Nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin, such diclofenac, may increase a person’s chance of having a heart attack or stroke compared to a person who does not take them. These occurrences could be fatal and could occur suddenly. For those who take NSAIDs for an extended period of time, this risk may be larger. If you have recently experienced a heart attack, avoid taking an NSAID like diclofenac unless your doctor specifically instructs you to. Inform your doctor if you smoke, have high cholesterol, high blood pressure, or diabetes, or if you or anyone in your family has ever suffered from heart disease, a heart attack, or a stroke. If you suffer any of the following symptoms, seek emergency medical attention right away: chest pain, shortness of breath, weakness on one side or area of the body, or slurred speech.

You shouldn’t take diclofenac just before or just after having coronary artery bypass graft surgery (CABG; a form of cardiac surgery).

NSAIDs like diclofenac may result in stomach or intestine ulcers, bleeding, or holes. These issues can arise at any point during therapy, without any prior symptoms, and they have the potential to be fatal. Long-term NSAID users, the elderly, persons in poor health, and those who consume substantial amounts of alcohol while taking diclofenac may be at higher risk. If you use any of the following medications, let your doctor know: Aspirin, other NSAIDs including ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and warfarin (Coumadin, Jantoven) are anticoagulants (also known as “blood thinners”); oral steroids like dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); and aspirin; SNRIs include desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine. Selective serotonin reuptake inhibitors (SSRIs) include citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisd (Effexor XR). Tell your doctor if you suffer from or have ever suffered from ulcers, gastrointestinal bleeding, or any other bleeding disorders. Call your doctor and stop taking diclofenac if you have any of the following symptoms: stomach ache, heartburn, vomiting anything bloody or resembling coffee grounds, faeces that are black and tarry, or blood in the stool.

Keep all of your appointments with your physician and the lab. Your doctor will keep a close eye on your symptoms and possibly recommend a few tests to see how your body is reacting to the diclofenac. Inform your physician about your feelings so that they can prescribe the ideal dosage of medication to cure your problem with the least chance of negative side effects.

When you first start receiving therapy with diclofenac and at each time your prescription is renewed, your doctor or pharmacist will give you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the material and contact your doctor or pharmacist. The Medication Guide is also available on the Food and Drug Administration (FDA) website.

To treat mild to moderate pain, people take diclofenac pills (Cataflam) and capsules (Zipsor, Zorvolex). Osteoarthritis (arthritis brought on by a disintegration of the lining of the joints) and rheumatoid arthritis are treated with diclofenac extended-release tablets (Voltaren XR), tablets (Cataflam), and delayed-release pills (available generically) (arthritis caused by swelling of the lining of the joints). Ankylosing spondylitis is also treated with diclofenac extended-release and delayed-release tablets (arthritis that mainly affects the spine). Painful menstrual periods can also be managed with diclofenac pills (Cataflam). Adults with migraine headaches are treated with diclofenac solution (Cambia); nevertheless, migraines cannot be prevented or treated with this medication, nor can headaches of any other kind. Diclofenac belongs to a group of drugs known as NSAIDs. It functions by halting the body’s production of a chemical responsible for inflammation, fever, and discomfort.

Diclofenac is available as a tablet, liquid-filled capsule, hard gelatin capsule, delayed-release (long-acting) tablet, packets of powder for solution (to be mixed with water), and extended-release (long-acting) tablet. Diclofenac hard gelatin capsules are often taken three times daily on an empty stomach, while diclofenac liquid-filled capsules are typically taken four times daily. Diclofenac extended-release pills are typically given once day, though they may occasionally be taken twice daily if further pain management is required. It is typical to take diclofenac tablets and diclofenac delayed-release tablets 2, 3, or 4 times a day. One dose of diclofenac solution is used without food to treat migraine headache pain. Take diclofenac at about the same time(s) every day if you were instructed to do so. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Diclofenac should be taken as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.

You cannot interchangeably use different diclofenac preparations because they all affect how the drug is released in your body. Take the diclofenac medication that your doctor has prescribed only; do not change to another diclofenac medication unless your doctor instructs you to.

Depending on how you react to the drug, your doctor may change the dose you are taking during treatment. Discuss your feelings on your diclofenac treatment with your doctor.

You must combine the powder with water before consuming it if you plan to use it as a solution. Remove one package from the row of three attached packets before mixing the medication. Fill a cup with 1 to 2 ounces (or 2 to 4 teaspoons; 30 to 60 mL) of water. Mix thoroughly before adding the packet’s contents. Immediately consume the entire combination. The empty packet should be disposed of in a trash bin that is out of kids’ and animals’ reach.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking diclofenac,

• Aspirin, other NSAIDs like ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (also sold under the brand names Solaraze and Pennsaid in Arthrotec), as well as any other medications or inactive ingredients in the diclofenac product you intend to use should be disclosed to your doctor and pharmacist. For a list of the inactive substances, consult your pharmacist or the prescription guide. Inform your doctor if you have any allergies to bovine (cow) proteins, such as those in milk, beef, or gelatin, if you intend to take diclofenac capsules (Zipsor).
• Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Mention the drugs in the IMPORTANT CAUTION section as well as any of the following: acetaminophen (Tylenol, in other products) (Tylenol, in other products), drugs that block the action of the angiotensin-converting enzyme (ACE), such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc, in Uniretic), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Accuretic, in Quinaretic); angiotensin receptor blockers such olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta), azilsartan (Edarbi, in Edarbyclor), candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide); cyclosporine (Gengraf, Neoral, Sandimmune); digoxin (Lanoxin); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, and Innopran); lithobid, methotrexate (Otrexup, Rasuvo, Trexall), rifampin (Rifadin, Rimactane, in Rifamate, in Rifater), voriconazole, and oral diabetes treatments such as insulin and antidiabetic drugs are also available (Vfend). Diclofenac may interact with a variety of other drugs, so even if a drug is not on this list, be careful to notify your doctor about all of the medications you are currently taking. The dosage of your drugs may need to be adjusted, and your health may need to be closely watched for any negative effects.
• Inform your physician if you have or have ever had any of the conditions listed in the IMPORTANT WARNING section, as well as asthma, particularly if you also suffer from frequent stuffy or runny noses, nasal polyps (swelling of the nasal lining), porphyria (an abnormal increase in the amount of certain natural substances produced by the liver), heart failure, swelling of the hands, feet, ankles, or lower legs, or liver or kidney disease.
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. If diclofenac is consumed beyond 20 weeks of pregnancy, it may harm the foetus and complicate delivery. Unless specifically instructed to do so by your doctor, avoid taking diclofenac during or after the first 20 weeks of pregnancy. Call your doctor if you become pregnant while taking diclofenac.
• If you are 75 years of age or older, discuss with your doctor the advantages and disadvantages of taking diclofenac. Never take this drug for longer than your doctor has prescribed or at a higher dose.
• Inform the surgeon or dentist that you are taking diclofenac if you are undergoing surgery, including dental surgery.
• The powder for solution contains aspartame, a source of phenylalanine, therefore you should be aware of this if you have phenylketonuria (PKU; an inherited disorder that necessitates a particular diet to prevent mental impairment).

Keep eating normally unless your doctor instructs you otherwise.

The powder for solution is normally taken as needed to treat migraine headaches. If you are taking any other diclofenac medicine and you forget to take a dose, take the missed dose right away. If your next dose is approaching, skip the missed one and resume your regular dosing schedule. Do not take a second dose to make up for a missed one.

Diclofenac might have unwanted effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Diarrhea
• Constipation
• Bloating or gas
• Headache
• Dizziness
• Hearing ringing

Some adverse effects may be severe. Get emergency medical assistance or call your doctor right away if you develop any of the following symptoms or those listed in the IMPORTANT WARNING section. Unless you speak with your doctor, stop taking diclofenac.

• Rise in weight without cause
• Respiratory issues or lack of breath
• Abdomen, lower legs, or foot and ankles swelling
• Extreme fatigue
• Not really enough energy
• Nausea
• Reduced appetite
• Itching
• Stomach ache in the top right corner
• Eyes or skin that have a yellow tint
• Flu-like signs
• Fever
• Blisters
• Rash
• Hives
• Swelling of the hands, arms, hands, face, tongue, lips, throat, or eyes
• Breathing or swallowing challenges
• Hoarseness
• Light skin
• Rapid heart rate
• Urine that is hazy, discoloured, or bloody
• Back ache
• Uncomfortable or challenging urinating

Further adverse effects of diclofenac are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom).

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

• Nausea
• Vomiting
• Abdominal pain
• Tarry, dark, or bloody stools
• Vomiting something that looks like coffee grounds or is bloody
• Drowsiness
• Uneven, shallow, or slow breathing
• Consciousness is lost

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.