Detailed Drug Information:

DRUG CLASS AND MECHANISM: Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) effective in treating fever, pain, and inflammation in the body. As a group, NSAIDs are non-narcotic relievers of mild to moderate pain of many causes, including injury, menstrual cramps,arthritis, and other musculoskeletal conditions. Since the response todifferent NSAIDs varies from patient to patient, it is not unusual for adoctor to try different NSAIDs for any given condition.

PREPARATIONS: The stomach-coated (delayed-release) tablets(25mg, 50mg, 75mg) are called Voltaren. The immediate-release tablets(50mg) are called Cataflam. The extended release tablets (100mg) arecalled Voltaren-XR.

STORAGE: Store at room temperature and protect from moisture.

PRESCRIBED FOR: Diclofenac is used for the treatment ofinflammation and pain caused by arthritis conditions such as rheumatoidarthritis, osteoarthritis, and ankylosing spondylitis. The medication canalso be effective in treating soft tissue inflammations such as tendinitisand bursitis. Voltaren is stomach-coated and is slowly released into theblood. Cataflam is immediately released into the blood and is useful whenrapid relief of mild to moderate pain is desired, as in treating menstrualcramps.

DOSING: Should be taken with food.

DRUG INTERACTIONS: Diclofenac should be avoided by patients witha history of asthma attacks, hives, or other allergic reactions to aspirinor other NSAIDs. Rare but severe allergic reactions have been reported insuch individuals. It should also be avoided by patients with peptic ulcerdisease or poor kidney function, since this medication can potentiallyaggravate both conditions. Diclofenac is generally used with caution inpatients taking blood thinning medications (anticoagulants), such aswarfarin (Coumadin), because of increased risk of bleeding. Patientstaking lithium can develop toxic blood lithium levels. Safety in childrenis unknown. Diclofenac is not habit forming. NSAIDs should be discontinuedprior to elective surgery because of their mild tendency to interfere withblood clotting. Diclofenac is best discontinued at least two days inadvance of the procedure.

Persons who have more than 3 alcoholic beverages per day are atincreased risk of developing stomach ulcers when taking diclofenac orother NSAIDs.

PREGNANCY: Diclofenac is generally avoided during pregnancy.

NURSING MOTHERS: Diclofenac is generally avoided in nursingmothers.

SIDE EFFECTS: Most patients benefit from diclofenac and other NSAIDs with few side effects. However, serious side effects can occur, and generally tend to be dose related. Therefore, it is often desirable to use the lowest effective dose to minimize side effects. The most common side effects of diclofenac involve the gastrointestinal system. It can cause ulcerations, abdominal burning, pain, cramping, nausea, gastritis, and even serious gastrointestinal bleeding and liver toxicity. Sometimes, stomach ulceration and bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding. Rash, kidney impairment, ringing in the ears,and lightheadedness are also seen.