n
trade names: Cataflam, Voltaren; drug class: nonsteroidal antiinflammatory; action: inhibits prostaglandin synthesis; uses: acute and chronic rheumatoid arthritis, osteoarthritis, ankylosing spondylitis.
| Dental Dictionary: diclofenac |
trade names: Cataflam, Voltaren; drug class: nonsteroidal antiinflammatory; action: inhibits prostaglandin synthesis; uses: acute and chronic rheumatoid arthritis, osteoarthritis, ankylosing spondylitis.
| 5min Related Video: Diclofenac |
| Drug Info: Diclofenac |
Brand names: Cataflam®SolarazeVoltaren®Voltaren®-XR
Chemical formula:

Diclofenac delayed-release tablets
What are diclofenac delayed-release tablets?
DICLOFENAC (Voltaren®) is an anti-inflammatory drug. Diclofenac reduces the joint pain, stiffness, inflammation, or swelling caused by rheumatoid arthritis (rheumatism) and osteoarthritis. Generic diclofenac delayed-release tablets are available.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
asthma, especially aspirin sensitive asthma
bleeding problems or taking medicines that make you bleed more easily such as anticoagulants ('blood thinners')
cigarette smoker
coronary artery bypass graft (CABG) surgery within the past 2 weeks
dental disease
diabetes
drink more than 3 alcohol-containing beverages a day
heart or circulation problems like angina, high blood pressure, heart failure, heart rhythm problems, history of heart attack, history of blood clots, or leg edema (fluid retention)
kidney disease
liver disease
porphyria
stomach or duodenal ulcers
history of stroke
systemic lupus erythematosus
ulcerative colitis
an unusual or allergic reaction to diclofenac, aspirin, other salicylates, other NSAIDs, other medicines, foods, dyes or preservatives
pregnant or trying to get pregnant
breast-feeding
How should I take this medicine?
Take diclofenac tablets by mouth. Follow the directions on the prescription label. Swallow tablets whole with a full glass of water; take tablets in an upright or sitting position. Do not crush or chew tablets. Taking a sip of water first, before taking the tablets, may help you swallow them. It is better to take diclofenac with food. Take your doses at regular intervals. Do not take your medicine more often than directed.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
What drug(s) may interact with diclofenac?
alcohol
alendronate
aspirin and aspirin-like medicines
cidofovir
cyclosporine
drospirenone; ethinyl estradiol (Yasmin®)
entecavir
herbal products that contain feverfew, garlic, ginger, or ginkgo biloba
lithium
medicines for high blood pressure
medicines that affect platelets
medicines that treat or prevent blood clots such as warfarin and other 'blood thinners'
methotrexate
other antiinflammatory drugs (such as ibuprofen or prednisone)
pemetrexed
water pills (diuretics)
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking diclofenac?
Let your prescriber or health care professional know if your pain continues, do not take with other pain-killers without advice. If you get flu-like symptoms (fever, chills, muscle aches and pains), call your prescriber or health care professional; do not treat yourself.
To reduce unpleasant effects on your throat and stomach, take diclofenac with a full glass of water and never just before lying down. If you notice black, tarry stools or experience severe stomach pain and/or vomit blood or what looks like coffee grounds, notify your health care prescriber immediately.
If you are taking medicines that affect the clotting of your blood, such as aspirin or blood thinners such as Coumadin®, talk to your health care provider or prescriber before taking this medicine.
You may get dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how diclofenac affects you. Do not sit or stand up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.
Do not smoke cigarettes or drink alcohol; these increase irritation to your stomach and can make it more susceptible to damage from diclofenac.
If you are going to have surgery, tell your prescriber or health care professional that you are taking diclofenac. Diclofenac can cause you to bleed more easily. Problems can arise if you need dental work, and in the day to day care of your teeth. Try to avoid damage to your teeth and gums when you brush or floss your teeth.
It is especially important not to use diclofenac during the last 3 months of pregnancy unless specifically directed to do so by your health care provider. Diclofenac may cause problems in the unborn child or complications during delivery.
What side effects may I notice from taking diclofenac?
Elderly patients are at increased risk for developing side effects.
Side effects that you should report to your prescriber or health care professional as soon as possible:
signs of bleeding from the stomach - black tarry stools, blood in the urine, unusual tiredness or weakness, vomiting blood or vomit that looks like coffee grounds
signs of an allergic reaction - difficulty breathing or wheezing, skin rash, redness, blistering or peeling skin, hives, or itching, swelling of eyelids, throat, lips
change in the amount of urine passed
difficulty swallowing, severe heartburn or burning, pain in throat
pain or difficulty passing urine
stomach pain or cramps
swelling of feet or ankles
yellowing and/or itching of eyes or skin, upper right abdominal/chest tenderness, fatigue
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
constipation or diarrhea
dizziness
gas or heartburn
headache
nausea, vomiting
Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.
Store at room temperature below 30 degrees C (86 degrees F). Protect from moisture. Keep container tightly closed. Throw away any unused medicine after the expiration date.
Last updated: 7/1/2002
Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.
| Veterinary Dictionary: diclofenac |
A nonsteroidal anti-inflammatory agent, used topically in ophthalmic diseases.
| Wikipedia: Diclofenac |
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Diclofenac
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| Systematic (IUPAC) name | |
| 2-(2-(2,6-dichlorophenylamino)phenyl)acetic acid | |
| Identifiers | |
| CAS number | 15307-86-5 |
| ATC code | M01AB05 M02, S01 |
| PubChem | 3033 |
| DrugBank | APRD00527 |
| ChemSpider | 2925 |
| Chemical data | |
| Formula | C14H11Cl2NO2 |
| Mol. mass | 296.148 g/mol |
| SMILES | eMolecules & PubChem |
| Pharmacokinetic data | |
| Bioavailability | 100% |
| Protein binding | more than 99% |
| Metabolism | hepatic, no active metabolites exist |
| Half life | 1.2-2 hr (35% of the drug enters enterohepatic recirculation) |
| Excretion | biliary, only 1% in urine |
| Therapeutic considerations | |
| Pregnancy cat. |
A(AU) B (1st. and 2nd. trimenon), X (third trimenon) |
| Legal status |
POM(UK) Rx-only most preparations/countries. Limited OTC some countries. Manufacture and veterinary use is banned in India, Nepal and Pakistan due to imminent extinction of local vultures. |
| Routes | oral, rectal, im, iv (renal- and gallstones), topical |
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Diclofenac (marketed as Voltaren and under a number of other trade names, see below) is a non-steroidal anti-inflammatory drug (NSAID) taken to reduce inflammation and as an analgesic reducing pain in conditions such as arthritis or acute injury. It can also be used to reduce menstrual pain, dysmenorrhea. The name is derived from its chemical name: 2-(2,6-dichloranilino)phenylacetic acid.
In the United Kingdom, India, and the United States, it may be supplied as either the sodium or potassium salt, in China most often as the sodium salt, while in some other countries only as the potassium salt. Diclofenac is available as a generic drug in a number of formulations. Over the counter (OTC) use is approved in some countries for minor aches and pains and fever associated with common infections.
Contents |
| This section requires expansion. |
Diclofenac originated from Ciba-Geigy (now Novartis) in 1973.[1] Diclofenac was first introduced in the UK in 1979.[2][3]
[4]The exact mechanism of action is not entirely known, but it is thought that the primary mechanism responsible for its anti-inflammatory, antipyretic, and analgesic action is inhibition of prostaglandin synthesis by inhibition of cyclooxygenase (COX) and it appears to inhibit DNA synthesis.[5]
Inhibition of COX also decreases prostaglandins in the epithelium of the stomach, making it more sensitive to corrosion by gastric acid. This is also the main side effect of diclofenac. Diclofenac has a low to moderate preference to block the COX2-isoenzyme (approximately 10-fold) and is said to have therefore a somewhat lower incidence of gastrointestinal complaints than noted with indomethacin and aspirin.[citation needed]
The action of one single dose is much longer (6 to 8 hours) than the very short half-life that the drug indicates. This could partly be due to a particular high concentration achieved in synovial fluids.
Diclofenac may also be a unique member of the NSAIDs. There is some evidence that diclofenac inhibits the lipoxygenase pathways[citation needed], thus reducing formation of the leukotrienes (also pro-inflammatory autacoids). There is also speculation that diclofenac may inhibit phospholipase A2 as part of its mechanism of action.[citation needed] These additional actions may explain the high potency of diclofenac – it is the most potent NSAID on a broad basis.[citation needed]
There are marked differences among NSAIDs in their selective inhibition of the two subtypes of cyclo-oxygenase, COX-1 and COX-2. Much pharmaceutical drug design has attempted to focus on selective COX-2 inhibition as a way to minimize the gastrointestinal side effects of NSAIDs like aspirin. In practice, use of some COX-2 inhibitors due to their adverse effects has led to massive numbers of patient family lawsuits alleging wrongful death by heart attack, yet other significantly COX-selective NSAIDs like diclofenac have been well-tolerated by most of the population.
Besides the well-known and often cited COX-inhibition, a number of other molecular targets of diclofenac have recently been identified which could contribute to its pain-relieving actions. These include:
Diclofenac is used for musculoskeletal complaints, especially arthritis, rheumatoid arthritis, Polymyositis, Dermatomyositis, osteoarthritis, spondylarthritis, ankylosing spondylitis, gout attacks, and pain management in cases of kidney stones and gallstones. An additional indication is the treatment of acute migraines. Diclofenac is used commonly to treat mild to moderate post-operative or post-traumatic pain, particularly when inflammation is also present, and is effective against menstrual pain and endometriosis.
As long-term use of diclofenac and similar NSAIDs predisposes for peptic ulcer, many patients at risk for this complication are prescribed a combination (Arthrotec) of diclofenac and misoprostol, a synthetic prostaglandin analogue, to protect the gastric mucosa.
An external, gel-based formulation containing 3% of diclofenac (Solaraze) is available for the treatment of facial actinic keratosis which is caused by over-exposure to sunlight. Some countries have also approved the external use of diclofenac 1% gel to treat musculoskeletal conditions.
Over-the-counter use against minor aches and pains and fever associated with common infections is also licensed in some countries, such as Australia and New Zealand.
In many countries eye-drops are sold to treat acute and chronic non-bacterial inflammations of the anterior part of the eyes (e.g. postoperative states). A common brand name is Voltaren-ophta.
Diclofenac is often used to treat chronic pain associated with cancer, particularly if inflammation is also present (Step I of the World Health Organization (WHO) Scheme for treatment of chronic pain). Good results (sometimes better than those with opioids) have been seen in female breast cancer and in the pain associated with bony metastases. Diclofenac can be combined with opioids if needed. Combaren, a fixed combination of diclofenac and codeine (50 mg each), is available for cancer treatment in Europe. Combinations with psychoactive drugs such as chlorprothixene and/or amitriptyline have also been investigated and found useful in a number of cancer patients.
Fever due to malignant lymphogranulomatosis (Hodgkin's lymphoma) often responds to diclofenac. Treatment can be terminated as soon as the usual treatment with radiation and/or chemotherapy causes remission of fever.
Diclofenac may prevent the development of Alzheimer's disease if given daily in small doses during many years. All investigations were stopped after it was found that some of the other investigated NSAIDs (naproxen, rofecoxib) caused a higher incidence of death cases due to cardiovascular events and stroke compared to placebo.
Diclofenac has been found to increase the blood pressure in patients with Shy-Drager syndrome and Diabetes Mellitus. Currently, this use is highly investigative and cannot be recommended as routine treatment.
Diclofenac has been found to be effective against all strains of multi drug resistant E. coli, with a MIC of 25 micrograms/mL. Therefore, it may be suggested that diclofenac has the capacity to treat uncomplicated urinary tract infections (UTI) caused by E. coli.[6] It has also been shown to be effective in treating Salmonella infections in mice [7] and is under investigation for the treatment of tuberculosis[8].
Diclofenac is an antiuricosuric.[9]
Flector Patch is a minimally systemic topical patch formulation of diclofenac. It is indicated for acute pain due to minor sprains, strains, and contusions. The patch has been approved in many other countries outside the U.S.A under different brand names.
Voltaren and Voltarol contain the sodium salt of diclofenac. In the United Kingdom Voltarol can be supplied with either the sodium salt or potassium salt, while Cataflam in some other countries is the potassium salt only.
Diclofenac is available in stomach acid resistant formulations (25 and 50 mg), fast disintegrating oral formulations (25 and 50 mg), slow- and controlled-release forms (75, 100 or 150 mg), suppositories (50 and 100 mg), and injectable forms (50 and 75 mg).
Diclofenac is also available over the counter (OTC) in some countries: 12.5 mg diclofenac as potassium salt in Switzerland, Germany ("Voltaren dolo"), United Kingdom (since October 2008 as "Voltarol Pain-eze"), and preparations containing 25 mg diclofenac as the potassium salt in New Zealand, Australia (Voltaren Rapid, and Sweden (Voltaren T and Diclofenac T).
Trade names include:
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Use of diclofenac in animals has been reported to have led to a sharp decline in the vulture population in the Indian subcontinent, 95% decline in 2004, 99.9% decline as of 2008.[15] The mechanism is probably renal failure, a known side-effect of diclofenac. Vultures eat the carcasses of livestock that have been administered veterinary diclofenac, and are poisoned by the accumulated chemical. At a meeting of the National Wildlife Board in March 2005, the Government of India announced that it intended to phase out the veterinary use of diclofenac.[16] Meloxicam is a safer (though more expensive) candidate to replace use of diclofenac.[17] "The loss of tens of millions of vultures over the last decade has had major ecological consequences across the Indian subcontinent that pose a potential threat to human health. In many places, populations of feral dogs (Canis familiaris [sic]) have increased sharply from the disappearance of Gyps vultures as the main scavenger of wild and domestic ungulate carcasses. Associated with the rise in dog numbers is an increased risk of rabies"[17] and casualties of almost 50,000 people.[18]
The Government of India cites one of those major consequences as a vulture species extinction.[16] A major shift in transfer of corpse pathogens from vultures to feral dogs and rats can lead to a disease pandemic causing millions of deaths in a crowded country like India.
The loss of vultures has had a social impact on the Indian Zoroastrian Parsi community, who traditionally use vultures to dispose of human corpses in Towers of Silence, but are now compelled to seek alternate methods of disposal.[17]
Diclofenac was shown also to cause harm to freshwater fish species such as rainbow trout.[19][20][21][22]
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This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)
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