II. Indications
- See NSAID
- Specific FDA-approved Diclofenac Indications
- Osteoarthritis
- Rheumatoid Arthritis
- Ankylosing Spondylitis
- Primary Dysmenorrhea
- Musculoskeletal Pain
- Migraine Headache (Cambia)
III. Contraindications
- See NSAID
V. Precautions
- Other NSAIDs are preferred over Diclofenac
- Diclofenac has more adverse effects than other NSAIDs
- Cardiovascular Risk (similar to vioxx)
- Hepatotoxicity risk
- Increased GI toxicity risk
- References
- (2013) Presc Lett 20(7):42
VI. Medications
- Oral
- Diclofenac Potassium (Voltaren, Cataflam)
- Diclofenac XR (Voltaren XR)
- Dose: 100 mg orally daily (up to twice daily)
- Diclofenac Powder (Cambia)
- Dissolve 50 mg packet in 30 to 60 ml water for Migraine Headache
- Arthrotec (50 mg Diclofenac with 200 mcg Misoprostol)
- Dose: 50/200 mg orally three times daily
- In addition to pregnancy-related NSAID contraindications, Misoprostol is also contraindicated in pregnancy
- Misoprostol may be associated with Diarrhea and Abdominal Pain
- Zorvolex 18 or 35 mg orally every 8 hours
- Topical
- Precautions
- Apply gel or patch only to unbroken skin
- Wash hands after applying gel or patch and avoid eye contact with product
- Do not wear patch while showering or bathing
- Diclofenac Gel (Pennsaid)
- Apply 2 gram dose to hands, 4 gram dose to knees
- Enclosed Card indicates 2 gram and 4 gram doses
- Flector Patch
- Applied to most painful area every 12 hours
- Licart Patch
- Applied to most painful area daily
- Precautions
VII. Adverse Effects
- See NSAID
- Hepatotoxicity
- Monitor Liver Function Tests at baseline, 4 and 8 weeks after starting, then periodically
VIII. Safety
IX. Resources
- Diclofenac Sodium (DailyMed)
- Diclofenac Delayed Release (DailyMed)
- Diclofenac XR (DailyMed)
- Diclofenac Topical Solution (DailyMed)
Images: Related links to external sites (from Bing)
Related Studies
diclofenac (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
DICLOFENAC 0.1% EYE DROPS | Generic | $1.98 per ml |
DICLOFENAC 1.5% TOPICAL SOLN | Generic | $0.10 per ml |
DICLOFENAC 2% SOLUTION PUMP | Generic | $13.39 per gram |
DICLOFENAC EPOLAMINE 1.3% PTCH | Generic | $5.69 each |
DICLOFENAC POT 50 MG POWDR PKT | Generic | $17.79 each |
DICLOFENAC POT 50 MG TABLET | Generic | $0.20 each |
DICLOFENAC POTASSIUM 25 MG CAP | Generic | $7.89 each |
DICLOFENAC SOD DR 25 MG TAB | Generic | $0.80 each |
DICLOFENAC SOD DR 50 MG TAB | Generic | $0.09 each |
DICLOFENAC SOD DR 75 MG TAB | Generic | $0.09 each |
DICLOFENAC SOD EC 25 MG TAB | Generic | $0.80 each |
DICLOFENAC SOD EC 50 MG TAB | Generic | $0.09 each |
DICLOFENAC SOD EC 75 MG TAB | Generic | $0.09 each |
DICLOFENAC SOD ER 100 MG TAB | Generic | $1.09 each |
DICLOFENAC SODIUM 1% GEL | Generic OTC | $0.07 per gram |
DICLOFENAC SODIUM 3% GEL | Generic | $0.48 per gram |
DICLOFENAC-MISOPROSTOL DR 50-0.2 MG TABLET | Generic | $1.02 each |
DICLOFENAC-MISOPROSTOL DR 75-0.2 MG TABLET | Generic | $1.37 each |
Ontology: Diclofenac (C0012091)
Definition (CHV) | A non-steroidal anti-inflammatory agent |
Definition (CHV) | A non-steroidal anti-inflammatory agent |
Definition (NCI_NCI-GLOSS) | The active ingredient in a drug that is used to treat the symptoms of rheumatoid arthritis and is being studied in the prevention and treatment of some types of skin cancer. It blocks substances that cause inflammation and pain. It may also prevent the growth of new blood vessels that tumors need to grow. It is a type of cyclooxygenase inhibitor, a type of nonsteroidal anti-inflammatory drug (NSAID), and a type of antiangiogenesis agent. |
Definition (NCI) | A nonsteroidal benzeneacetic acid derivative with anti-inflammatory activity. As a nonsteroidal anti-inflammatory drug (NSAID), diclofenac binds and chelates both isoforms of cyclooxygenase (COX-1 and-2), thereby blocking the conversion of arachidonic acid to pro-inflammatory-proprostaglandins. This agent also may inhibit COX-2-mediated tumor angiogenesis. When inhibiting COX-2, diclofenac may be effective in relieving pain and inflammation; when inhibiting COX-1, it may produce unacceptable gastrointestinal side effects. This agent may be more active against COX-2 than several other carboxylic acid-containing NSAIDs. (NCI04) |
Definition (MSH) | A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D004008 |
SnomedCT | 350316001, 7034005, 363598004 |
LNC | LP17915-7, MTHU024758 |
English | Dichlofenal, Diclofenac, Diclophenac, Dicrofenac, Benzeneacetic acid, 2-((2,6-dichlorophenyl)amino)-, 2-[(2,6-Dichlorophenyl)amino]benzeneacetic Acid, diclofenac (medication), Diclofenac [Chemical/Ingredient], diclophenac, Diclofenac (product), DICLOFENAC, diclofenac, Diclofenac (substance), Diclofenac product (product), Diclofenac product, Diclofenac product (substance) |
Swedish | Diklofenak |
Czech | diklofenak |
Finnish | Diklofenaakki |
Russian | DIKLOFENAK NATRIIA, NATRIIA DIKLOFENAK, DIKLOFENAK, ДИКЛОФЕНАК, ДИКЛОФЕНАК НАТРИЯ, НАТРИЯ ДИКЛОФЕНАК |
Japanese | シーコレン, ジクロード, スタフルミン, ダイスパス, ナボールSR, ブセトン徐放カプセル, ボルマゲン, アデフロニック, イリナトロン, クロルギー, サビスミンTP, ストロングコールSR, フェニタレン, ブレシン, ボルタレン, ボンフェナック, ジクロニック, ジクロフェナクナトリウム, ジフェナック, ボナフェック, メクロフェン, ワンフェロン, ガウテリン, サンナックス, ジクロフェナク(Diclofenac Sodium), ジクロフェナック, ソレルモン, ネリオジン, ボラボミン, ヨウフェナック, サフラック, ソファリン, チカタレン, ナトリウムジクロフェナク, ニフレリール, メリカット, ジクロスター, ジクロフェナックナトリウム, ドセル錠, プロフェナチン, アナバン, ドンジャストA, バレタン, フェナシドン, ベギータ, アロンピン, ジクロフェノン, ピナナック, レクトス, ジクロフェナク, アスピゾン |
Spanish | diclofenac, producto (producto), diclofenac, producto, diclofenaco (sustancia), diclofenaco, diclofenac, diclofenaco (producto), diclofenac (sustancia), diclofenac (producto), Diclofenaco |
Italian | Diclofenal, Diclofenac |
Croatian | DIKLOFENAK |
Polish | Diklofenak |
French | Diclofenac |
German | Diclofenac, Diclophenac |
Portuguese | Diclofenaco |