{"id":55098,"date":"2022-11-08T10:28:05","date_gmt":"2022-11-08T15:28:05","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=55098"},"modified":"2024-10-25T11:03:20","modified_gmt":"2024-10-25T15:03:20","slug":"diclofenac-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/diclofenac-side-effects\/","title":{"rendered":"Diclofenac side effects and how to avoid them"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/diclofenac-sodium\/what-is\"><span style=\"font-weight: 400;\">Diclofenac<\/span><\/a><span style=\"font-weight: 400;\"> is a prescription drug that is part of a class of medications called <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/nsaids\"><span style=\"font-weight: 400;\">non-steroidal anti-inflammatory drugs<\/span><\/a><span style=\"font-weight: 400;\">, or NSAIDs. If you have ever had any type of <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/lower-back-pain-treatment-and-medications\"><span style=\"font-weight: 400;\">back pain<\/span><\/a><span style=\"font-weight: 400;\">, inflammation, or other injury, you may have taken an NSAID. Some popular NSAIDs include oral tablets like aspirin, Advil and Motrin (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ibuprofen\"><span style=\"font-weight: 400;\">ibuprofen<\/span><\/a><span style=\"font-weight: 400;\">), and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/naproxen\"><span style=\"font-weight: 400;\">naproxen<\/span><\/a><span style=\"font-weight: 400;\">, among others. NSAIDs like diclofenac can help with pain, inflammation, and fever. Diclofenac works by preventing enzymes called COX-1 and COX-2 from making prostaglandin. Prostaglandin causes pain, inflammation, and fever. By decreasing the production of prostaglandin, symptoms of pain, inflammation, and fever can improve.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are various forms of diclofenac. This article will focus on oral <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=40879600-ba6c-43a8-aa5d-d0d41503d593\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">diclofenac sodium<\/span><\/a><span style=\"font-weight: 400;\">. Diclofenac sodium is a prescription medicine that is approved by the FDA. Diclofenac may sometimes be referred to as the brand-name drugs Voltaren (delayed-release tablets) and Voltaren-XR (extended-release tablets). However, these brand names are no longer available in the US&mdash;only the generic versions of oral diclofenac are available. Diclofenac sodium is used to treat symptoms of various conditions such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/conditions\/arthritis-treatment-and-medications\"><span style=\"font-weight: 400;\">Osteoarthritis&nbsp;<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/conditions\/arthritis-treatment-and-medications\"><span style=\"font-weight: 400;\">Rheumatoid arthritis<\/span><\/a><span style=\"font-weight: 400;\">&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ankylosing spondylitis<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For reference, there are different forms of diclofenac. Other forms of this medication that are available by prescription include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/arthrotec\"><b>Arthrotec<\/b><\/a><span style=\"font-weight: 400;\"> (diclofenac\/misoprostol): treats symptoms of osteoarthritis and rheumatoid arthritis and includes misoprostol to protect the stomach<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/cambia\/what-is\"><b>Cambia<\/b><\/a><span style=\"font-weight: 400;\"> (diclofenac powder): treats acute migraine headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/cataflam\/what-is\"><b>Cataflam<\/b><\/a><span style=\"font-weight: 400;\"> (diclofenac potassium tablets): treats symptoms of osteoarthritis, rheumatoid arthritis, menstrual pain, mild to moderate pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Diclofenac gel<\/b><span style=\"font-weight: 400;\">: a topical diclofenac gel that treats joint pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Flector<\/b><span style=\"font-weight: 400;\"> (diclofenac) transdermal patch: treats acute pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Pennsaid<\/b><span style=\"font-weight: 400;\"> (diclofenac) solution: treats symptoms of knee osteoarthritis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Solaraze<\/b><span style=\"font-weight: 400;\"> (diclofenac) topical gel: treats actinic keratosis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Voltaren<\/b><span style=\"font-weight: 400;\"> (diclofenac) ophthalmic (eye drops): treats eye inflammation after cataract surgery; also is used before and after corneal refractive surgery<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Zipsor<\/b><span style=\"font-weight: 400;\">:<\/span> <span style=\"font-weight: 400;\">(diclofenac capsules): treats mild to moderate pain<\/span><b>&nbsp;<\/b><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Zorvolex<\/b><span style=\"font-weight: 400;\"> (diclofenac capsules): treats mild to moderate pain and symptoms of osteoarthritis<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Diclofenac is also available over-the-counter as a topical medication to treat joint pain. Some medications that are available OTC and contain diclofenac include Voltaren Arthritis Pain, Aspercreme Arthritis Pain, Dr. Scholl&rsquo;s Arthritis Pain Reliever, and Salonpas Arthritis Pain Relief Gel.&nbsp;<\/span><\/p>\n<h2 id=\"common-side-effects-of-diclofenac\"><span style=\"font-weight: 400;\">Common side effects of diclofenac<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Patients who take diclofenac may experience stomach problems as a common side effect&mdash;this may include indigestion, stomach pain, nausea, vomiting, diarrhea or constipation, and\/or gas.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/19305\/diclofenac-sodium\/Adverse-Reactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">common side effects<\/span><\/a><span style=\"font-weight: 400;\"> of oral diclofenac include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Skin reactions such as rash, itching, hives<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increased liver function tests<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drowsiness&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling of the extremities (legs, ankles, feet, hands, arms)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/conditions\/tinnitus-treatment-and-medications\"><span style=\"font-weight: 400;\">Ringing in the ears<\/span><\/a><span style=\"font-weight: 400;\">&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bruising<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sun sensitivity (patients should avoid the sun as much as possible when taking diclofenac and use extra caution when in the sun, wearing protective clothing and applying sunscreen)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Delayed ovulation (women who are trying to conceive or having trouble conceiving should consult their health care provider for medical advice)<\/span><\/li>\n<\/ul>\n<h2 id=\"serious-side-effects-of-diclofenac\"><span style=\"font-weight: 400;\">Serious side effects of diclofenac<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Before taking diclofenac, tell your doctor about any medical conditions you have, as well as family history and medical history. <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/19305\/diclofenac-sodium\/Adverse-Reactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Serious possible side effects<\/span><\/a><span style=\"font-weight: 400;\"> of oral diclofenac may include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gastrointestinal bleeding, perforation, and ulcers<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart and clotting problems: heart attack, stroke, blood clots, heart failure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High blood pressure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Problems with the kidneys or kidney failure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver damage<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pancreas problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Serious and life-threatening allergic reactions, skin reactions, or drug reactions, including <\/span><a href=\"https:\/\/www.hopkinsmedicine.org\/health\/conditions-and-diseases\/generalized-exfoliative-dermatitis\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">exfoliative dermatitis<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/17656-stevens-johnson-syndrome\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Stevens-Johnson syndrome, toxic epidermal necrolysis<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.hopkinsmedicine.org\/health\/conditions-and-diseases\/erythema-multiforme\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">erythema multiforme<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.aaaai.org\/conditions-treatments\/related-conditions\/dress\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">drug reaction with eosinophilia and systemic symptoms<\/span><\/a><span style=\"font-weight: 400;\"> (DRESS)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Anemia<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blood disorders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Prolonged <\/span><a href=\"https:\/\/www.mountsinai.org\/health-library\/tests\/bleeding-time\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">bleeding time<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hyperkalemia (high potassium levels in the blood)&nbsp;<\/span><\/li>\n<\/ul>\n<h3 id=\"diclofenac-and-gastrointestinal-problems\"><span style=\"font-weight: 400;\">Diclofenac and gastrointestinal problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Any NSAID, including diclofenac, can cause serious <\/span><span style=\"font-weight: 400;\"> including inflammation, bleeding, ulceration (sores), and perforation (holes) of the stomach, esophagus, or intestines, which can cause death. These events can happen at any time, with or without warning symptoms. Only about 20% of patients who take an NSAID and develop a GI complication have symptoms. In clinical studies, ulcers, bleeding, and perforation due to NSAIDs occurred in about 1% of patients who took an NSAID for three to six months, and in about 2-4% of patients who took an NSAID for one year.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Individuals with a history of stomach problems such as ulcers or bleeding have more than 10 times the risk for developing GI complications from an NSAID than those who do not have risk factors. Other risk factors include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Longer duration of NSAID treatment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/smoking-cessation-drugs\/\"><span style=\"font-weight: 400;\">Smoking<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Alcohol use<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Older age<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bleeding disorders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Poor general health status<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Other medications taken at the same time including oral steroids, aspirin, blood thinners, <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/ssris\"><span style=\"font-weight: 400;\">selective serotonin reuptake inhibitor (SSRI) antidepressants<\/span><\/a><span style=\"font-weight: 400;\">, or SNRI antidepressants<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Those who take NSAIDs should be prescribed the lowest effective dose for the shortest possible time and should be closely monitored.&nbsp;<\/span><\/p>\n<h3 id=\"diclofenac-and-heart-problems\"><span style=\"font-weight: 400;\">Diclofenac and heart problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">NSAIDs, including diclofenac, can increase the risk of serious heart events, such as heart attack and stroke, which can cause death. Individuals with heart disease or other risk factors have a higher incidence of serious heart events. These complications can occur early in treatment, or at any time. As with GI problems, patients who take NSAIDs should be prescribed the lowest effective dose for the shortest time and should be closely monitored.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">NSAIDs should never be used before or after coronary artery bypass graft (CABG) surgery. In most cases, NSAIDs should not be used after a heart attack.&nbsp;<\/span><\/p>\n<h3 id=\"diclofenac-and-allergic-skin-or-drug-reactions\"><span style=\"font-weight: 400;\">Diclofenac and allergic, skin, or drug reactions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">NSAIDs like diclofenac can cause a severe allergic reaction. Patients who experience signs of an allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, should get emergency medical help.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Diclofenac can cause serious or life-threatening skin reactions that require emergency medical attention. Patients should be alert to fever, burning eyes, sore throat, red or purple rash (or any kind of skin rash), and\/or blistering or peeling skin. These symptoms require emergency medical attention.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Diclofenac may also cause a serious drug reaction that could potentially affect many parts of the body. Symptoms may include rash, fever, swollen glands, weakness, muscle aches, bruising, or yellowing of the skin or whites of the eyes.&nbsp;<\/span><\/p>\n<h2 id=\"how-soon-do-diclofenac-side-effects-start\"><span style=\"font-weight: 400;\">How soon do diclofenac side effects start?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Many patients have only mild side effects, especially with a short course of treatment. Stomach problems, such as diarrhea, stomach pain, and heartburn, tend to occur fairly <\/span><a href=\"https:\/\/www.pdr.net\/drug-summary\/Diclofenac-Sodium-Delayed-Release-diclofenac-sodium-1413.6161\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">quickly<\/span><\/a><span style=\"font-weight: 400;\"> in treatment.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">More serious stomach problems like bleeding, perforations, and ulcers, can occur at any time during treatment, with or without warning. Other serious problems like heart attack, blood clots, serious skin reactions, and pancreas, kidney, or liver problems, may occur after a period of time of diclofenac treatment.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Before taking diclofenac, ask your healthcare provider for more information about risk factors for side effects, what side effects to expect, what to do if they occur, and any other questions you may have.&nbsp;<\/span><\/p>\n<h2 id=\"how-long-do-diclofenac-side-effects-last\"><span style=\"font-weight: 400;\">How long do diclofenac side effects last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Mild stomach problems, like heartburn or diarrhea, may go away in a few days as your body adjusts to the medicine.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other side effects can be more serious, with longer-lasting effects (see next section).&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you experience any side effects that cause concern or that do not go away, consult your healthcare provider. Seek emergency medical help if symptoms are more urgent, such as swelling, trouble breathing, or any changes in the skin such as rashes, blistering, or peeling.<\/span><\/p>\n<h2 id=\"what-are-the-long-term-side-effects-of-diclofenac\"><span style=\"font-weight: 400;\">What are the long-term side effects of diclofenac?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Many people who take diclofenac will only experience mild side effects. It is important to take diclofenac exactly as prescribed&mdash;this may help avoid more severe or long-term side effects or complications. Many side effects are mild and tend to go away as you adjust to the medicine, like stomach upset or drowsiness.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some long-term side effects, if diclofenac is taken for a period of time, may include anemia (low red blood cells), kidney problems, and liver problems. However, diclofenac is generally prescribed at the lowest dose and for the shortest time possible, which can help avoid many long-term side effects.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&nbsp;<\/span><span style=\"font-weight: 400;\">Serious side effects, including stomach ulcers, bleeding, and perforation, can occur at any time during treatment. These can lead to long-term complications. Heart attacks, strokes, and kidney problems are other possible, but rare, problems that could occur, causing long-term complications.&nbsp;<\/span><\/p>\n<h2 id=\"diclofenac-contraindications\"><span style=\"font-weight: 400;\">Diclofenac contraindications<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Before using diclofenac, patients should consult their healthcare provider, and review their medical conditions and history. Diclofenac is not safe for everyone to take. It is <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/19303\/diclofenac-sodium\/Contraindications-Cautions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">contraindicated<\/span><\/a><span style=\"font-weight: 400;\"> (should not be taken) for certain individuals. Diclofenac should not be used in:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People who are allergic to diclofenac, any NSAID, or any ingredient in the medication<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with aspirin-induced or NSAID-induced asthma or hives<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with aspirin triad (individuals who have all 3: aspirin or NSAID allergy, asthma, and sinus disease with nasal polyps)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People who are undergoing CABG surgery (heart bypass surgery)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with severe kidney disease\/poor kidney function<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pregnant women starting at 30 weeks of pregnancy (diclofenac could harm the unborn baby)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Diclofenac may or may not be used in certain other patients. If it is used, diclofenac should be used cautiously and with close monitoring. These individuals include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pregnant women before 30 weeks of pregnancy<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Older adults<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Debilitated (in a weakened state) patients&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with kidney problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with liver disease\/liver problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/asthma-treatment-and-medications\"><span style=\"font-weight: 400;\">asthma<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People who have had a recent heart attack<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with heart disease (cardiovascular disease), or who are at risk for heart disease due to risk factors or a family history of heart disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/blood-pressure-levels\/\"><span style=\"font-weight: 400;\">high blood pressure<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with congestive heart failure (CHF)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with fluid retention<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with blood clotting disorders<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People with a history of GI bleeding or ulcers<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People who smoke or use alcohol<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People who are dehydrated<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Women who are trying to conceive<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">People who take diclofenac for a long time (this increases the risk of serious complications)<\/span><\/li>\n<\/ul>\n<h2 id=\"diclofenac-warnings\"><span style=\"font-weight: 400;\">Diclofenac warnings<\/span><\/h2>\n<h3 id=\"diclofenac-black-box-warning\"><span style=\"font-weight: 400;\">Diclofenac black box warning<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/black-box-warning\/\"><span style=\"font-weight: 400;\">black box warning<\/span><\/a><span style=\"font-weight: 400;\"> is the strongest warning required by the United States Food and Drug Administration (FDA). Diclofenac&mdash;as well as all NSAIDs&mdash;have a black box warning. This <\/span><span style=\"font-weight: 400;\">:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">NSAIDs cause an increased risk of serious heart and clotting complications, including heart attack and stroke, which can cause death. This risk can occur early in treatment and may increase the longer the medication is taken.&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diclofenac should not be taken before or after CABG surgery.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">NSAIDs cause a greater risk of serious GI problems including bleeding, ulcers, and perforation of the stomach or intestines, which can cause death. These can occur at any time during diclofenac use, with or without warning symptoms. Certain patients are at higher risk, including older adults and patients with a history of ulcers or GI bleeding.&nbsp;<\/span><\/li>\n<\/ul>\n<h3 id=\"is-diclofenac-a-controlled-substance\"><span style=\"font-weight: 400;\">Is diclofenac a controlled substance?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Diclofenac is not a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/controlled-substances-act\/\"><span style=\"font-weight: 400;\">controlled substance<\/span><\/a><span style=\"font-weight: 400;\"> and is not habit-forming. Other NSAID treatment options are not controlled substances, either.<\/span><\/p>\n<h3 id=\"diclofenac-overdose\"><span style=\"font-weight: 400;\">Diclofenac overdose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Taking too much diclofenac may cause low energy, drowsiness, nausea, vomiting, and abdominal pain. Other problems that may occur in rare cases include GI bleeding, high blood pressure, kidney problems, respiratory depression, and coma. If you think you took too much diclofenac, consult your healthcare provider right away, or call Poison Control at 1-800-222-1222. If your symptoms are severe or life-threatening, call 911 and go to the emergency room.&nbsp;<\/span><\/p>\n<h2 id=\"diclofenac-interactions\"><span style=\"font-weight: 400;\">Diclofenac interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Before taking diclofenac, tell your healthcare professional about any allergies to medications and all the medications you take. This includes prescription and OTC drugs, vitamins, and supplements.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some interactions with diclofenac include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Toradol (<\/b><a href=\"https:\/\/online.epocrates.com\/drugs\/19304\/diclofenac-sodium\/Drug-Interactions\" target=\"_blank\" rel=\"noopener\"><b>ketorolac<\/b><\/a><b>)<\/b><span style=\"font-weight: 400;\"> should never be taken with diclofenac. The combination could increase the risk of GI ulcers, perforation, and bleeding, which could be life-threatening. This combination could also cause high blood pressure, kidney problems, and other complications.&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Avoid consuming <\/span><b>alcohol<\/b><span style=\"font-weight: 400;\"> while taking diclofenac. The combination of diclofenac and alcohol can increase the risk of GI ulcers, perforation, and bleeding, which could be life-threatening.&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">While taking diclofenac, avoid excessive <\/span><b>caffeine<\/b><span style=\"font-weight: 400;\"> intake, which could increase the risk of high blood pressure.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Diuretics<\/b><span style=\"font-weight: 400;\"> (water pills) combined with diclofenac could increase the risk of kidney problems. If the combination cannot be avoided, kidney function should be closely monitored.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diclofenac combined with certain medications can increase the risk of bleeding. These drugs include <\/span><b>blood thinners, antiplatelet drugs,<\/b><span style=\"font-weight: 400;\"> selective serotonin reuptake inhibitor <\/span><b>(SSRI) antidepressants<\/b><span style=\"font-weight: 400;\">, and serotonin norepinephrine reuptake inhibitor <\/span><b>(SNRI) antidepressants<\/b><span style=\"font-weight: 400;\">. Patients who take a combination of one of these drugs with diclofenac will be closely monitored for signs of bleeding.&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diclofenac can interact with <\/span><b>ACE inhibitors, angiotensin receptor blockers, or beta-blockers<\/b><span style=\"font-weight: 400;\">. These drugs may not work as well to control blood pressure when taken with an NSAID like diclofenac. In some patients, this combination can worsen kidney function or cause kidney failure. This includes patients who are older adults, volume-depleted (including those who take diuretics), or who have kidney problems. If these drugs are used together, depending on the risk factors, the healthcare professional will monitor blood pressure and kidney function on a regular basis, and ensure the patient is adequately hydrated.&nbsp;<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">This is not a full list of drug interactions and others may occur. Consult your healthcare professional for more information about drug interactions with diclofenac.<\/span><\/p>\n<h2 id=\"how-to-avoid-diclofenac-side-effects\"><span style=\"font-weight: 400;\">How to avoid diclofenac side effects<\/span><\/h2>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Before taking diclofenac, review your medical history, family history, allergies to medications, and medication list with your healthcare provider. This will ensure that diclofenac is safe for you to take. Only take diclofenac if approved by your healthcare provider. Do not take someone else&rsquo;s diclofenac, even if they have the same symptoms, because it may not be safe for you. In the same regard, do not share your diclofenac with others, because it may not be safe for them.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ask your healthcare professional what side effects to expect and what to do if you experience them. Carefully read the prescription label, patient information leaflet, and medication guide. Consult your healthcare provider or pharmacist if you have any questions or concerns.&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Take diclofenac exactly as directed. Do not take more than prescribed, and do not take diclofenac for longer than prescribed. Diclofenac should be taken at the lowest effective dose for the shortest time to avoid complications, so follow your doctor&rsquo;s directions closely.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Take diclofenac with food. This may decrease the chance of stomach upset. Diclofenac tablets are delayed-release or extended-release and should be swallowed whole. Do not chew, break, or crush diclofenac tablets.&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">While taking diclofenac, avoid alcohol and caffeine. Do not start any new medications&mdash;including OTC medications&mdash;unless approved by your healthcare provider or pharmacist. Some OTC medications contain NSAIDs, and taking diclofenac with other NSAIDs can increase the risk of serious side effects.<\/span><\/li>\n<\/ol>\n<h2 id=\"how-to-treat-side-effects-of-diclofenac\"><span style=\"font-weight: 400;\">How to treat side effects of diclofenac<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Report side effects to your prescriber. It is best to report concerning side effects right away (or seek emergency treatment if needed) rather than wait because serious side effects can occur.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For mild side effects, you can often treat them or use non-medicinal methods until your body adjusts to the medicine. For example, if you experience a headache, you can take Tylenol (acetaminophen)&mdash;avoid OTC medications that contain an NSAID such as Advil. Check with your pharmacist if you need help selecting an OTC medicine. Resting in a cool, dark, quiet room and drinking plenty of fluids may help, too.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another example is a mild upset stomach. You can take diclofenac with food to lessen the chance of an upset stomach. If you feel nauseous, you can try eating bland foods as well as avoiding foods that are fried or spicy.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you experience the following symptoms, call your doctor right away:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Skin rash (even a mild rash)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Flulike symptoms<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Swelling, fast weight gain, shortness of breath (these could signal heart problems)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Little or no urination, painful\/difficult urination, tiredness, shortness of breath, swelling in the arms\/legs (these could be symptoms of kidney problems)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea, diarrhea, stomach pain, tiredness, itching, dark urine, clay-colored stools, yellowing of the skin or whites of the eyes (these could be symptoms of liver problems)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bloody or tarry stools, coughing up blood or vomit that has a coffee ground appearance (these symptoms could signal internal bleeding)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Other symptoms can be more severe and require emergency medical attention. These may include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Allergic reaction<\/b><span style=\"font-weight: 400;\">: hives, difficulty breathing, swelling of the face or throat<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Skin reaction<\/b><span style=\"font-weight: 400;\">: fever, sore throat, burning eyes, skin pain, red or purple rash, blistering or peeling skin<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Serious drug reaction<\/b><span style=\"font-weight: 400;\">: rash, fever, swollen glands, muscle pain, weakness, bruising, yellowing of the skin or whites of the eyes<\/span><\/li>\n<\/ul>\n<p><b>Signs of a heart attack or stroke<\/b><span style=\"font-weight: 400;\">: chest pain that spreads to the jaw or shoulder, numbness\/weakness on one side of the body, shortness of breath, slurred speech<\/span><\/p>\n<h2 id=\"sources\"><span style=\"font-weight: 400;\">Sources<\/span><\/h2>\n<ul>\n<li><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=b2d71822-a7f3-447c-911c-971a21af5346\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Diclofenac sodium<\/span><\/a><span style=\"font-weight: 400;\">, DailyMed<\/span><\/li>\n<li><a href=\"https:\/\/online.epocrates.com\/drugs\/19301\/diclofenac-sodium\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Diclofenac sodium<\/span><\/a><span style=\"font-weight: 400;\">, Epocrates<\/span><\/li>\n<li><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a689002.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Diclofenac<\/span><\/a><span style=\"font-weight: 400;\">, Medline Plus<\/span><\/li>\n<li><span style=\"font-weight: 400;\">, Prescriber&rsquo;s Digital Reference (PDR)<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Diclofenac is a prescription drug that is part of a class of medications called non-steroidal anti-inflammatory drugs, or NSAIDs. If you have ever had any type of back pain, inflammation, or other injury, you may have taken an NSAID. Some popular NSAIDs include oral tablets like aspirin, Advil and Motrin (ibuprofen), and naproxen, among others. [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":55101,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[12752,808],"coauthors":[10668],"class_list":["post-55098","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-medication-side-effects","tag-pain-management","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Diclofenac side effects and how to avoid them | SingleCare<\/title>\n<meta name=\"description\" content=\"Gastrointestinal problems, heart problems, and skin and drug reactions are common diclofenac side effects. 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