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What is diclofenac?

• Diclofenac is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Diclofenac works by reducing hormones that cause inflammation and pain in the body.
• Diclofenac is used to reduce pain, inflammation and stiffness caused by many conditions, such as osteoarthritis, rheumatoid arthritis, abdominal cramps associated with menstruation, and ankylosing spondylitis.
• Diclofenac may also be used for purposes other than those listed in this medication guide.

• Before taking this medication, tell your doctor if you
  • have an allergy to aspirin or any other NSAIDs,
  • have an ulcer or bleeding in your stomach,
  • drink more than three alcoholic beverages a day,
  • have liver disease,
  • have kidney disease,
  • have a coagulation (bleeding) disorder,
  • have congestive heart failure,
  • have fluid retention,
  • have heart disease, or
  • have high blood pressure.
• You may not be able to take diclofenac, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Diclofenac is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Diclofenac should not be taken late in pregnancy (the third trimester) because a similar drug is known to affect the baby's heart. Do not take diclofenac without first talking to your doctor if you are pregnant.
• Diclofenac passes into breast milk and may affect a nursing infant. Do not take this medicine without first talking to your doctor if you are breast-feeding a baby.

• Take diclofenac exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Take diclofenac with milk, food, or an antacid to lessen stomach upset.
• Do not crush or chew diclofenac tablets. Swallow them whole.
• Shake the suspension well before measuring a dose. To ensure that you get the correct dose, measure the liquid form of diclofenac with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
• Store diclofenac at room temperature away from moisture and heat.

• If you are taking diclofenac on a regular schedule, take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose.
• If you are taking diclofenac as needed, take the missed dose if it is needed, then wait the recommended or prescribed amount of time before taking another dose.

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of a diclofenac overdose may include nausea, vomiting, stomach pain, dizziness, drowsiness, headache, ringing in the ears, blurred vision, seizures, sweating, numbness or tingling, little or no urine production, and slow breathing.

• Avoid prolonged exposure to sunlight. Diclofenac may increase the sensitivity of the skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.
• Avoid alcohol or use it with moderation. If you drink more than three alcoholic beverages a day, diclofenac may increase the risk of dangerous stomach bleeding. Talk to your doctor before taking diclofenac if you drink more than 3 alcoholic beverages a day.
• Many over-the-counter cough, cold, allergy, and pain medicines contain aspirin or other medicines similar to diclofenac (such as ibuprofen, ketoprofen, and others). Before taking any prescription or over-the-counter medicine, talk to your doctor and pharmacist.

• Contact your doctor if you experience blood in vomit or bloody, black, or tarry stools. These symptoms could indicate damage to the stomach or intestines, which could be dangerous.
• If you experience any of the following serious side effects, stop taking diclofenac and seek medical attention or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • muscle cramps, numbness, or tingling;
  • ulcers (open sores) in the mouth;
  • rapid weight gain (fluid retention);
  • seizures;
  • decreased hearing or ringing in the ears;
  • yellowing of the skin and eyes (jaundice); or
  • abdominal cramping, indigestion, or heartburn.
• Other, less serious side effects may be more likely to occur. Continue to take diclofenac and talk to your doctor if you experience
  • dizziness or headache;
  • nausea, diarrhea, or constipation;
  • depression;
  • fatigue or weakness;
  • dry mouth; or
  • irregular menstrual periods.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

• Before taking diclofenac, tell your doctor if you are taking any of the following drugs:
  • aspirin or another salicylate (form of aspirin) such as salsalate (Disalcid), diflunisal (Dolobid), choline salicylate-magnesium salicylate (Trilisate, Tricosal, others), and magnesium salicylate (Doan's, others);
  • another nonsteroidal anti-inflammatory drug (NSAID) such as etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Motrin, Advil, others), indomethacin (Indocin), ketoprofen (Orudis, Orudis KT), ketorolac (Toradol), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn, Anaprox, others), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), or tolmetin (Tolectin);
  • an over-the-counter cough, cold, allergy, or pain medicine that contains aspirin, ibuprofen, diclofenac, or ketoprofen;
  • an anticoagulant (blood thinner) such as warfarin (Coumadin);
  • a steroid such as prednisone (Deltasone);
  • insulin or an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Diabeta, Micronase), and others;
  • probenecid (Benemid);
  • lithium (Eskalith, Lithobid, others); or
  • bismuth subsalicylate in drugs such as Pepto-Bismol.
• You may not be able to take diclofenac, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with diclofenac. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

• 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)

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.