GENERIC NAME: diclofenac

BRAND NAMES: Voltaren, Cataflam, Voltaren-XR

DRUG CLASS AND MECHANISM: Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) effective in treating fever, pain, and inflammation in the body. As a group, NSAIDs are non-narcotic relievers of mild to moderate pain of many causes, including injury, menstrual cramps, arthritis , and other musculoskeletal conditions. Since the response to different NSAIDs varies from patient to patient, it is not unusual for a doctor to try different NSAIDs for any given condition.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: The stomach-coated (delayed-release) tablets (25mg, 50mg, 75mg) are called Voltaren. The immediate-release tablets (50mg) are called Cataflam. The extended release tablets (100mg) are called Voltaren-XR.

STORAGE: Store at room temperature and protect from moisture.

PRESCRIBED FOR: Diclofenac is used for the treatment of inflammation and pain caused by arthritis conditions such as rheumatoid arthritis, osteoarthritis , and ankylosing spondylitis . The medication can also be effective in treating soft tissue inflammations such as tendinitis and bursitis . Voltaren is stomach-coated and is slowly released into the blood. Cataflam is immediately released into the blood and is useful when rapid relief of mild to moderate pain is desired, as in treating menstrual cramps.

DOSING: Should be taken with food.

DRUG INTERACTIONS: Diclofenac should be avoided by patients with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It should also be avoided by patients with peptic ulcer disease or poor kidney function, since this medication can potentially aggravate both conditions. Diclofenac is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of increased risk of bleeding. Patients taking lithium can develop toxic blood lithium levels. Safety in children is unknown. Diclofenac is not habit forming. NSAIDs should be discontinued prior to elective surgery because of their mild tendency to interfere with blood clotting. Diclofenac is best discontinued at least two days in advance of the procedure.

Persons who have more than 3 alcoholic beverages per day are at increased risk of developing stomach ulcers when taking diclofenac or other NSAIDs.

PREGNANCY: Diclofenac is generally avoided during pregnancy.

NURSING MOTHERS: Diclofenac is generally avoided in nursing mothers.

SIDE EFFECTS: Most patients benefit from diclofenac and other NSAIDs with few side effects. However, serious side effects can occur, and generally tend to be dose related. Therefore, it is often desirable to use the lowest effective dose to minimize side effects. The most common side effects of diclofenac involve the gastrointestinal system. It can cause ulcerations, abdominal burning, pain, cramping, nausea, gastritis, and even serious gastrointestinal bleeding and liver toxicity. Sometimes, stomach ulceration and bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding. Rash, kidney impairment, ringing in the ears, and lightheadedness are also seen.

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