Diclofenac

Conditions Treated
Diclofenac is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly affects the spine). Diclofenac immediate-release (short-acting) tablets are also used to treat painful menstrual periods and pain from other causes. Diclofenac is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

Possible Side Effects
What Side Effects Can This Cause?
Diclofenac may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- diarrhea
- constipation
- gas or bloating
- headache
- dizziness
- ringing in the ears
Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more diclofenac until you speak to your doctor.
- unexplained weight gain
- excessive tiredness
- lack of energy
- nausea
- loss of appetite
- itching
- pain in the upper right part of the stomach
- yellowing of the skin or eyes
- flu-like symptoms
- fever
- blisters
- rash
- hives
- swelling of the eyes, face, tongue, lips, throat, arms, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing
- hoarseness
- pale skin
- fast heartbeat
- cloudy, discolored, or bloody urine
- back pain
- difficult or painful urination

Usage Instructions
How Should This Medication Be Used
Diclofenac comes as an immediate-release tablet and liquid-filled capsule and an extended-release (long-acting) tablet to take by mouth. Diclofenac immediate-release tablets and capsules are usually taken two to four times a day. Diclofenac extended-release tablets are usually taken once a day, and in rare cases are taken twice a day. Take diclofenac at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take diclofenac exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
What Dietary Instructions Should I Follow
Unless your doctor tells you otherwise, continue your normal diet.
Are There Any Special Instructions
Before taking diclofenac, tell your doctor and pharmacist if you are allergic to diclofenac (Cataflam, Voltaren XR, in Arthrotec), aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), any other medications, or any of the inactive ingredients in diclofenac tablets or extended release tablets. Ask your pharmacist for a list of the inactive ingredients. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); cyclosporine (Neoral, Sandimmune); digoxin (Lanoxin); diuretics ('water pills'); insulin and oral medication for diabetes;lithium (Eskalith, Lithobid); and methotrexate (Rheumatrex). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); lupus (a condition in which the body attacks many of its own tissues and organs, often including the skin, joints, blood, and kidneys); porphyria (an abnormal increase in the amount of certain natural substances made by the liver); liver or kidney disease; or swelling of the hands, feet, ankles, or lower legs . if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking diclofenac.

Brand Names
Common Brand Names for This Medication
- Cataflam®
- Voltaren®
- Zipsor®

Overdose
What To Do In The Case of Emergency
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Symptoms of overdose may include:
- nausea
- vomiting
- stomach pain
- bloody, black, or tarry stools
- vomiting a substance that is bloody or looks like coffee grounds
- drowsiness
- slow, shallow, or irregular breathing
- loss of consciousness

Forgotten Doses
What Should I Do If I Forget A Dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Additional Information
What Are the Storage Conditions for this Medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
What Other Information Should I Know?
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

