by DICLOFENAC USE
Continuing Education ActivityDiclofenac is a medication used in the management and treatment of inflammatory conditions and pain. It is in the class of non-steroidal anti-inflammatory drugs (NSAID). This activity outlines the indications, mechanism of action, administration, adverse effect profile, contraindications, and other key factors for diclofenac in the clinical setting pertinent to healthcare team members to treat and manage patients with inflammation-related conditions. Objectives: Outline the mechanisms of action of diclofenac.Review the indications for therapy with diclofenac.Summarize the potential adverse reactions of diclofenac. Outline the importance of improving care coordination among the interprofessional team to improve outcomes for patients receiving diclofenac. Access free multiple choice questions on this topic.
Voltaren and Voltarol contain the sodium salt of diclofenac. In the United Kingdom, Voltarol can be supplied with either the sodium salt or the potassium salt, while Cataflam, sold in some other countries, is the potassium salt only. However, Voltarol Emulgel contains diclofenac diethylammonium, in which a 1.16% concentration is equivalent to a 1% concentration of the sodium salt. In 2016 Voltarol was one of the biggest selling branded over-the-counter medications sold in Great Britain, with sales of £39.3 million.[52]
Kidney problems can sometimes occur with the use of NSAID medications, including diclofenac. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have pink/bloody urine or any unusual change in the amount of urine.
Important considerations for using diclofenacKeep these considerations in mind if your doctor prescribes diclofenac for you.RefillsA prescription for this medication is refillable. You shouldn’t need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.TravelWhen traveling with your medication:Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.Don’t worry about airport X-ray machines. They can’t harm your medication.You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.Clinical monitoringIf you use diclofenac for a long time, your doctor should do blood tests to check your kidney and liver function at least once a year.You should check your own blood pressure from time to time. Home blood pressure monitors are available at most pharmacies and online.Shop online for blood pressure monitors.Sun sensitivityYou may have increased sensitivity to the sun while using diclofenac. To protect your skin, use sunscreen with SPF 30 or greater.AvailabilityNot every pharmacy stocks this drug. However, you may be able to order it. When filling your prescription, be sure to call the pharmacy first to make sure they stock this drug or can order it for you.Prior authorizationMany insurance companies require a prior authorization for this form of this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.If your insurance company won’t cover this form, you may consider checking whether it will cover the tablet or capsule form instead.
Diclofenac initiators had a 50% increased rate of major adverse cardiovascular events compared with NSAID non-initiators (incidence rate ratio 1.5, 95% confidence interval 1.4 to 1.7). Supporting use of a combined endpoint, event rates consistently increased for all individual outcomes: 1.2-fold for atrial fibrillation or flutter, 1.6-fold for ischaemic stroke, 1.7-fold for heart failure, 1.9-fold for myocardial infarction, and 1.7-fold for cardiac death (fig 2 and eTable 5). Cardiac death was driven by death from heart failure (incidence rate ratio 2.3, 1.3 to 4.2), cardiac arrhythmia (1.9, 1.1 to 3.3), and myocardial infarction (1.7, 1.2 to 2.4).
Diclofenac can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
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.Swallow the whole and do not crush, chew, or break it. tablet Take on an empty stomach, at least 1 hour before or 2 hours after a meal. ZorvolexCall your doctor if your headache does not completely go away after taking Cambia.Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.Follow all directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Use the lowest dose that is effective in treating your condition.Dissolve diclofenac powder 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. (Cambia)If you use diclofenac long-term, you may need frequent medical tests.
Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen, ketorolac, naproxen). These drugs are similar to diclofenac and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.
What will happen if I stop taking it? When you stop taking diclofenac tablets or capsules, or stop using the suppositories, the effects will wear off after about 15 hours.When you stop using the gel, plasters or patches, the effects will wear off after 1 or 2 days.
ContraindicationsLike other selective COX-2 inhibitors, diclofenac is contraindicated with an FDA boxed warning in patients with a history of increased cardiovascular risk such as MI or stroke. Diclofenac should not be used in bypass graft surgery of coronary artery due to a higher risk of MI and stroke. Diclofenac is also listed as a Beers list drug and should be avoided in elderly patients due to potential adverse effects involving the cardiovascular and gastrointestinal systems. It is also contraindicated in patients with a history of anaphylactoid reaction to NSAID drugs.Also, diclofenac is contraindicated in patients with mild or severe renal insufficiency due to potential negative effects of decreased renal perfusion. Clinicians should not use diclofenac or other NSAIDs in patients with a history of GI bleeds or ulcerations. Special monitoring is a consideration in patients with a history of Helicobacter pylori infection. Formulations of diclofenac with misoprostol are contraindicated in pregnant females due to possible side effects involving loss of pregnancy associated with misoprostol.
Diclofenac is a medication used in the management and treatment of inflammatory conditions and pain. It is in the class of non-steroidal anti-inflammatory drugs (NSAID). This activity outlines the indications, mechanism of action, administration, adverse effect profile, contraindications, and other key factors for diclofenac in the clinical setting pertinent to healthcare team members to treat and manage patients with inflammation-related conditions.
Patient Counseling Information This drug may cause dizziness, drowsiness or blurred vision, if affected, do not drive or operate machinery. Avoid excessive exposure of affected area to sunlight (transdermal or topical/cutaneous). Remove contact lenses prior to administration and reinsert after 15 minutes (ophthalmic).
Diclofenac Sodium 50mg with food and drinkTake this medicine with or after food.Pregnancy and breast-feeding Although not common, abnormalities have been reported in babies whose mothers have taken NSAIDs during pregnancy. You should not take DICLOFENAC SODIUM 50mg tablets during the last 3 months of pregnancy as it may affect the baby's circulation.You should advise your doctor or pharmacist if you think you might be pregnant or are up to 6 months pregnant.Taking Diclofenac Sodium 50mg tablets may make it more difficult to become pregnant. You should talk to your doctor if you are planning to become pregnant, or if you have problems getting pregnant.You should avoid taking Diclofenac Sodium whilst breast feeding.
Depending on why you're taking diclofenac, you may only need to take it for a short time. For example, if you have a sore back or toothache, you may only need to take diclofenac for 1 or 2 days.
Symptoms of overdose include lethargy, drowsiness, nausea, vomiting, and epigastric pain, and gastrointestinal bleeding.Label Hypertension, acute renal failure, respiratory depression and coma occur rarely. In case of overdose, provide supportive care and consider inducing emesis and administering activated charcoal if overdose occurred less than 4 hours prior.
See also Warning section.The enteric-coated tablet form of diclofenac is used to reduce pain, swelling (inflammation), and joint stiffness from arthritis. Reducing these symptoms helps you do more of your normal daily activities.Diclofenac is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.Ask your doctor about non-drug treatments and/or using other medications to treat your pain.
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