Diclofenac is a prescription non-steroidal anti-inflammatory drug (NSAID) that works well to treat pain and swelling in certain conditions, such as osteoarthritis, rheumatoid arthritis, and menstrual cramps. Diclofenac comes in different formulations, including delayed-release tablet and powder packet for oral solution. Similar to other NSAIDs, it has warnings for serious side effects, such as stroke, heart attack, and stomach bleeds, especially with higher doses and longer use.
Mild to moderate pain
Osteoarthritis
Rheumatoid arthritis
Ankylosing spondylitis (arthritis of the spine)
Migraine attacks
Menstrual cramps
Diclofenac is a NSAID. It works by blocking certain proteins in your body that cause pain and swelling.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Burning, itching, redness, skin rash, swelling, or soreness at the application site
itching skin
Less common
Blood in the urine
dry, itching, or burning eyes
headaches, including migraines
increased sensitivity of the skin to sunlight
pain or tenderness around the eyes and cheekbones
redness of the skin
redness or swelling of the eyes
runny or stuffy nose
skin rash other than at the application site
tightness in the chest
troubled breathing
ulcers or sores on the skin, other than at the application site
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Chills
general feeling of discomfort or illness
joint pain
loss of appetite
muscle aches and pains
scaly, thick, or tingling skin
shivering
sweating
trouble sleeping
unusual tiredness or weakness
vomiting
Less common
back pain
belching
bleeding skin
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
dizziness
increase in body movements
indigestion
lack or loss of strength
loss of or change in taste
loss or thinning of the hair
neck pain
sleepiness or unusual drowsiness
stomach upset or pain
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Available in many different formulations, such as tablet, capsule, and powder
Available in a long-acting form that only needs to be take once per day
Diclofenac potassium (Cambia) powder can help with migraine pain in as quickly as 15 minutes.
All brands of diclofenac are available as lower-cost generics.
Typically have to take multiple times a day (except for the powder and extended-release tablet)
Not recommended for use in children (except for diclofenac potassium (Zipsor) capsules, which can be used in children age 12 years and older)
Not recommended for use in pregnancy, especially starting in the second trimester or later
Not the best option if you're 65 years or older, or have kidney, heart, liver, or bleeding problems
You can take diclofenac with or without food. If it hurts your stomach, try taking it with food or milk to help. But, doing so might affect how fast your body absorbs the medication and how well it works.
Don't break, crush, or chew the diclofenac tablets or capsules without first checking with your provider if it's safe to do so. Typically, this medication needs to be swallowed whole. Some diclofenac pills have a special coating that affects how the medication is absorbed in the body.
Keep in mind that diclofenac potassium (Cambia) powder can only treat migraine attacks, but won't prevent them from happening. Mix the powder only with water, not any other types of liquid. Once you've mixed the powder well, drink it immediately. A single dose can provide up to 24 hours of pain relief. A second dose isn't recommended because researchers haven't studied whether it’s safe or if it works well to relieve further migraine pain.
If you're using diclofenac for arthritis, it won't prevent your condition from getting worse. Some things you can do to prevent your arthritis from getting worse include physical therapy, exercise, or taking other medications. Discuss with your provider what the best options are for you.
Diclofenac can put you at higher risk for bleeds when you get injured. Let your provider know if you've had any recent falls or injuries. Sometimes, bleeds on the inside of your body might not show any outward symptoms. Get medical help right away if you experience signs of bleeds, such as bruises that don't go away, bleeds that take a long time to stop, or blood in your vomit.
Diclofenac can cause anemia (low red blood cell levels). Let your provider know if you experience symptoms of anemia, such as feeling tired or weak, having pale skin, trouble breathing, or cold hands and feet.
Let your provider know if you're breastfeeding or planning to breastfeed. Limited information suggest that diclofenac is likely safe to take during breastfeeding, but more research is needed in this area. Depending on the type of pain you have, your provider can recommend treatment options to ease your symptoms during pregnancy.
Diclofenac can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of heart problems, including heart attack | Taking high doses of diclofenac | Taking diclofenac for a long time | History of heart bypass surgery
Diclofenac can raise your risk of having blood clots, heart attacks, or strokes. This can happen as early as within the first weeks of starting this medication. People with heart problems, those taking high doses of diclofenac, and those taking diclofenac for a long time have a higher risk of this happening. That’s why it’s important to take the lowest possible dose for the shortest possible time. If you have heart problems, talk to your healthcare provider before starting this medication. Don't take diclofenac if you've had or will be having heart bypass surgery. Call 911 or seek immediate medical help if you experience chest pain, trouble breathing, weakness on one side of your body, or trouble speaking or walking.
Risk factors: History of stomach bleeding or ulcers | Older adults | Taking aspirin (Aspir-Low), other NSAIDs, corticosteroids, blood thinners, or SSRIs | Drinking alcohol | Smoking | Having poor health | Bleeding problems | Liver problems | Taking diclofenac for a long time | Taking high doses of diclofenac
Diclofenac can cause stomach bleeding and ulcers, which can be dangerous. There are many conditions and medications that raise your risk of this problem, so speak with your provider before starting this medication. Stomach bleeding and ulcers can occur without warning or symptoms, so it's best to take the lowest possible dose for the shortest possible time to minimize your risk. If you notice blood in your vomit, stool that looks like black coffee grounds, or if you have pain in your stomach that doesn't go away, stop taking diclofenac and talk to your healthcare provider right away.
Risk factors: History of liver damage | Taking other medications that can cause liver damage | Taking high doses of diclofenac | Taking diclofenac for a long time
Very rarely, diclofenac can cause life-threatening liver damage. This can happen as early as within the first month of starting this medication. Your risk is higher if you take diclofenac with other medications that can also cause liver damage, such as acetaminophen (Tylenol). Liver damage can happen with or without symptoms, so if you take this medication for a long time, you might need to get lab work done regularly to check your liver. Stop diclofenac and talk to your healthcare provider right away if you experience symptoms, such as fever, chills, fatigue, nausea, vomiting, yellowing of the skin or whites of the eyes, clay-colored stool, and dark urine.
Risk factors: High blood pressure | Heart failure | Taking certain high blood pressure medications, such as water pills, ACE inhibitors, and ARBs
Diclofenac can raise your blood pressure, and it can also cause your body to hold onto more water. This can lead to new or worsening blood pressure problems, heart failure, and swelling of your arms and legs. Diclofenac can also cause some blood pressure and heart failure medications, such as furosemide (Lasix), lisinopril (Zestril), and losartan (Cozaar), to not work well. Diclofenac isn't recommended if you have severe heart failure, so discuss with your provider before starting this medication. Monitor your blood pressure closely while taking diclofenac. Let your provider know right away if you notice any changes in your blood pressure or experience symptoms, such as trouble breathing, tiredness, swelling in your body, or sudden weight gain.
Risk factors: Kidney or liver problems | Heart failure | Taking certain high blood pressure medications, such as water pills, ACE inhibitors, or ARBs | Older adults | Loss of body fluid through conditions such as severe vomiting, bleeding, or diarrhea | Using diclofenac for a long time
Diclofenac can damage your kidneys by slowing down blood flow to the kidneys. The risk is higher if you're taking certain blood pressure medications (like ACE inhibitors, ARBs, or water pills), or have certain conditions (like kidney or liver problems and heart failure). Kidney damage is usually reversible once you stop taking diclofenac. This medication isn't recommended if you have very severe kidney problems, so discuss the risks and benefits of taking it with your provider. Let your provider know if you notice a change in how often you urinate after starting diclofenac as this can be a sign of kidney damage.
In addition, kidney damage from diclofenac can also lead to high potassium levels. Sometimes, this medication can cause high potassium levels even in people with normal kidneys. If you experience signs of high potassium levels, such as nausea, muscle weakness, or tingling sensations in your muscles, tell your healthcare provider right away because it might be dangerous.
Risk factors: Asthma and stuffy nose with or without nasal polyps | Allergic reaction to aspirin or other NSAIDs
Diclofenac can cause your airways to tighten, which might lead to severe asthma attacks. Be careful using this medication if you have asthma. People who've experienced asthma attacks triggered by aspirin (Aspir-Low) or other NSAIDs in the past should avoid diclofenac. Get medical help right away if your throat tightens and you can't breathe.
Risk factors: Past allergic reactions to other NSAIDs | Allergy to bovine (cow) ingredients (for people taking Zipsor only)
Diclofenac might cause sudden, very serious, and sometimes life-threatening allergic and skin reactions. Avoid Zipsor (diclofenac) if you're allergic to bovine (cow) products because it contains gelatin, which is made from cows. Symptoms of serious reactions include fever, body aches, rash, peeling skin, painful blisters all over your body, and swelling of the face. Stop the medication and get help right away if you experience these symptoms.
Risk factors: Currently pregnant
If diclofenac is taken during or after the second trimester of pregnancy, it can lower the amniotic fluid (the fluid that surrounds the baby in the womb). This can occur as soon as 2 days after starting the medication and result in serious kidney problems in your unborn baby. Babies born to mothers who take diclofenac starting in the third trimester of pregnancy or later can also develop heart problems. If you're thinking of getting pregnant or become pregnant, talk to your provider about the risks and benefits of using diclofenac.
Different types of diclofenac are not interchangeable with each other because they're not absorbed by your body in the same way. Discuss with your healthcare provider if you want to switch between different types of diclofenac.
In addition, your dose might be lower if you have liver problems.
Diclofenac sodium delayed-release (DR) tablets
Osteoarthritis: The typical dose is 50 mg by mouth two to three times a day, or 75 mg two times a day.
Rheumatoid arthritis: The typical dose is 50 mg by mouth three to four times a day, or 75 mg two times a day.
Ankylosing spondylitis: The typical dose is 25 mg by mouth four times a day, with an extra 25 mg at bedtime if needed.
Diclofenac sodium extended-release (ER) tablets
Osteoarthritis or rheumatoid arthritis: The typical dose is 100 mg by mouth once a day.
Diclofenac potassium capsule (Zipsor)
Mild to moderate pain (age 12 years and older): The typical dose is 25 mg by mouth four times a day.
Diclofenac potassium tablet (Lofena)
Mild to moderate pain, including menstrual cramps: The typical dose is 50 mg by mouth three times a day.
Osteoarthritis: The typical dose is 50 mg by mouth two to three times a day.
Rheumatoid arthritis: The typical dose is 50 mg by mouth three to four times a day.
Diclofenac potassium powder for solution (Cambia)
Migraine attacks: The typical dose is one packet (50 mg total) by mouth as a one-time dose when you have a migraine attack. Mix the packet with 2 to 4 tablespoons (30 mL to 60 mL) of water and drink the entire mixture right away.
Mild to moderate pain: The typical dose is 18 mg or 35 mg by mouth three times a day.
Osteoarthritis: The typical dose is 35 mg by mouth three times a day.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
History of asthma, hives, or other allergic reactions after taking aspirin or another NSAID
Use of diclofenac 10 to 14 days after open heart surgery
Bovine (cow) allergy (for diclofenac potassium (Zipsor) capsules only)
Mild to moderate pain
Osteoarthritis
Rheumatoid arthritis
Ankylosing spondylitis (arthritis of the spine)
Migraine attacks
Menstrual cramps
Short-term relief of minor aches and pains due to headache, muscle aches, minor arthritis pain, toothache, backache, the common cold, or menstrual cramps
Fever
Mild-to-moderate pain
Pain from rheumatoid arthritis (RA) or osteoarthritis (OA)
Pain from menstrual cramps
Ankylosing spondylitis (AS) (arthritis of the spine)
Polyarticular juvenile idiopathic arthritis (arthritis in children)
Tendonitis and bursitis
Pain
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Advanced Rx Pharmacy of Tennessee, LLC. (2023). DICLOFENAC SODIUM DR- diclofenac sodium tablet, delayed release [package insert]. DailyMed.
Al-Saeed, A. (2011). Gastrointestinal and cardiovascular risk of nonsteroidal anti-inflammatory drugs. Oman Medical Journal.
Altman, R., et al. (2015). Advances in NSAID Development: Evolution of Diclofenac Products Using Pharmaceutical Technology. Drugs.
American Kidney Fund. (2023). High potassium (hyperkalemia): Causes, prevention and treatment.
Assertio Therapeutics, Inc. (2021). CAMBIA- diclofenac potassium powder, for solution [package insert]. DailyMed.
Assertio Therapeutics, Inc. (2021). ZIPSOR- diclofenac potassium capsule, liquid filled [package insert]. DailyMed.
CARWIN PHARMACEUTICAL ASSOCIATES, LLC. (2021). LOFENA- diclofenac potassium tablet, film coated [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2023). Facts about Gastroschisis.
Crofford, L. J. (2013). Use of NSAIDs in treating patients with arthritis. Arthritis Research & Therapy.
Lannett Company, Inc. (2022). DICLOFENAC SODIUM tablet, extended release [package insert]. DailyMed.
Montford, J. R., et al. (2017). How Dangerous Is Hyperkalemia? Journal of the American Society of Nephrology: JASN.
Moore, R. A., et al. (2015). Effects of food on pharmacokinetics of immediate release oral formulations of aspirin, dipyrone, paracetamol and NSAIDs – a systematic review. British Journal of Clinical Pharmacology.
Sousa, A. G. P., et al. (2016). Hyporeninemic hypoaldosteronism and diabetes mellitus: Pathophysiology assumptions, clinical aspects and implications for management. World Journal of Diabetes.
U.S. Food and Drug Administration. (2020). Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Drug Safety Communication - Avoid Use of NSAIDs in Pregnancy at 20 Weeks or Later.
U.S. Food and Drug Administration. (2022). FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid.
Zyla Life Sciences US Inc. (2021). ZORVOLEX- diclofenac capsule [package insert]. DailyMed.
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