some serious side effects that can occur during treatment with diclofenac may include swelling of the face, fingers, feet, and/or lower legs; severe stomach pain, black, tarry stools, and/or vomiting of blood or material that looks like coffee grounds; unusual weight gain; yellow skin or eyes; decreased urination; unusual bleeding or bruising; and/or blistering, peeling, or red skin rash. Also, signs of serious heart problems could occur such as chest pain, tightness in chest, fast or irregular heartbeat, unusual flushing or warmth of skin, weakness, or slurring of speech. Stop taking diclofenac and check with your doctor immediately if you notice any of these warning signs .
diclofenac may also cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur more often in patients who are allergic to aspirin or to any of the nonsteroidal anti-inflammatory drugs. Anaphylaxis requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in color of the skin of the face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; and puffiness or swelling of the eyelids or around the eyes. If these effects occur, get emergency help at once .
Using diclofenac while you are pregnant can harm your unborn baby. If you think you have become pregnant while using diclofenac, tell your doctor right away .
If your symptoms become worse, check with your doctor.
While using diclofenac, your skin may become more sensitive to sunlight than usual, and too much sunlight may increase the effects of the medicine. During this period of time:
- Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
- Wear protective clothing, including a hat and sunglasses.
- Do not use a sunlamp or tanning bed or booth.
- Make sure you have discussed the use of a sun block product with your doctor.
If you have a severe reaction from the sun, check with your doctor.
diclofenac Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
More common- Application site reactions, including skin rash, pain, tingling, or burning sensation
- flu-like syndrome (bodyache; headache; fever, with or without chills)
- itching skin
- Application site reactions, including swelling; increased skin sensitivity; or skin rash, itching, redness, or pain caused by reaction from exposure to sun
- blood in the urine
- cough
- decrease in body movement
- dry, itching, or burning eyes
- eye pain
- fever
- headaches, including migraines
- high blood pressure
- increased sensitivity of eyes to light
- infection
- nasal congestion
- pain or tenderness around eyes and cheekbones
- redness or swelling of eyes
- shortness of breath
- skin rash other than at the application site
- sore throat
- tightness in chest
- troubled breathing
- ulcers or sores on skin, other than at the application site
- wheezing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common- Burning skin
- dry skin
- red skin
- scaly skin
- thickened skin
- tingling skin
- Acne
- back pain
- belching
- bleeding skin
- chest pain
- diarrhea
- heartburn
- indigestion
- joint pain
- lack or loss of strength
- loss or thinning of hair
- muscle pain
- neck pain
- runny nose
- stomach upset or pain
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
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More diclofenac Topical resources
diclofenac topical Drug Interactions
Compare diclofenac Topical with other medications for the treatment of:
Osteoarthritis, Pain, Actinic Keratosis
