What it's for (Indications)
- Used for the treatment of muscle and skeletal disorders, rheumatoid arthritis (an autoimmune condition with joint inflammation), osteoarthritis (inflammation of the bone), ankylosing spondylitis (a condition where the bones in the spine fuse), acute gout (complex form arthritis), and in chronic juvenile arthritis (long-lasting joint inflammation in children).
Dosage Information
| Type | Guideline |
|---|---|
| Standard | For oral administration: Take this medicine by mouth with a glass of water, with or after food. Administer exactly as prescribed by your doctor, usually once to thrice daily. Always use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals to minimize risks. Store this medicine at room temperature, away from direct light and heat. Keep it out of the reach of children and pets. |
Safety & Warnings
Common Side Effects
- Common side effects include transient epigastric pain, gastrointestinal disturbance, headache, and peripheral edema.
- More serious adverse reactions, which are also significant warnings, include an increased risk of cardiovascular thrombotic events (e.
- g.
- , myocardial infarction, stroke), GI bleeding, ulceration, and perforation, hepatotoxicity, hypertension, heart failure and edema, renal toxicity and hyperkalemia, anaphylactic reactions, serious skin reactions, and hematologic toxicity (e.
- g.
- , blood dyshaematopoiesis).
- Rare occurrences of peptic ulcer and abnormalities of liver and kidney function have also been reported.
Serious Warnings
- Black Box Warning: WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS. Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Diclofenac is contraindicated in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs also 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 and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.
- Patients should inform their doctor about their complete medical history before use, especially regarding gastrointestinal disorders, liver or kidney impairment, peptic ulcer, and recent heart surgery.
- Use with grave caution in individuals with a history of gastrointestinal disease, kidney, liver, or cardiac insufficiency, hematological abnormalities, porphyria, decreased fluid volume, elderly patients, cardiovascular disease, hypertension, volume depletion, blood coagulation defects, and various autoimmune disorders.
- NSAIDs, including diclofenac, can cause serious cardiovascular thrombotic events, gastrointestinal bleeding, ulceration, and perforation.
- Other warnings include hepatotoxicity, hypertension, heart failure and edema, renal toxicity and hyperkalemia, and serious skin reactions.
- Pregnancy: Insufficient evidence for risk; use this medicine only on the advice of a doctor.
- Lactation: Not recommended for use in nursing females; its use is contraindicated in nursing mothers.
How it Works (Mechanism of Action)
Diclofenac has analgesic, anti-inflammatory, and antipyretic properties. Its mechanism of action, like that of other NSAIDs, involves the inhibition of cyclooxygenase (COX-1 and COX-2) enzymes. This inhibition leads to a decrease in prostaglandin synthesis in peripheral tissues. Prostaglandins sensitize afferent nerves, potentiate bradykinin in inducing pain, and are mediators of inflammation.