• Diclofenac sodium extended-release can interact with certain medications (see Drug Interactions With Diclofenac Sodium Extended-Release).
   
• All NSAIDs, including diclofenac sodium extended-release, have been reported to cause cardiovascular events, such as heart attack or stroke, both of which can result in loss of life. People with cardiovascular disease or who have risk factors for the condition appear to be at greater risk. To decrease the chances of these problems occurring, you should take the smallest effective dose for the shortest period of time. Call 911 if you notice:

• Chest pain
• Shortness of breath
• Weakness
• Slurring of speech.

• All NSAIDs, including diclofenac sodium extended-release, may cause high blood pressure or make it worse. Thus, diclofenac sodium extended-release should be used with caution in people with known high blood pressure.
   
• All NSAIDs, including diclofenac sodium extended-release, may cause congestive heart failure or swelling. Contact your healthcare provider if you notice unexplained weight gain or swelling. The drug should be used with caution in people with heart failure.
   
• All NSAIDs, including diclofenac sodium extended-release, have been reported to cause problems in the stomach and intestines, including bleeding (known as gastrointestinal bleeding), stomach ulcers, or holes in the stomach or intestines (called perforations). These problems can lead to serious complications or even loss of life. Therefore, extreme caution should be used if diclofenac sodium extended-release is prescribed to people with a history of ulcers or gastrointestinal bleeding. To decrease the chances of these problems occurring, you should take the smallest effective dose for the shortest period of time. Contact your healthcare provider immediately if you experience any signs of stomach ulcers or bleeding, including:

• Stomach pain
• Indigestion
• Black, tarry stools
• Vomiting blood.

• People taking NSAIDs, including diclofenac sodium extended-release, can suffer kidney damage. It is more common in the elderly and people with kidney disease, heart failure, or liver problems. It is also more common in those taking diuretics or ACE inhibitors.

   
• People taking diclofenac sodium extended-release can suffer liver damage. Contact your healthcare provider immediately if you notice:

• Nausea
• Tiredness
• Lethargy
• Itchy or yellowing skin
• Abdominal pain
• Flu-like symptoms.

• NSAIDs, including diclofenac sodium extended-release, have been reported to cause allergic reactions. Seek emergency medical attention immediately if you notice things such as difficulty breathing and swelling of the face and throat.
   
• In rare cases, people taking diclofenac sodium extended-release can develop a serious rash. If you notice an unexplained rash or blisters, fever, or itchy skin, stop taking diclofenac sodium extended-release and call your healthcare provider.
   
• If you are an alcoholic or drink alcohol frequently, discuss this with your healthcare provider prior to starting diclofenac sodium extended-release. Alcohol can affect the way the liver works, indirectly affecting how diclofenac sodium extended-release works.
   
• NSAIDs have been known to cause an increase in liver enzymes. Therefore, you should have a blood test that looks at your liver function before starting diclofenac sodium extended-release and then again 12 weeks after treatment has started.
   
• Diclofenac sodium extended-release has been known to cause anemia. If you are taking the drug for an extended amount of time and show signs of anemia, talk to your healthcare provider.
   
• You should not take diclofenac sodium extended-release with any other NSAID, as this may increase your risk for any of the problems discussed in this article. Many NSAIDs are available without a prescription, so read labels carefully. Examples of NSAIDs include:

• Ibuprofen (Motrin^®, Advil^®)
• Naproxen (Aleve^®, Anaprox^®, Naprosyn^®, Naprelan^®)
• Celecoxib (Celebrex^®)
• Ketoprofen (Orudis^®, Oruvail^®)
• Meloxicam (Mobic^®)
• Etodolac (Lodine^®).

• Diclofenac sodium extended-release is a pregnancy Category C medicine, meaning that it could potentially cause harm to your unborn child. If you are pregnant, you should take diclofenac sodium extended-release only if the benefit outweighs the possible risk to the fetus. Diclofenac sodium extended-release is not recommended for women in the third trimester of pregnancy, since it can cause injury and even loss of life to the developing fetus. If you become pregnant while taking diclofenac sodium extended-release, contact your healthcare provider immediately (see Voltaren and Pregnancy for more information).
   
• If you are nursing, it is recommended that you not take diclofenac sodium extended-release. Therefore, if you are taking the drug and nursing, ask your healthcare provider whether to stop nursing or to stop taking diclofenac sodium extended-release.