Voltaren interactions to avoid

Drug interactions | Food interactions | Other interactions | Avoiding interactions | When to see a doctor

Voltaren, also known as its generic counterpart diclofenac sodium, is a brand-name medication approved by the Food and Drug Administration (FDA) to treat the signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It belongs to the class of nonsteroidal anti-inflammatory drugs (NSAIDs) and works by blocking certain substances in the body that cause pain and inflammation. 

Although Voltaren is an effective treatment option for arthritis patients, it may interact with several other drugs. Medications that affect bleeding, other NSAIDs, acetaminophen, ACE Inhibitors, aspirin, and certain blood pressure medications may contribute to interactions. Combining Voltaren with these medications can increase the risk of serious side effects, such as bleeding in the stomach, severe skin reactions, fluid retention, sudden weight gain, high blood pressure, or chest pain.

Read on to learn more about potential Voltaren drug interactions. 

Voltaren drug interactions

Voltaren interacts with various medications. The effects of each interaction depend on the specific medication. A doctor will manage each interaction differently. 

Blood pressure medications

NSAIDs, including Voltaren, can cause or worsen high blood pressure, which can increase the risk of heart problems. Due to this risk, taking Voltaren with blood pressure medications can weaken their ability to control blood pressure levels. Such a situation can complicate maintaining a healthy blood pressure range.

Like Voltaren, some blood pressure medications can temporarily cause kidney problems that affect kidney function. Therefore, taking these medications together can increase the risk of kidney damage. Examples of blood pressure drugs that affect the kidneys include:

• Angiotensin-converting enzyme (ACE) inhibitors, such as Zestril (lisinopril), benazepril, and enalapril
• Angiotensin II receptor blockers (ARBs), such as Cozaar (losartan), Benicar (olmesartan), and Avapro (irbesartan)
• Diuretics (water pills), such as Microzide (hydrochlorothiazide) and Lasix (furosemide)
• Beta blockers, such as Lopressor (metoprolol) and propranolol

Other NSAIDs

Taking Voltaren with other NSAIDs can cause a higher risk of NSAID-related side effects. Included are serious stomach problems, heart attack, stroke, and kidney damage. For this reason, avoid taking Voltaren with any other NSAIDs. If Voltaren alone isn’t managing your pain, discuss other treatment options with your healthcare provider. 

Examples of other NSAIDs include:

• Advil (ibuprofen)
• Naprosyn (naproxen)
• Indocin (indomethacin)

Many over-the-counter (OTC) medications, including cold and flu treatments, contain NSAIDs. Check any new medication’s ingredients to ensure it doesn’t combine multiple NSAIDs. Contact the pharmacist or healthcare provider for additional medical advice if unsure.

Aspirin

Some people take low-dose aspirin to lower their risk of heart attack and stroke. Aspirin does this by blocking the production of a hormone called thromboxane. However, some NSAIDs, including Voltaren, can weaken aspirin’s heart-protective effects. Therefore, doctors typically won’t prescribe this combination of medications unless it’s the best or only treatment option. 

Medications that affect bleeding

Anticoagulants, blood thinners, and antiplatelet medications are commonly prescribed to prevent blood clots. Anticoagulants thin the blood, which keeps blood from clotting as easily. Antiplatelets block platelets from clumping together.

Voltaren alone has antiplatelet effects and has the potential to cause serious bleeding. Therefore, taking Voltaren with anticoagulants or antiplatelets can greatly increase the risk of bleeding. 

Examples of anticoagulants include:

• Coumadin (warfarin)
• Eliquis (apixaban)
• Xarelto (rivaroxaban)

Examples of antiplatelets include:

• Plavix (clopidogrel)
• Cilostazol
• Brilinta (ticagrelor)

Certain antidepressants

Voltaren may interact with antidepressants that affect serotonin levels in the body. Examples include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Taking Voltaren with these drugs may increase the risk of stomach-related side effects, such as stomach bleeding, tears in the stomach lining, and ulcers (sores) in the stomach. When taking an antidepressant with Voltaren, the healthcare provider will likely monitor one more closely for side effects. 

Examples of SSRIs include:

• Prozac (fluoxetine)
• Celexa (citalopram)
• Lexapro (escitalopram)

Examples of SNRIs include:

• Cymbalta (duloxetine)
• Effexor (venlafaxine)
• Pristiq (desvenlafaxine)

Corticosteroids

Corticosteroids, used to treat allergies, lung conditions, skin conditions, and multiple sclerosis, may also interact with Voltaren. Like other interactions, this interaction can increase gastrointestinal side effects risk factors, such as stomach ulcers (sores) or bleeding. 

Examples of corticosteroids include:

• Prednisone
• Pulmicort (budesonide)
• Flovent HFA (fluticasone)
• Dexamethasone

Lithium

Taking Voltaren with lithium can increase the risk of serious side effects. This occurs because Voltaren may slow down the ability to clear lithium from the body. This results in high lithium levels in the blood, which is known as lithium toxicity. Symptoms of lithium toxicity include vomiting, lethargy, confusion, fast heart rate, seizures, and low blood pressure. If taking Voltaren with lithium, a healthcare professional may order regular blood tests to ensure lithium levels are in a healthy range. 

Digoxin

Similar to its interaction with lithium, Voltaren may interact with digoxin. As a result, digoxin toxicity can occur in the body. Symptoms include stomach upset, heart palpitations, shortness of breath, and fainting.

Methotrexate

Taking methotrexate with Voltaren can increase the levels of methotrexate in the body. Adverse effects may occur, such as blurry vision, seizures, and confusion. 

Cyclosporine

Voltaren can also interact with cyclosporine, which is an immunosuppressant used to prevent organ rejection after a transplant. Combining the use of cyclosporine and Voltaren can increase the risk of kidney damage. 

Pemetrexed

Pemetrexed is a drug used to treat certain types of cancer. Taking Voltaren with pemetrexed can increase the risk of serious side effects, including low blood cell counts, kidney damage, and stomach problems. 

Voltaren food interactions

There aren’t any known foods that interact with Voltaren. However, certain foods may help with osteoarthritis or ankylosing spondylitis. This can include fruit, vegetables, beans, fish, and healthy fats for osteoarthritis. A healthy diet with fruits, vegetables, lean proteins, whole grains, and healthy fats may help with ankylosing spondylitis. 

Keep in mind that Voltaren may be taken with or without food. However, taking it with food or milk may lower the risk of stomach upset. 

Other Voltaren interactions

Voltaren may also interact with other substances, such as alcohol and tobacco. Read on to learn more about the effects of other substances on Voltaren. 

Voltaren and alcohol

Alcohol can interact with many medications, including Voltaren. Studies show drinking alcohol while taking an NSAID increases the risk of stomach bleeding. For this reason, it’s best to avoid alcohol while taking Voltaren. The National Kidney Foundation also recommends avoiding alcohol while taking NSAIDs due to the risk of kidney damage. 

Voltaren and smoking

Similar to alcohol, smoking while taking Voltaren can increase the risk of stomach problems, including bleeding, stomach pain, ulcers, and tears in the stomach lining. 

Voltaren and disease

Some medical conditions can increase the risk of Voltaren-related side effects. Therefore, Voltaren should be used cautiously in people with certain health conditions. These include:

• People with kidney disease
• People with liver disease
• People with heart disease or a history of heart attack, stroke, or heart failure
• People with a history of stomach problems
• Older adults aged 65 years and above
• Women who are pregnant as Voltaren may harm an unborn baby
• Women who are breastfeeding, it is not known if diclofenac passes into breast milk

If one has any of the above conditions, they may need closer monitoring for side effects and possibly a lower dosage of Voltaren. 

How to minimize Voltaren interactions

Taking Voltaren with certain medications can increase the risk of serious side effects, including stomach bleeding, tears in the stomach lining, confusion, and seizures. To minimize these risks, be sure to provide healthcare professionals with a list of all current medications and medical conditions. This includes over-the-counter and prescription drugs, vitamins, herbs, and supplements. If needed, the doctor can adjust dosages, monitor for adverse effects, or recommend alternative therapies if there’s a potential Voltaren interaction. 

When to talk to a healthcare provider about Voltaren interactions

Inform a healthcare provider before starting any new medications. Doing so can allow them to screen for Voltaren interactions before they occur. Additionally, keep an eye out for any warning signs of an interaction. This includes new or worsening side effects, changes in a drug’s effectiveness, or new or worsening symptoms of medical conditions. Report any warning signs to a healthcare professional. 

Remember that this article doesn’t contain an exhaustive list of all Voltaren interactions. So, it’s essential to consult a healthcare provider regarding potential drug interactions.