Diclofenac: Side Effects, Dosage, Uses, and More

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Highlights for diclofenac

The topical gel form of diclofenac is offered both under its brand name and as a generic alternative. Brand names: Solaraze, Voltaren.

In addition to oral pills and capsules, ocular drops, powder packs for oral solution, a transdermal patch, and topical solution, diclofenac is also available in a variety of different dosage forms.

Pain caused by osteoarthritis can be alleviated in some joints with the help of diclofenac topical gel. Additionally, it is employed in the treatment of actinic keratosis (AK).

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What exactly is the diclofenac?

Diclofenac is a medication that requires a doctor’s prescription. It is available in a topical gel, an oral capsule, an oral tablet, eye drops, a transdermal patch, a topical solution, and powder packets for oral solution. All of these forms can be used orally.

There is a topical gel formulation of diclofenac that is sold under the brand names Solaraze and Voltaren. A generic version of the medication is also on the market. Generic versions of medications typically have lower prices than their brand-name counterparts. It’s possible that you won’t be able to get them in every strength or formulation if you buy them under their brand name.

Voltaren (diclofenac 1%), formerly known as Voltaren Arthritis Pain, is now available over-the-counter in the United States.

Why it’s put to use

Diclofenac topical gel is used for joints that can be helped by medication delivered via the skin and are used to provide pain relief from osteoarthritis. The joints in your hands and knees are examples of this category.

The topical gel form of diclofenac is also employed in the treatment of actinic keratosis (AK). This disorder causes older persons to develop patches of their skin that are rough and scaly.

The workings of it

A nonsteroidal anti-inflammatory medication, diclofenac, is the subject of this article (NSAID).

The medication achieves its therapeutic effect by inhibiting the activity of a certain enzyme in the body. Blocking an enzyme causes your body to produce less inflammatory chemicals, which can help reduce pain and discomfort. Inflammation and pain are both reduced as a result of this.

Drowsiness is one of the possible side effects of using diclofenac topical gel. Do not operate a motor vehicle or any heavy machinery until you have determined how this medicine affects you.

Diclofenac side effects

The adverse effects caused by diclofenac might range from minor to severe. The list that follows provides examples of some of the most common adverse reactions that could take place as a result of taking diclofenac. This list does not include all possible negative effects. Talk to your healthcare provider or pharmacist if you would like additional information about the potential adverse effects of diclofenac, or for pointers on how to manage an adverse effect that causes you concern.

Additional adverse effects may be brought on by the usage of diclofenac.

More common side effects

The following are some of the most prevalent adverse effects that may be brought on by the use of diclofenac gel:

irritation or a rash at the point of application

stomach discomfort

constipation

diarrhea \sgas

heartburn

nausea

vomiting

sleepiness

Serious adverse effects may result.

If you are experiencing major adverse effects, you should contact your physician as soon as possible. In the event that your symptoms appear to be life-threatening or if you believe you may be experiencing a medical emergency, dial 911 immediately. The following is a list of potentially serious side effects and the symptoms they cause:

Reactions caused by allergies Itching, rashes, and difficulties breathing are some of the possible symptoms.

hives

Edema. Some of the symptoms include an enlargement of the feet or ankles.

higher risk of cardiovascular disease increased weight

ulcer of the stomach or bleeding from the stomach. Having really dark feces; having blood in your stools is one of the possible symptoms.

Taking more easily to bruising.

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Instructions for taking diclofenac

The amount of diclofenac that your physician recommends for you will be based on a number of different factors. These are the following:

the kind and severity of the condition you are trying to treat with diclofenac, as well as your age, the specific formulation of diclofenac that you are using, as well as any other medical issues you may have.

In most cases, your physician will begin treatment with a low dosage and gradually increase it until they reach the level that is appropriate for you. In the end, they will prescribe the lowest possible dosage that still achieves the desired effect.

The material that follows provides a description of dosages that are typically employed or suggested. However, make sure to take the dosage that was prescribed for you by your medical professional. Your physician will calculate the correct dosage for you based on your individual requirements.

It’s probable that not all imaginable dosages and forms have been mentioned here.

Diclofenac is the generic name for the dosage for actinic keratoses (AK).

Topical gel as its form

Strengths: 3%

Brand: Solaraze

Topical gel as its form

Strengths: 3% Adult dose (ages 18 years and older)

AK lesions should have diclofenac gel applied to them twice daily. In most cases, 0.5 grams (gm) of gel will be applied to each spot that measures 2 inches by 2 inches (5 centimeters by 5 centimeters). The duration of treatment that is advised is between sixty and ninety days.

Child dose (ages 0–17 years)

There is no recognized dosage for people younger than 18 years old at this time.

Diclofenac is the generic name for the dosage used for osteoarthritis.

Topical gel as its form

Strengths: 1%

Brand: Voltaren

Topical gel as its form

Strengths: 1% Adult dose (ages 18 years and older)

The afflicted area will often receive an application of diclofenac gel four times each day. It is important to follow the instructions on the dosing card that comes with the medication in order to ensure that the appropriate amount of gel is applied to aching joints.

A single joint of the hand, wrist, or elbow should not receive more than 8 grams of glucosamine every day of treatment.

A single knee, ankle, or foot joint should not get more than 16 grams of glucosamine and chondroitin sulphate per day.

Over the course of a day, the total amount of diclofenac gel that is applied to all of the affected joints shouldn’t exceed 32 grams.

Child dose (ages 0–17 years)

There is no recognized dosage for people younger than 18 years old at this time.

Special dose considerations

Attention senior citizens: If you are 65 or older, your body may metabolize this medication more slowly than younger adults. It’s possible that your physician will start you out on a lesser dose so that you don’t end up with an unsafely high level of this drug in your system. If you take too much of the drug, it could put your health at risk.

Use as directed

Diclofenac is typically used for treatment that is just temporary. In order to effectively treat the issue, you should apply it for the least amount of time possible. If your doctor wants you to continue using medication for a longer amount of time, he or she should monitor your blood pressure, liver function, and kidney function on a regular basis.

If you don’t follow the doctor’s orders when taking this medication, you could put yourself in danger.

If you discontinue the use of the medication or don’t take it at all: If you discontinue the use of diclofenac and continue to have swelling and discomfort, you may have joint or muscle damage that doesn’t heal properly.

If you skip doses or don’t take the prescription according to the prescribed schedule, the effects of your medication may be diminished or they may even stop working entirely. In order for this medication to perform properly, there must always be a specific quantity present in the body.

If you use the drug to an excessive degree, you run the risk of having potentially lethal levels of it in your body. The following are some of the symptoms that may accompany an overdose of this drug:

stomach ulcer

a headache accompanied by gastrointestinal hemorrhage

Call your physician immediately if you believe that you have taken an unsafe amount of this medication, or consult the American Association of Poison Control Centers at 800-222-1222 or use the resource that they provide on their website. However, if the severity of your symptoms continues to worsen, you should immediately dial 911 or go to the emergency room in the local hospital.

In the event that you forget to take a dose, you should administer the medication as soon as you realize it. If, however, you only remember a few hours before your next planned dose, then you should only take that one dose. Under no circumstances should you attempt to catch up by taking two doses at once. Because of this, potentially harmful consequences could arise.

How to tell if the medicine is having the desired effect: It is expected that your symptoms will get better.

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Warnings regarding Diclofenac

This medication comes with a number of precautions.

Warning from the FDA regarding nonsteroidal anti-inflammatory medication (NSAID)

This medication comes with a “black box” warning. The Food and Drug Administration has deemed this their most urgent health advisory to date (FDA). A “black box warning” provides notice to both medical professionals and patients about the potential adverse effects of medication.

The use of NSAIDs is associated with an increased risk of significant bleeding, sores (ulcers), and holes (perforation) in the stomach or intestines, all of which have the potential to be lethal. These responses can happen at any point during use, and there are typically no warning indications beforehand. People who are older and those who have a history of gastrointestinal bleeding or peptic ulcer disease are at a larger risk for major gastrointestinal events.

Potential for coronary heart disease: A nonsteroidal anti-inflammatory medication, diclofenac, is the subject of this article (NSAID). The use of any nonsteroidal anti-inflammatory drug (NSAID) can raise your chance of having a heart attack, heart failure, or stroke. The longer you use NSAIDs or if you take higher doses of them, the higher your exposure to this risk may become. If you have risk factors for cardiovascular diseases, such as high blood pressure, then your risk may be higher than average. If you suffer from heart disease, you should consult your physician before beginning treatment with diclofenac.

Diclofenac shouldn’t be taken in the days leading up to surgery, especially if you’re going to have heart bypass surgery. If you take diclofenac and are about to have surgery in the near future, you should discuss this with your doctor.

Caution: allergens present

It is possible to have an adverse reaction to diclofenac if you are sensitive to aspirin or to other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. If you see any of the following symptoms, you should contact your doctor straight away:

symptoms including wheezing, difficulty breathing, hives, and an itchy rash

In the event that you get these symptoms, you should immediately dial 911 or go to the emergency room in your area.

If you have ever experienced an adverse reaction to this medication, you should never take it again. It’s possible that using it again might be fatal (cause death).

Caution regarding alcohol and drug interactions

While under the influence of this medicine, alcohol use should be avoided. Consuming alcohol while taking diclofenac may increase the likelihood that you may get stomach ulcers.

Warning signs for the medication

It is possible for others to contract diclofenac gel. Before you touch anyone else, check that the gel has completely dried on your skin first.

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Warnings for individuals who have the following health conditions:

Before beginning treatment with diclofenac, it is important to consult your primary care physician if you have hypertension or experience fluid retention. It’s possible that your heart is already working very hard, and taking an NSAID can make it work even harder.

People who have had an ulcer or bleeding from the digestive system should consult their physician before taking diclofenac. If you’ve ever had an ulcer or bleeding from your digestive system, consult your physician before using diclofenac. You have a greater chance of experiencing another bleeding episode.

For patients with renal illness or those who take diuretics (water pills): If you have kidney disease or take diuretics (water pills), there is a possibility that this medication will interfere with your kidneys’ ability to eliminate excess water from your body. Talk to your primary care physician about whether or not diclofenac is the proper medication for you.

For individuals who suffer from asthma and have an adverse reaction to aspirin: If you suffer from asthma and have an adverse reaction to aspirin, you may also have a negative reaction to diclofenac. Before beginning to take the medication, you should consult your doctor.

Cautionary notes for members of other groups

This medication is considered a pregnancy category C medicine if taken by a pregnant woman before the 30th week of their pregnancy. It is considered a pregnancy category D drug after the first 30 weeks of the pregnancy.

A substance is considered to be in category C if it has been shown through scientific research to potentially pose a threat to the progeny of test animals. On the other hand, not enough research has been done to demonstrate the danger to humans.

Category D refers to not one but two things:

According to the findings of many studies, there is a possibility that the drug’s usage by the pregnant mother could have negative consequences on the developing child.

In certain circumstances, the potential benefits of using diclofenac during pregnancy may outweigh the hazards that are involved.

Do not use diclofenac if you’re pregnant, unless your doctor tells you to. Diclofenac should not be used at any point after the 30th week of pregnancy. This is especially important.

For mothers who are nursing their children, please note that this medication has the potential to enter breast milk, which implies it has the potential to enter the body of a kid who is breastfed. This could have potentially harmful consequences for the youngster.

Have a discussion with your primary care provider to determine whether or not breastfeeding is a healthy option for you.

Diclofenac can cause a variety of adverse effects, including gastrointestinal difficulties, bleeding, water retention, and others, which are more likely to occur in elderly patients. Because the medicine is more likely to accumulate and cause more adverse effects in elderly patients, this demographic may also have kidneys that do not function at optimal levels.

Diclofenac may interact with other medications

Diclofenac has the potential to interact negatively with a number of different drugs. Numerous possible outcomes can result from a single contact. For instance, some can impede how well a drug works, while others can create higher negative effects. Furthermore, some can even induce fatal side effects.

The following is a list of drugs that may cause adverse reactions when used with diclofenac. This list does not contain all medications that may interact negatively with diclofenac; only some of them are included.

Be sure to tell your doctor and pharmacist about any and all medications you take, including those obtained with a prescription, those purchased over the counter, and any others before beginning treatment with diclofenac. Tell them anything you know about the vitamins, herbs, and supplements you take as well. If you tell people this information, it will help you avoid potentially awkward situations.

Talk to your primary care physician or a pharmacist if you have any concerns or questions regarding possible adverse effects caused by drug interactions.

Blood pressure medications

Diclofenac may counteract the blood pressure-lowering effects of other medications that are prescribed for the purpose of managing high blood pressure. Increasing your risk of kidney damage may be one of the potential side effects of combining diclofenac with certain blood pressure drugs.

The following are some examples of blood pressure medications:

beta-blockers, such as acebutolol, atenolol, metoprolol, and propranolol; angiotensin II receptor blockers, such as candesartan, irbesartan, losartan, and olmesartan; diuretics (water pills), such as furosemide and hydrochlorothiazide; and angiotensin-converting enzyme (ACE) inhibitors, such as

Cancer drug

It is possible that the anti-cancer medicine pemetrexed will be more effective when used with the pain reliever diclofenac. Fever, chills, body aches, mouth sores, and severe diarrhea are some of the symptoms that may be experienced.

In addition to NSAIDs

A nonsteroidal anti-inflammatory medication, diclofenac, is the subject of this article (NSAID). Because taking it in conjunction with other nonsteroidal anti-inflammatory drugs (NSAIDs) may raise your risk of stomach and blood problems, you should avoid doing so unless specifically ordered to do so by your doctor. The following are some examples of other NSAIDs:

ketorolac \sibuprofen \snaproxen \scelecoxib \saspirin

Substances that act on the circulation of the blood

Combining diclofenac with other medications that alter the way blood moves through the body can increase the likelihood that you will have bleeding. Some examples of these medications are as follows:

warfarin aspirin selective serotonin reuptake inhibitors (SSRIs), such as desvenlafaxine, duloxetine, venlafaxine, and levomilnacipran serotonin-norepinephrine reuptake inhibitors (SNRIs), such as escitalopram, fluoxetine, paroxetine, and sertraline serotonin-norepinephrine reuptake

Bipolar disorder drug

If you take lithium at the same time as diclofenac, the amount of lithium in your body could rise to potentially dangerous levels. It’s possible that your doctor will closely check your lithium levels.

Immunosuppressant medication

Combining diclofenac, an anti-inflammatory medication, with cyclosporine, a medication that lowers your immune system’s defenses, may increase the likelihood that you will develop kidney problems.

Methotrexate

Combining the use of methotrexate and diclofenac can result in dangerously high levels of methotrexate being produced in the body. This can put you at a greater risk of infection as well as kidney problems.

Digoxin

Combining digoxin and diclofenac use can result in higher digoxin levels in the body as well as enhanced negative effects from both medications. It’s possible that your doctor may closely check your digoxin levels.

Considerations that must be made before taking diclofenac

If your physician recommends diclofenac for you, keep these things in mind when you take the medication.

Refills It is possible to get further refills of this medication if you have a prescription for it. If you have an existing prescription for this drug, you shouldn’t need a new one in order to get it refilled. On your prescription, your physician will indicate the maximum number of refills that are permitted.

Travel

If you are going to travel with your medication, you should:

Always ensure that you have your medication on you. When flying, you should under never circumstances put it in a checked bag. Keep it in the carry-on bag you’re using.

You don’t need to be concerned about the X-ray machines at the airport. They are unable to affect the medication you are taking.

It’s possible that airport employees will ask to see the pharmacy label for the medication you’re carrying with you. Always make sure you have the original container with the prescription label on it.

Do not place this medication in the glove compartment of your vehicle or leave it in the vehicle alone. Make it a point to steer clear of doing this when the temperature is either hot or extremely cold.

Clinical monitoring

If you have been using diclofenac for an extended period of time, your primary care physician should perform blood tests at least once per year to evaluate how well your kidneys and liver are functioning.

It is important that you monitor your own blood pressure on a regular basis. Home blood pressure monitors are widely distributed and can be purchased at most pharmacies and on the internet.

You may buy blood pressure monitors by shopping online.

Sun sensitivity

While taking diclofenac, you may have an increase in your sensitivity to the sun. Applying sunscreen with an SPF of 30 or higher is recommended for skin protection.

Availability

This medication is not available at all pharmacies. On the other hand, you might be able to place an order for it. Be careful to give the pharmacy a call before going in to fill your prescription to verify that they either already have the medication in store or have the ability to special order it for you.

Authorization in advance

This particular formulation of the medicine is subject to pre-approval by the majority of insurance providers. This indicates that in order for your insurance company to pay for the prescription, your doctor will first need to obtain permission from your insurance company.

If your insurance provider is not willing to pay for this type of medication, you should investigate whether they will pay for the tablet or capsule form instead.

Are there any other options available?

There are additional medications that can be used to treat your illness. It’s possible that some will work better for you than others. Talk to your healthcare provider about the possibility of trying out other medications to see if any of them help.