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Voltaren (diclofenac) - What You Need to Know

NSAIDs Are Commonly Prescribed for Arthritis

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Updated June 27, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Voltaren (diclofenac) belongs to the class of drugs known as NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs are commonly prescribed to treat arthritis. The brand name version, Voltaren, which was manufactured by Novartis, was FDA-approved in 1988.

What is the availability of diclofenac?

Diclofenac is available as an immediate-release tablet, liquid-filled capsule, and an extended-release tablet taken orally (by mouth). Diclofenac immediate-release tablets and capsules are available in 50 mg. and 75 mg. strength. Diclofenac extended-release tablets are available in 100 mg. strength.

When is diclofenac prescribed?

Diclofenac is prescribed for relief of the signs and symptoms of osteoarthritis, relief of the signs and symptoms of rheumatoid arthritis, and for acute or long-term use to relieve signs and symptoms of ankylosing spondylitis.

Diclofenac, like all other NSAIDs, have anti-inflammatory and analgesic properties. The mechanism of action is thought to be related to the inhibition of prostaglandins which are involved in inflammation.

Are there any special instructions regarding how to take diclofenac?

Usually, directions suggest taking NSAIDs with food to decrease the risk of gastrointestinal problems, but diclofenac is available as an enteric-coated tablet. The enteric coating helps protect the stomach. Therefore, taking diclofenac with food is not mandatory.

Patients are advised to take the lowest effective dose of diclofenac for the shortest duration possible. Some patients will be treated with the drug longterm. Your doctor will adjust dose and frequency to meet your needs. The recommended dose for osteoarthritis is 100-150 mg. per day taken as 50 mg. two or three times a day, or 75 mg. twice a day. The recommended dose for rheumatoid arthritis is 150-200 mg per day, taken as 50 mg. three or four times a day, or 75 mg. twice a day. For ankylosing spondylitis, 100-125 mg per day is recommended, taken as 25 mg. four times a day with an additional 25 mg. dose at bedtime if needed.

What side effects can occur with diclofenac?

Common side effects associated with diclofenac include: diarrhea, constipation, gas or bloating, headache, dizziness, and ringing in the ears. If these side effects are bothersome and do not go away, call your doctor.

Side effects that may be more severe and warrant an immediate call to your doctor include: weight gain,excessive fatigue, lack of energy, nausea, loss of appetite, itching, stomach pain (especially upper right part), skin or eye yellowing, flu-like symptoms, fever, rash, hives, swelling of eyes face, tongue, lips, throat, or upper/lower extremities, difficulty breathing, difficulty swallowing, hoarseness, pale skin, rapid heartbeat, cloudy or discolored urine, back pain, or painful urination. The side effects listed are not exclusive. If you have any unusual occurrence while taking diclofenac, call your doctor.

What special warnings and precautions are associated with diclofenac?

Diclofenac, as is the case with all non-aspirin NSAIDs, may be associated with increased risk of serious cardiovascular side effects, such as heart attack or stroke, which may result in hospitalization or death. Diclofenac, like all NSAIDs, can cause gastrointestinal side effects, such as bleeding and ulcers. The scary part is that the gastrointestinal complications can occur without warning. Rarely, diclofenac can be associated with serious skin side effects including Stevens-Johnson syndrome, exfoliative dermatitis, and Toxic Epidermal Necrolysis which can result in hospitalization and death. Anaphylactic reactions are also possible. Patients should be aware that the serious side effects are possible and be aware of unusual symptoms.

Are there drug interactions associated with diclofenac?

Be sure to tell your doctor about all drugs and supplements you take. Drug interactions can occur with diclofenac and the following drugs: aspirin, methotrexate, cylosporine, ACE inhibitors, furosemide, lithium, warfarin, and CYP2C9 inhibitors.

Are there special instructions for pregnant or nursing women?

Use of diclofenac is not recommended during pregnancy or while nursing.

Learn more about Topical Voltaren Gel.

Sources:

Voltaren. Medication Guide for NSAIDs. Novartis. Accessed 12/15/12.
http://www.fda.gov/downloads/Drugs/DrugSafety/ucm089822.pdf

Diclofenac. MedlinePlus. 10/1/2010.
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a689002.html

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