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Active substance(s): DICLOFENAC SODIUM

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Package leaflet: Information for the user


Rhumalgan® 75 and 100 CR Tablets
(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 Rhumalgan Tablets are and what they are used for
2. Before you take Rhumalgan Tablets
3. How to take Rhumalgan Tablets
4. Possible side effects
5. How to store Rhumalgan Tablets
6. Further Information


What Rhumalgan Tablets are and what they are
used for

Diclofenac sodium, the active ingredient in Rhumalgan Tablets, is
one of a group of medicines called non-steroidal anti-inflammatory
drugs (NSAIDs). NSAIDs reduce pain and inflammation.
• Rhumalgan Tablets relieve pain, reduce swelling and ease
inflammation in a wide range of conditions:
- Rheumatoid arthritis, osteoarthritis, acute gout, ankylosing
- 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
Rhumalgan Tablets are controlled release tablets, this means they
are designed to release the diclofenac sodium more gradually over
the day, compared with a standard release tablet. This helps to
reduce the number of tablets you may need to take each day.


Before you take Rhumalgan Tablets

DO NOT take Rhumalgan 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
Rhumalgan 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.
• 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 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 Rhumalgan 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
suggest 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.
• 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).
• Lupus (SLE) or any similar condition.
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 Rhumalgan 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
• Diuretics (water tablets).
• Lithium (used to treat some mental problems).
• Methotrexate (for some inflammatory diseases and some
• 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
• 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 to treat gout) or voriconazole (a
medicine used to treat fungal infections).
• Phenytoin, a treatment for epilepsy.
Pregnancy and breast-feeding
You should not take Rhumalgan 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 Rhumalgan Tablets should only be taken if the benefit
is likely to outweigh the risks.
Taking Rhumalgan 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
Driving or using machinery
Very occasionally people have reported that Rhumalgan 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.

Continued on the next page >>

Other special warnings
• You should take the lowest dose of Rhumalgan 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 Rhumalgan. 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
• Your doctor may want to give you an occasional check-up whilst
you are taking these medicines.
• 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.
• Rhumalgan 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


How to take Rhumalgan Tablets

Your doctor will tell you how many Rhumalgan 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 had stomach
problems before, you are elderly, or you are taking certain other
medicines as well.
Adults and children over 12
Rhumalgan CR 75 tablets: One tablet, taken once or twice daily.
Rhumalgan CR 100 tablets: One tablet daily.
Your doctor may give you a lower dose than the usual adult dose.
He or she may also want to check regularly that the Rhumalgan
Tablets are not affecting your stomach.
Children aged 1–12 years
Rhumalgan Tablets are not recommended for children.
If you forget to take a dose
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 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.


Possible side effects

Rhumalgan Tablets are suitable for most people, but, like all
medicines, they can sometimes cause side effects.
Some side effects can be serious
Stop taking Rhumalgan 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, local irritation.
• 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).
• 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
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),
exacerbation of haemorrhoids.
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
Effects on skin or hair:
Serious skin reactions, including Stevens-Johnson syndrome and
Lyell’s 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 talk to your doctor.
He/she may want to give you a different medicine.


How to store Rhumalgan Tablets

Store below 25°C. Store in the original package to protect from
light. Keep out of the reach and sight of children.
Do not take Rhumalgan 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.


Further information

What Rhumlagan Tablets contain
Rhumalgan CR 75 Tablets contain 75 mg of the active ingredient,
diclofenac sodium.
Rhumalgan CR 100 Tablets contain 100 mg of the active
ingredient, diclofenac sodium.
The other ingredients are: talc, ethylcellulose, magnesium stearate,
povidone, stearic acid, hydroxypropyl methylcellulose, diethyl
phthalate, titanium dioxide and polyethylene glycol.
Rhumalgan CR 100 Tablets also contain iron oxide.
Contents of the pack
Rhumalgan Tablets come in blister packs of 28, 30, 50, 56, 60, 84,
100, 250, 500 and 1,000. 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 in 12/2010

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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.