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DICLOFENAC TABLETS 25MG

Active substance: DICLOFENAC SODIUM

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Sandoz Ltd
Diclofenac 25 & 50mg Tablets

Page 1
PL 04416/0361 & 0362

Package leaflet: Information for the user
Diclofenac® Tablets 25 and 50 mg
(diclofenac sodium)
Please read this leaflet carefully before you start to take your medicine. It contains
important information.
• Keep the leaflet in a safe place because you may want to read it again.
• If you have any other questions, or if there is something you don’t understand, please
ask your doctor or pharmacist.
• This medicine has been prescribed for you. Never give it to someone else. It may not be
the right medicine for them even if their symptoms seem to be the same as yours.
• If any of the side effects gets serious, or if you notice any side effects not listed in this
leaflet, please tell your doctor or pharmacist.
In this leaflet:
1. What Diclofenac Tablets are and what they are used for
2. Before you take Diclofenac Tablets
3. How to take Diclofenac Tablets
4. Possible side effects
5. How to store Diclofenac Tablets
6. Further Information

1. What Diclofenac Tablets are and what they are used for
Diclofenac sodium, the active ingredient in Diclofenac Tablets, is one of a group of
medicines called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce pain
and inflammation.
• Diclofenac Tablets relieve pain, reduce swelling and ease inflammation in a wide range
of conditions:
- Rheumatoid arthritis, osteoarthritis, acute gout, ankylosing spondylitis.
- Backache, sprains and strains, soft tissue sports injuries, frozen shoulder, dislocations
and fractures.
- Tendonitis, tenosynovitis, bursitis.
• They are also used to treat pain and inflammation associated with orthopaedic (bone
and joint surgery), dental and minor surgery

2. Before you take Diclofenac Tablets
DO NOT take Diclofenac Tablets. Talk to your doctor if you:
• are allergic to diclofenac sodium, aspirin, ibuprofen or any other NSAID, or to any
of the other ingredients of Diclofenac Tablets. (These are listed at the end of the
leaflet). Signs of an allergic reaction include swelling of the face and mouth
(angioedema), breathing problems, runny nose, skin rash or any other allergic type
reaction.

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Sandoz Ltd
Diclofenac 25 & 50mg Tablets

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• have ever had a stomach (gastric) or duodenal (peptic) ulcer, or bleeding in the
digestive tract (this can include blood in vomit, bleeding when emptying bowels, fresh
blood in faeces or black, tarry faeces).
• have established heart disease and /or cerebrovascular disease e.g. if you have had a
heart attack, stroke, mini-stroke (TIA) or blockages to blood vessels to the heart or brain
or an operation to clear or bypass blockages.
• have or have had problems with your blood circulation (peripheral arterial disease).
• have had stomach or bowel problems after you have taken other NSAIDs.
• have severe heart, kidney or liver failure.
• are more than six months pregnant.
• are having an acute attack of porphyria.
Talk to your doctor before taking Diclofenac Tablets if any of the following apply to
you:
• any stomach or bowel disorders including ulcerative colitis or Crohn's disease.
• kidney or liver problems or you are elderly.
• a condition called porphyria.
• any blood or bleeding disorder. If you do, your doctor may ask you to go for regular
check-ups while you are taking these tablets.
• asthma, allergic rhinitis (including hay fever), nasal polyps (swelling or lumps in your
nose), problems with your lungs including a long-term chest infection or had an allergic
reaction to anything.
• angina, blood clots, high blood pressure, raised cholesterol or raised triglycerides.
• heart problems or have had a stroke or you think you might be at risk of these
conditions (for example, if you have high blood pressure, diabetes, high cholesterol or
you are a smoker).
• you smoke.
• you have diabetes.
• Lupus (SLE) or any similar condition.
• an inherited intolerance to some sugars such as lactose. (Diclofenac Tablets contain a
small amount of lactose).
If you can say ‘yes’ to any of the above, ask your doctor or pharmacist for advice
before taking this medicine. It may not be suitable for you or you may need to take
special care when taking it.
Taking other medicines
Always tell your doctor or pharmacist about all the medicines you are taking. This means
medicines you have bought yourself, including herbal remedies, as well as medicines on
prescription from your doctor.
There may be problems if you take Diclofenac Tablets with certain other medicines.
Tell your doctor or pharmacist if you are taking any of the following:
• Medicines to treat diabetes.
• Medicines that affect blood clotting (eg anticoagulants to ‘thin’ your blood such as
warfarin or anti-platelet agents such as aspirin).
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PL 04416/0361 & 0362

• Diuretics (water tablets).
• Lithium (used to treat some mental problems).
• Methotrexate (for some inflammatory diseases and some cancers).
• Ciclosporin and tacrolimus (for some inflammatory diseases and after transplants).
• Quinolone antibiotics (for infections).
• Any other NSAID or COX-2 inhibitor, for example aspirin, ibuprofen or celecoxib).
• Mifepristone (used to terminate pregnancy).
• Cardiac glycosides (for example digoxin), used to treat heart problems.
• Medicines known as SSRIs, and an SNRI, venlafaxine, used to treat depression.
• Corticosteroids (anti-inflammatory drugs).
• Medicines used to treat heart conditions or high blood pressure, for example beta
blockers or ACE inhibitors.
• Ritonavir and zidovudine (used to treat HIV AIDS).
• Baclofen, a muscle relaxant often used in MS.
• Drospirenone (used in an oral contraceptive pill).
• Ketorolac (used to treat post-operative pain).
• Penicillamine, a treatment for rheumatoid arthritis.
• Erlotinib (for cancer).
• Iloprost, a treatment for pulmonary hypertension (high blood pressure in the artery
carrying blood from the heart to the lungs).
• Pentoxifylline (used to treat circulation disorders).
• Sibutramine (for obesity).
 Sulfinpyrazone (a medicine used to treat gout) or voriconazole (a medicine used to treat fungal
infections).

• Phenytoin, a treatment for epilepsy.

Pregnancy and lactation
You should not take Diclofenac Tablets during the last 3 months of pregnancy as it may
affect the baby’s circulation. If you are in the first 6 months of pregnancy talk to your
doctor before taking this medicine as Diclofenac Tablets should only be taken if the
benefit is likely to outweigh the risks.
Taking Diclofenac Tablets may make it more difficult for you to get pregnant. You
should talk to your doctor if you are planning to become pregnant or if you have
problems getting pregnant.
If you are breast-feeding, avoid taking this medicine because very small amounts of
diclofenac sodium have been found in breast milk.
Driving or using machinery
Very occasionally people have reported that Diclofenac Tablets have made them feel
dizzy, tired or sleepy. Problems with eyesight have also been reported. If you are affected
in this way, you should not drive or operate machinery.
Other special warnings
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PL 04416/0361 & 0362

• You should take the lowest dose of Diclofenac for the shortest possible time,
particularly if you are underweight or elderly.
• There is a small increased risk of heart attack or stroke when you are taking any
medicine like Diclofenac. The risk is greater if you are taking high doses for a long time.
Always follow the doctor’s instructions on how much to take and how long to take it for.
Do not exceed the recommended dose or duration of treatment.
• Your doctor may want to give you an occasional check-up whilst you are taking this
medicine.
• If you have a history of stomach problems when you are taking NSAIDs, particularly if
you are elderly, you must tell your doctor straight away if you notice any unusual
symptoms.
• Diclofenac may reduce the symptoms of infection, for example, headache and high
temperature. If you feel unwell and need to see a doctor, remember to tell him or her that
you are taking Diclofenac.
• The 50 mg tablets are not suitable for children aged under 12.
• The 25 mg tablets contain sunset yellow FCF (E110), which may cause allergic
reactions in some people.

3. How to take Diclofenac Tablets
Your doctor will tell you how many Diclofenac Tablets to take and when to take them.
Always follow his/her instructions carefully. The dose will be on the pharmacist’s label.
Check the label carefully. If you are not sure, ask your doctor or pharmacist. Keep taking
your tablets for as long as you have been told. If you have any problems, talk to your
doctor.
Swallow the tablets whole with a drink of water. Do not crush or chew the tablets. If
possible, take the tablet at meal times.
Your doctor may prescribe another medicine at the same time to protect your stomach,
particularly if you have ever had stomach problems before, you are elderly or you are
taking certain other medicines as well.
Adults and children over 12
75 mg to 150 mg daily divided into two or three doses. The number of tablets which you
take will depend on the strength the doctor has given you.
Elderly
Your doctor may give you a lower dose than the usual adult dose. He or she may want to
check regularly that the Diclofenac Tablets are not affecting your stomach.
Children aged 1–12 years
Doses vary with the age and weight of the child. The usual dose is 1 mg to 3 mg per
kilogram of body weight a day. This is usually divided into two or three separate doses.
The 50 mg tablets are not recommended for use in children.
If you forget to take a dose
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If you forget to take a dose, take one as soon as you remember. If it is nearly time for
your next dose, just take the next dose and forget about the one you missed. Do not
double up on the next dose to make up for the one missed. Do not take more than 150 mg
(three 50 mg tablets or six 25 mg tablets) in 24 hours.
If you take too many tablets
If you, or anyone else, accidentally take too many tablets (an overdose) tell your doctor
or your nearest hospital casualty department. Take the medicine pack with you.

4. Possible side effects
Diclofenac Tablets are suitable for most people, but, like all medicines, they can
sometimes cause side effects. Side effects may be minimised by using the lowest
effective dose for the shortest duration necessary.
Some side effects can be serious
Stop taking Diclofenac Tablets and tell your doctor immediately if you notice:
• Stomach pain, indigestion, heartburn, wind, nausea (feeling sick) or vomiting (being
sick).
• Any sign of bleeding in the stomach or intestine, for example, when emptying your
bowels, blood in vomit or black, tarry faeces.
• Allergic reactions which can include skin rash, itching, bruising, painful red areas,
peeling or blistering.
• Wheezing or shortness of breath (bronchospasm).
• Swollen face, lips, hands or fingers.
• Yellowing of your skin or the whites of your eyes.
• A persistent sore throat or high temperature.
• An unexpected change in the amount of urine produced and/or its appearance.
• You bruise more easily than usual or have frequent sore throats or infections.
The side effects listed below have also been reported.
Between 1 in 100 and 1 in 10 people have experienced:
• Stomach pain, heartburn, nausea, vomiting, diarrhoea, indigestion, wind, loss of
appetite.
• Headache, dizziness, vertigo.
• Skin rash or spots.
• Raised levels of liver enzymes in the blood.
Between 1 in 10,000 and 1 in 1,000 people have experienced:
• Stomach ulcers or bleeding (there have been very rare reported cases resulting in death,
particularly in the elderly).
• Inflammation of the stomach, which may cause pain and an upset stomach.
• Drowsiness, tiredness.
• Hypotension (low blood pressure, symptoms of which may include faintness, giddiness
or light headedness).
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V016: SPC & PIL referral updates

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Sandoz Ltd
Diclofenac 25 & 50mg Tablets

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PL 04416/0361 & 0362

• Skin rash and itching.
• Fluid retention, symptoms of which include swollen ankles.
• Liver function disorders, including hepatitis and jaundice.
• Allergic reactions, including anaphylaxis and shock.
• Asthma, difficulty breathing and lung disorders (alveolitis and pulmonary eosinophilia).
• Kidney problems, which may lead to kidney failure.
Very rare side-effects, reported in less than 1 in 10,000 people include:
Effects on the nervous system:
Tingling or numbness in the fingers, tremor, blurred or double vision, hearing loss or
impairment, tinnitus (ringing in the ears), sleeplessness, nightmares, feeling irritable,
depression, anxiety, mental disorders, confusion, hallucinations, malaise, disorientation
and loss of memory, fits, headaches together with a dislike of bright lights, fever and a
stiff neck, disturbances in sensation.
Effects on the stomach and digestive system:
Constipation, a red swollen tongue, mouth ulcers, taste changes, lower gut disorders
(including inflammation of the colon).
Effects on the heart, chest or blood:
Palpitations (fast or irregular heart beat), chest pain, hypertension (high blood pressure),
inflammation of blood vessels (vasculitis), inflammation of the lung (pneumonitis),
congestive heart failure, blood disorders (including anaemia).
Effects on the liver or kidneys:
Kidney or liver disorders, the presence of blood or protein in the urine.
Effects on skin or hair:
Serious skin reactions, including Stevens-Johnson syndrome and Lyellʼs syndrome, as
well as other skin problems, some of which may be made worse by exposure to sunlight.
Hair loss or eczema.
Other effects:
Inflammation of the pancreas or impotence. Medicines such as diclofenac may be
associated with a small increased risk of heart attack or stroke.
If any of the symptoms become troublesome or if you notice anything else not
mentioned here, please tell your doctor. He/she may want to give you a different
medicine.

5. How to store Diclofenac Tablets
Store below 25°C. Store in the original package to protect from moisture. Keep out of the
reach and sight of children.

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V016: SPC & PIL referral updates

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Sandoz Ltd
Diclofenac 25 & 50mg Tablets

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PL 04416/0361 & 0362

Do not take Diclofenac Tablets after the expiry date which is printed on the outside of the
pack.
If your doctor tells you to stop taking the tablets, please take any unused tablets back to
your pharmacist to be destroyed. Do not throw them away with your normal household
water or waste. This will help to protect the environment.

6. Further Information
What Diclofenac Tablets contain
The tablets come in two strengths containing either 25 mg or 50 mg of the active
ingredient, diclofenac sodium. The tablets are gastro-resistant. This gastro-resistant
coating reduces the risk of stomach irritation.
The 25 mg tablets also contain the inactive ingredients sodium starch glycollate,
microcrystalline cellulose, lactose, starch maize, magnesium stearate, purified talc,
cellulose acetate phthalate, titanium dioxide (E171), quinoline yellow (E104), sunset
yellow FCF (E110) and indigo carmine (E132).
The 50mg tablets also contain the inactive ingredients, povidone K25, starch maize,
lactose, magnesium stearate, purified talc, cellulose acetate phthalate, titanium dioxide
(E171) quinoline yellow (E104), iron oxide (E172) and indigo carmine (E132).
Contents of the pack
The tablets come in blister packs containing 28, 50, 84 and 100 tablets. Not all pack sizes
may be marketed.
The Marketing Authorisation Holder and manufacturer is
Sandoz Ltd, Frimley Business Park, Frimley, Camberley, Surrey, GU16 7SR.
This leaflet was revised 10/2013

This leaflet applies to PL 04416/0361 and 0362.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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