You may have been prescribed Diclofenac tablets by your doctor for knee pain, back pain, or other body aches. This is a very common painkiller that many people use. However, like any medicine, there are a few things we need to be careful about when using it. So today, let's talk about these Diclofenac tablets, especially the Extended-Release type, as if we were talking to a friend.
What is this diclofenac?
Simply put, diclofenac is a medicine used to treat conditions such as pain, swelling, and arthritis. It belongs to a class of drugs called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) . That is, non-steroidal anti-inflammatory drugs.
"Extended-Release" (XR) means that the pill releases the medication into the body over a period of hours. This means that you only need to take it once a day. Your doctor may have prescribed it under a name like ``Voltaren-XR''.
Things you need to tell your doctor before taking this medicine
Before you start using diclofenac, it is important to tell your doctor the following information. Do not hide these things, as they are very important for your safety.
| Disease or condition | Description |
|---|---|
| Heart disease | Do you have conditions such as heart disease, heart attack, heart failure, high blood pressure? Have you recently (within 2 weeks) undergone bypass surgery (CABG)? |
| Stomach and intestinal problems | Have you had stomach ulcers or bleeding before? |
| Kidney or liver disease | Do you have any kidney or liver disease? |
| Blood-related problems | Do you have any bleeding disorders, high blood potassium levels, or low red blood cell count (anemia)? Are you taking medication that prevents blood clotting? |
| Other diseases and habits | Respiratory diseases such as asthma, use of steroid medications (such as prednisone), smoking, and frequent alcohol consumption. |
| Pregnancy and breastfeeding | Are you trying to get pregnant? Are you pregnant? Or are you breastfeeding? |
| Allergies | Are you allergic to diclofenac, aspirin, other NSAIDs, or any other medicine or food? |
How exactly do I use this medicine?
- Swallow the pill: Do not break or crush this pill, or chew it like chewing gum . Swallow it whole. This is because it is designed to release the medicine slowly. If you crush it, all the medicine will be absorbed into your body at once, which can increase side effects.
- With a glass of water: Take this pill with a full glass of water.
- With food: To reduce potential stomach upset, it is best to take this with or after a meal.
- Take it on time: Try to take it at the same time every day, as prescribed by your doctor. This will help maintain the same effectiveness of the medicine.
- Stopping: Do not stop taking the medication unless your doctor tells you to.
What if you miss your medication?
Imagine you forgot to take your morning pill. Take it as soon as you remember. But if it's almost time for your next dose (e.g., it's only a few hours away), skip the missed dose and take your next dose at the scheduled time. Never take two pills at once.
What if you take too much medicine? (Overdose)
If you think you have taken too much medicine, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
Other medications that may interact with diclofenac
Some medications can cause problems when taken with diclofenac, so tell your doctor about all the medications you take (including vitamins and herbal remedies).
| Medicines that should never be taken together | |
|---|---|
| Cidofovir | Ketorolac (another type of NSAID) |
| Methotrexate | |
| Other substances and medications that may cause problems | |
| Alcohol | Aspirin and other NSAIDs (Ibuprofen, Naproxen) |
| Medicines that prevent blood clotting (e.g. Warfarin) | Medication for high blood pressure |
| Diuretics (medicines that remove water from the body) | Lithium, Cyclosporine, Pemetrexed |
| Types of steroids (Prednisone, Cortisone) | Medications for osteoporosis (thinning of the bones) |
Things to consider when taking medication
Stomach bleeding
The main risk of using these medications is the possibility of stomach ulcers and bleeding.
This condition can occur without warning . Smoking, drinking alcohol, aging, and poor health increase your risk. If you have stomach pain, vomit that looks like coffee grounds, or black stools, see a doctor immediately.
Risk of heart attack and stroke
NSAIDs like diclofenac may slightly increase your risk of heart attack or stroke. This risk is higher if you use this medicine for a long time or if you already have heart disease. If you take aspirin to prevent heart attacks, be sure to talk to your doctor about taking diclofenac.
Skin reactions
Rarely, this medicine can cause severe skin reactions. These can occur even weeks after starting the medicine.
- Red rashes on the skin with fever and lethargy.
- These lesions may later turn into blisters or the skin may peel off.
- Red spots with swelling of the face and lips.
If you see symptoms like these, see a doctor immediately.
During pregnancy
Be especially careful about this if you are pregnant.
- Between 20 and 30 weeks: Taking diclofenac during this time can harm the baby in the womb. Therefore, take it only if absolutely necessary, under the close supervision of a doctor.
- After 30 weeks: Do not take this medicine at all during the last 3 months of pregnancy.
Side effects that may occur due to medication
| Side effects that should be reported to your doctor immediately | |
|---|---|
| Severe allergies | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Bleeding symptoms | Black or bloody stools, vomiting blood that looks like coffee grounds, red/dark brown urine, small red/purple spots on the skin, and unexplained bruising. |
| Heart attack symptoms | Pain/tightness in the chest, shoulder, arm, or jaw, nausea, difficulty breathing, feeling cold, fainting. |
| Heart failure symptoms | Difficulty breathing, swelling of the ankles, feet or hands, sudden weight gain, extreme fatigue. |
| Kidney/liver damage | Decreased urine output, swollen ankles (kidneys). / Pain in the upper right abdomen, loss of appetite, yellowing of the eyes/skin, dark yellow/brown urine (liver). |
| Stroke symptoms | Sudden numbness/numbness of the face, arm or leg (especially on one side), difficulty speaking, confusion, difficulty walking, severe headache. |
| Side effects that are usually not serious (but tell your doctor if they persist) | |
| Headache | Appetite |
| Nausea | Stomach upset |
Take-Home Message
- Diclofenac is an effective medication for pain and swelling, but it should only be used under the advice of a doctor.
- Do not break, crush, or chew these tablets. Swallow them whole with water.
- Be sure to tell your doctor about all other medications you are taking and any medical conditions you have.
- If you experience symptoms such as stomach pain, black stools, chest pain, or severe skin reactions, seek medical advice immediately .
- Avoid taking this medicine during pregnancy, especially in the last 3 months.
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