* Generic Name: diclofenac sodium
* Brand Name: Voltaren
* What is diclofenac?
* What are the possible side effects of diclofenac?
* What is the most important information I should know about
diclofenac?
* What should I discuss with my healthcare provider before taking
diclofenac?
* How should I take diclofenac?
* What happens if I miss a dose?
* What happens if I overdose?
* What should I avoid while taking diclofenac?
* What other drugs will affect diclofenac?
* Where can I get more information?
What is diclofenac?
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID).
This medicine works by reducing substances in the body that cause pain
and inflammation.
Diclofenac is used to treat mild to moderate pain, or signs and
symptoms of osteoarthritis or rheumatoid arthritis. The
Cataflam brand of this medicine is also used to treat menstrual
cramps.
Diclofenac powder (Cambia) is used to treat a migraine headache
attack. Cambia will only treat a headache that has already begun.
It will not prevent headaches or reduce the number of attacks.
Diclofenac may also be used for purposes not listed in this medication
guide.
What are the possible side effects of diclofenac?
Get emergency medical help if you have signs of an allergic reaction:
sneezing, runny or stuffy nose; wheezing or trouble
breathing; hives; swelling of your face, lips, tongue, or throat.
Get emergency medical help if you have signs of a heart attack or
stroke: chest pain spreading to your jaw or shoulder, sudden
numbness or weakness on one side of the body, slurred speech,
feeling short of breath.
Stop using diclofenac and call your doctor at once if you have:
* the first sign of any skin rash, no matter how mild;
* shortness of breath (even with mild exertion);
* swelling or rapid weight gain;
* signs of stomach bleeding--bloody or tarry stools, coughing up
blood or vomit that looks like coffee grounds;
* liver problems--nausea, upper stomach pain, itching, tired feeling,
flu-like symptoms, loss of appetite, dark urine,
clay-colored stools, jaundice (yellowing of the skin or eyes);
* kidney problems--little or no urinating, painful or difficult
urination, swelling in your feet or ankles, feeling tired or short
of breath;
* high blood pressure--severe headache, pounding in your neck or
ears, nosebleed, anxiety, confusion;
* low red blood cells (anemia)--pale skin, feeling light-headed
or short of breath, rapid heart rate, trouble concentrating; or
* severe skin reaction--fever, sore throat, swelling in your face
or tongue, burning in your eyes, skin pain followed by a red or
purple skin rash that spreads (especially in the face or upper
body) and causes blistering and peeling.
Common side effects may include:
* indigestion, gas, stomach pain, nausea, vomiting;
* diarrhea, constipation;
* headache, dizziness, drowsiness;
* stuffy nose;
* itching, increased sweating;
* increased blood pressure; or
* swelling or pain in your arms or legs.
This is not a complete list of side effects and others may occur. Call
your doctor for medical advice about side effects. You may report side
effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about diclofenac?
Diclofenac can increase your risk of fatal heart attack or stroke,
especially if you use it long term or take high doses, or if you have
heart disease. Do not use this medicine just before or after heart
bypass surgery (coronary artery bypass graft, or CABG).
Diclofenac may also cause stomach or intestinal bleeding, which can be
fatal. These conditions can occur without warning while you are using
diclofenac, especially in older adults.
Voltaren Patient Information including How Should I Take
Osteoarthritis (OA): Treatment, Symptoms, Diagnosis
Osteoarthritis Overview Slideshow Pictures
Osteoarthritis: 15 Tips to Improve Daily Living With OA
Osteoarthritis Tips for Living Better Daily Slideshow
Osteoarthritis:Exercises for OA of the Knee
Exercises for OA of the Knee Slideshow
What should I discuss with my healthcare provider before taking diclofenac?
Diclofenac can increase your risk of fatal heart attack or stroke,
especially if you use it long term or take high doses, or if you have
heart disease. Even people without heart disease or risk factors could
have a stroke or heart attack while taking this medicine.
Do not use this medicine just before or after heart bypass surgery
(coronary artery bypass graft, or CABG).
Diclofenac may also cause stomach or intestinal bleeding, which can be
fatal. These conditions can occur without warning while you are using
diclofenac, especially in older adults.
You should not use diclofenac if you are allergic to it, or if you have
ever had an asthma attack or severe allergic reaction after taking
aspirin or an NSAID.
Do not use Cambia to treat a cluster headache. Do not use Zipsor if
you are allergic to beef or beef protein.
To make sure diclofenac is safe for you, tell your doctor if you have:
* heart disease, high blood pressure, high cholesterol,
diabetes, or if you smoke;
* a history of heart attack, stroke, or blood clot;
* a history of stomach ulcers or bleeding;
* asthma;
* liver or kidney disease;
* fluid retention.
Taking diclofenac during the last 3 months of pregnancy may harm the
unborn baby. Tell your doctor if you are pregnant or plan to become
pregnant.
It is not known whether diclofenac passes into breast milk or if it
could harm a nursing baby. You should not breast-feed while using this
medicine.
Diclofenac is not approved for use by anyone younger than 18 years old.
How should I take diclofenac?
Different brands of diclofenac contain different amounts of this
medicine, and may have different uses. If you switch brands, your dose
needs may change. Follow your doctor's instructions about how much
medicine to take. Ask your pharmacist if you have any questions about
the brand of diclofenac you receive at the pharmacy.
Follow all directions on your prescription label. Your doctor may
occasionally change your dose. Do not take this medicine in larger
amounts or for longer than recommended. Use the lowest dose that is
effective in treating your condition.
Take Zorvolex on an empty stomach, at least 1 hour before or 2 hours
after a meal.
Do not crush, chew, or break an extended-release tablet or
delayed-release tablet. Swallow it whole.
Dissolve diclofenac powder (Cambia) with 1 to 2 ounces of water. Do not
use any other type of liquid. Stir this mixture and drink all of it
right away. Diclofenac powder works best if you take it on an empty
stomach.
Call your doctor if your headache does not completely go away after
taking Cambia. Do not take a second dose of diclofenac powder without
your doctor's advice. Overuse of migraine headache medicine can
make headaches worse. Tell your doctor if the medicine seems to stop
working as well in treating your migraine attacks.
If you use diclofenac long-term, you may need frequent medical tests.
Store at room temperature away from moisture and heat. Keep the bottle
tightly closed when not in use.
Read all patient information, medication guides, and instruction sheets
provided to you. Ask your doctor or pharmacist if you have any
questions.
Voltaren Patient Information including If I Miss a Dose
Osteoarthritis (OA): Treatment, Symptoms, Diagnosis
Osteoarthritis Overview Slideshow Pictures
Osteoarthritis: 15 Tips to Improve Daily Living With OA
Osteoarthritis Tips for Living Better Daily Slideshow
Osteoarthritis:Exercises for OA of the Knee
Exercises for OA of the Knee Slideshow
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if
it is almost time for your next scheduled dose. Do not take extra
medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at
1-800-222-1222.
What should I avoid while taking diclofenac?
Avoid drinking alcohol. It may increase your risk of stomach bleeding.
Avoid taking aspirin or other NSAIDs while you are taking
diclofenac.
Ask a doctor or pharmacist before using any cold, allergy, or pain
medication. Many medicines available over the counter contain aspirin
or other medicines similar to diclofenac. Taking certain products
together can cause you to get too much of this type of medication.
Check the label to see if a medicine contains aspirin, ibuprofen,
ketoprofen, or naproxen.
What other drugs will affect diclofenac?
Ask your doctor before using diclofenac if you take an antidepressant
such as citalopram, escitalopram, fluoxetine (Prozac),
fluvoxamine, paroxetine, sertraline (Zoloft),
trazodone, or vilazodone. Taking any of these medicines with an
NSAID may cause you to bruise or bleed easily.
Tell your doctor about all your current medicines and any you start or
stop using, especially:
* cyclosporine;
* lithium;
* methotrexate;
* rifampin;
* antifungal medicine;
* a blood thinner (warfarin, Coumadin, Jantoven);
* heart or blood pressure medication, including a diuretic or
"water pill";
* other forms of diclofenac (Flector, Pennsaid, Solaraze,
Voltaren Gel);
* other NSAIDs--aspirin, ibuprofen (Advil, Motrin), naproxen
(Aleve), celecoxib (Celebrex), indomethacin, meloxicam,
and others; or
* steroid medicine (prednisone and others).
This list is not complete. Other drugs may interact with diclofenac,
including prescription and over-the-counter medicines, vitamins, and
herbal products. Not all possible interactions are listed in this
medication guide.
Where can I get more information?
Your pharmacist can provide more information about diclofenac.
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