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Diclofenac General Product Information

Diclofenac capsules and tablets are used to relieve mild to moderate pain. Diclofenac extended-release tablets (Voltaren XR), tablets (Cataflam), and delayed release tablets (available generically) are used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Diclofenac extended-release tablets and delayed-release tablets are also used to treat ankylosing spondylitis (arthritis that mainly affects the spine). Diclofenac tablets (Cataflam) are also used to treat painful menstrual periods. Diclofenac solution (Cambia) is used to treat migraine headaches in adults, but cannot be used to prevent migraines or to treat other types of headaches. Diclofenac is in a class of medications. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

Diclofenac is a nonsteroidal anti-inflammatory drug. 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 brand names: Cambia, Cataflam, Voltaren, Zipsor, Zorvolex, Dyloject

Diclofenac Direction For Use

Diclofenac comes as a tablet, and liquid-filled capsule, a hard gelatin capsule, an extended-release (long-acting) tablet, a delayed-release (releases medication in the intestine) tablet, and as packets of powder for solution (to be mixed with water) and take by mouth. Diclofenac liquid-filled capsules are usually taken 4 times a day and diclofenac hard gelatin capsules are usually taken three times a day on an empty stomach. Diclofenac extended-release tablets are usually taken once a day, and in rare cases are taken twice a day, if needed to control pain. Diclofenac tablets and diclofenac delayed-release tablets are usually taken 2, 3, or 4 times a day. Diclofenac solution is taken without food as a one dose treatment to relieve the pain of migraine headaches. If you were told to take diclofenac on a regular basis, take it at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take diclofenac exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Different diclofenac products release the medication differently in your body and cannot be used interchangeably. Only take the diclofenac product prescribed by your doctor and do not switch to a different diclofenac product unless your doctor says that you should.

Your doctor may adjust the dose of your medication during your treatment depending on your response to the medication. Talk to your doctor about how you are feeling during your treatment with diclofenac.

If you are taking the powder for solution, you will need to mix it with water before you take it. To mix the medication, first remove one packet from a row of three attached packets. Place 2 to 4 tablespoons (1 to 2 ounces; 30 to 60 mL) of water in a cup. Add the contents of the packet and mix well. Drink the entire mixture right away. Throw away the empty packet in a trash can that is out of the reach of children and pets.

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 you receive at the pharmacy.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. 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 Cambia powder in to 2 ounces of water. Do not use any other type of liquid. Stir this mixture and drink all of it right away. Cambia works best if you take it on an empty stomach.

Diclofenac Special Precautions

Tell your doctor and pharmacist if you are allergic to diclofenac (also available as solaraze and pennsaid, in arthrotec), aspirin or other nsaids such as ibuprofen (advil, motrin) and naproxen (aleve, naprosyn), any other medications, or any of the inactive ingredients in the diclofenac product you plan to take. Ask your pharmacist or check the medication guide for a list of the inactive ingredients. If you will be taking diclofenac capsules (zipsor), tell your doctor if you are allergic to bovine (cow) proteins such as those found in milk, beef, or gelatin.

Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in this section. Many other medications may also interact with diclofenac, so be sure to tell your doctor about all the medications you are taking even if they do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Tell your doctor if you have or have ever had any of the conditions mentioned in this section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); porphyria (an abnormal increase in the amount of certain natural substances made by the liver); heart failure (condition in which the heart is unable to pump enough blood to all parts of the body); swelling of the hands, feet, ankles, or lower legs; or liver or kidney disease.

Tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding.

Diclofenac Common Use

Usual Adult Dose for Osteoarthritis:

Diclofenac free acid capsules: 35 mg orally 3 times a day
Diclofenac potassium immediate-release tablets: 50 mg orally 2 or 3 times a day
Diclofenac sodium enteric-coated tablets: 50 mg orally 2 or 3 times a day or 75 mg orally 2 times a day
Maximum dose: 150 mg daily

Diclofenac sodium extended-release tablets: 100 mg orally once a day

Use: For the relief of signs and symptoms of osteoarthritis.

Usual Adult Dose for Ankylosing Spondylitis:

Diclofenac sodium enteric-coated and delayed-release tablets: 25 mg orally 4 times a day. An additional 25 mg dose may be administered at bedtime, if necessary
Maximum dose: 125 mg per day

Use: For acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis.

Usual Adult Dose for Dysmenorrhea:

Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day

An initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief for some patients; initiate treatment upon appearance of the first symptoms and continue for a few days.

Use: For the relief of signs and symptoms of primary dysmenorrhea.

Usual Adult Dose for Rheumatoid Arthritis:

Diclofenac potassium immediate-release tablets: 50 mg orally 3 or 4 times a day
Diclofenac sodium enteric-coated and delayed-release tablets: 50 mg orally 3 to 4 times a day or 75 mg orally twice a day
Maximum dose: 225 mg daily

Diclofenac sodium extended-release tablets: 100 mg orally once a day
Maximum dose: 100 mg orally 2 times a day; this would be for the rare patient in whom the benefits outweigh the clinical risks.

For the relief of signs and symptoms of rheumatoid arthritis

Usual Adult Dose for Migraine:

Diclofenac potassium for oral solution packets: 50 mg (1 packet) orally once

This drug is not indicated for the prophylactic therapy of migraine or for use in cluster headaches; the safety and efficacy of a second dose has not been established.

Use: For acute treatment of migraine with or without aura.

Usual Adult Dose for Pain:

Oral:
Diclofenac potassium liquid-filled capsules: 25 mg orally 4 times a day
Diclofenac free acid capsules: 18 mg or 35 mg orally 3 times a day
Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day; an initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief in some patients.

Diclofenac Possible Side Effects

More frequently reported side effects include fluid retention, diarrhea, constipation, dyspepsia, nausea, abdominal pain, and headache. Diclofenac may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical help. Do not take any more diclofenac until you speak to your doctor.

Some of the side effects that can occur with diclofenac may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away.

Can I Buy Diclofenac Without Prescription?

Diclofenac is used in the treatment of back pain; frozen shoulder; sciatica; osteoarthritis; muscle pain, and belongs to the drug class nonsteroidal anti-inflammatory agents. There is positive evidence of human fetal risk during pregnancy. Diclofenac is not a controlled substance under the Controlled Substance Act.

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