Do you sometimes have a habit of going to the pharmacy to buy a painkiller when you have a toothache, headache, joint pain, or body ache? One of the most common painkillers is diclofenac. This is a popular and fast-acting painkiller. However, like all medicines, there are some things we need to be very careful about when using this one. So today, let's talk about this painkiller called diclofenac.
What is Diclofenac?
Simply put, diclofenac is a medication used to treat mild to moderate pain, swelling, and arthritis . It belongs to a class of drugs called NSAIDs (Nonsteroidal Anti-inflammatory Drugs). This class of drugs works by reducing the production of chemicals in our bodies that cause pain and swelling.
This medication may come under different brand names, such as Zipsor and Zorvolex. Also, sometimes your doctor may prescribe this medication for other conditions not mentioned in this article. So if you have any questions, ask your doctor about it.
Things you need to tell your doctor before taking this medicine
Diclofenac is not a one-size-fits-all medication. If you have any of the following medical conditions or habits, you should definitely inform your doctor before using this medication.
| Disease or condition | Why is it important to raise awareness about it? |
|---|---|
| Heart disease, heart attack, heart failure, or recent (within 2 weeks) coronary artery bypass grafting (CABG) surgery | Because these medications can increase the risk of heart attack and stroke. |
| High blood pressure | This medicine may increase blood pressure. |
| Stomach ulcers or stomach bleeding | Diclofenac increases the risk of stomach and intestinal bleeding. |
| Kidney disease or liver disease | Because the drug can affect these organs. |
| Asthma or other respiratory diseases | For some people, asthma may worsen. |
| If you are taking blood-thinning medication (e.g. Warfarin) | Because the risk of bleeding can be greatly increased. |
| If you regularly drink alcohol or smoke | The risk of side effects such as stomach bleeding increases. |
| If you are pregnant, trying to get pregnant, or breastfeeding | This medicine may be harmful to the baby during pregnancy and breastfeeding. |
| If you have allergies to diclofenac, aspirin, or other medications, foods, or dyes | To prevent a severe allergic reaction. |
How should I use this medicine?
It is very important to follow your doctor's instructions exactly when using this medicine.
- Swallow these capsules whole with a glass of water . Do not break, crush, or chew them.
- Try to take it at the same time every day, as prescribed by your doctor.
- This medicine can be taken before or after meals. However, if you experience heartburn, it is better to take it with food .
- Continue using this medicine until your doctor tells you to stop.
- If you are over 65 , you may be more sensitive to the medicine than the average person, so you may need a lower dose.
- If this medicine is given to children , it should only be done in special cases and on medical advice.
Important: This medicine is for you only. Do not give this medicine to a friend or relative just because it has helped you. It can be dangerous.
What to do if you miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at once.
What if I take too much medicine?
If you think you have taken more medicine than you think, go to the nearest Emergency Treatment Unit (ETU) immediately or call the National Poisons Information Centre at the Colombo National Hospital .
Other medications that may interact with this medicine
Diclofenac is a drug that can interact with other medications, so it is very important to tell your doctor about all the medications you are taking.
| Never take diclofenac with these medications. | |
|---|---|
| Cidofovir | Ketorolac |
| Methotrexate | |
| Problems can occur with these medications too - tell your doctor | |
| Alcohol | Aspirin and other similar drugs |
| Medicines that prevent blood clotting (e.g. Warfarin, Apixaban) | Medications for high blood pressure |
| Other NSAIDs (e.g., Ibuprofen, Naproxen) | Steroid-type medications (e.g. Prednisone) |
| Some medications for depression (e.g. Fluoxetine) | Diuretics (drugs that remove water from the body) |
This list is not complete. Tell your doctor about any vitamins, herbal products, or other over-the-counter medications you are taking.
Things to consider when taking the medicine
- Do not take other painkillers: When taking this medicine, do not take other NSAID painkillers such as aspirin and ibuprofen. Doing so greatly increases the risk of side effects such as stomach irritation, nausea, and stomach ulcers.
- Stomach bleeding: This medicine can cause severe stomach ulcers and bleeding without warning. If you have stomach pain, vomiting blood, vomiting something that looks like coffee grounds, or black stools, see a doctor immediately .
- Heart attack and stroke risk: This medicine does not prevent heart attack or stroke. In fact, this risk may increase when you use this medicine for a long time or if you already have heart disease.
- Skin reactions: Sometimes, a few weeks after starting the medication, you may experience a red rash, blisters, or peeling skin along with fever and body aches. If this happens, tell your doctor right away.
- Pregnancy: If you are pregnant, talk to your doctor before taking this medicine. Taking this medicine, especially between 20 and 30 weeks of pregnancy, may harm the unborn baby. Do not take this medicine after 30 weeks.
- Drowsiness and dizziness: This medication may make you feel drowsy or dizzy. Therefore, avoid driving or operating machinery until you know how this medication affects you.
What side effects can be expected?
| If you have these symptoms, see a doctor immediately. | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Bleeding | Bloody or tarry stools, vomiting a substance that looks like coffee grounds, dark red/brown urine. |
| Symptoms of a heart attack | Pain or tightness in the chest, shoulder, arm, or jaw, nausea, difficulty breathing. |
| Symptoms of a Stroke | Sudden numbness or weakness in the face, arm or leg, difficulty speaking, difficulty walking, severe headache. |
| Symptoms of kidney or liver damage | Decreased urine output, swelling of the ankles and feet, yellowing of the skin and eyes, and pain in the upper right side of the abdomen. |
| It is usually not dangerous, but if it persists, tell your doctor. | |
| Headache | Appetite |
| Nausea | Stomach upset or discomfort |
Take-Home Message
- Diclofenac is a medicine that should be used under the advice of a doctor. Do not buy it from the pharmacy and take it at will.
- Tell your doctor about all your medical conditions and all the medications you take.
- If you experience stomach pain, black stools, or chest pain while taking this medicine, seek medical advice immediately.
- Pregnant women, those trying to become pregnant, and nursing mothers should think twice before using this medicine.
- Store the medicine safely at room temperature, out of the reach of children and pets.
👩🏽⚕️ Additional questions (FAQs)
💬 What is Diclofenac, a pill that is taken orally?
This is a very strong 'pain reliever (NSAID)' that is commonly found in pharmacies (under the names Voltaren, Cataflam, etc.)! It is much stronger than ibuprofen. Doctors use it to quickly relieve severe 'swelling and inflammation' in the body, such as joint pain, arthritis (Osteoarthritis/Rheumatoid Arthritis), back pain, and severe lower abdominal pain that occurs during menstruation.
💬 How does this medicine (Diclofenac) relieve joint/muscle pain?
When you have back/joint pain, our body produces a chemical called 'Prostaglandins'. That's what causes the pain and swelling in the joints! When Diclofenac enters the body, it completely shuts down (severely blocks) the factory that makes that chemical (COX-1 & COX-2 enzymes). Then, there is no signal to send pain signals, so the pain and swelling disappear within minutes.
💬 What are the most dangerous risks (Black Box Warnings) of continuing to take these pills (Voltaren/Diclofenac)?
If you drink this on an 'empty stomach', you can develop severe stomach ulcers and bleed from the intestines (so if you continue to drink it, you should drink it with food along with an 'Omeprazole' medicine). The other most dangerous danger is that the risk of 'Heart attack' and stroke' is very high! (People with heart problems/bypass should not even put this in their mouth!). It can also cause significant damage to the kidneys (Nephrotoxicity).
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