Diclofenac Warnings and Precautions
Before starting diclofenac, let your healthcare provider know if you have asthma, heart disease, or high blood pressure. Warnings and precautions for diclofenac also include using this drug with caution during pregnancy, watching out for potential drug interactions, and avoiding the medication if you have recently had open heart surgery. You should also avoid using diclofenac if you are allergic to aspirin or other nonsteroidal anti-inflammatory drugs.
What Should I Tell My Healthcare Provider Before Using Diclofenac?
You should talk with your healthcare provider prior to taking diclofenac if you have:
- Bleeding problems (or are taking a blood-thinning medication)
- Stomach ulcers, stomach bleeding, or a history of these problems
- Heart disease, including congestive heart failure
- High blood pressure (hypertension)
- Liver disease or liver failure
- Kidney disease or kidney failure
- Any allergies, including allergies to medications, foods, dyes, or preservatives.
Also, let your healthcare provider know if you:
- Are pregnant or thinking of becoming pregnant
- Are breastfeeding
- Have had heart surgery recently.
You should also be sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Some Diclofenac Warnings and Precautions
Some warnings and precautions to be aware of with diclofenac include:
- There is a "Medication Guide" (an FDA-approved handout) that should be dispensed along with diclofenac. This medication guide discusses the risks associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac. Be sure to read the medication guide before using this medication and periodically thereafter.
- All NSAIDs, including diclofenac, 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).
Extreme caution should be used if diclofenac is prescribed for people with a history of ulcers or gastrointestinal bleeding. To decrease the risk of these problems, you should take the smallest effective dose for the shortest period of time. Contact your healthcare provider immediately if you experience any signs or symptoms of stomach ulcers or bleeding, including:
- Stomach pain
- Severe indigestion or heartburn
- Black, tarry stools
- Vomiting blood.
- All NSAIDs, including diclofenac, have been linked to cardiovascular events such as heart attack or stroke. People who have cardiovascular disease or cardiovascular risk factors appear to be at greater risk. To decrease the risk of these problems, you should take the smallest effective dose for the shortest period of time.
- Chest pain
- Shortness of breath
- Slurring of speech.
- Liver damage can occur in people taking diclofenac. Contact your healthcare provider immediately if you notice things such as:
- Itchy or yellowing skin
- Abdominal pain
- Flu-like symptoms.
It may be a good idea for your healthcare provider to monitor your liver by checking your liver enzymes (using a simple, standard blood test).
- All NSAIDs, including diclofenac, may cause high blood pressure or make it worse in people who already have it. Therefore, diclofenac should be used with caution in people with known high blood pressure.
- All NSAIDs, including diclofenac, may cause congestive heart failure or fluid retention. Contact your healthcare provider if you notice unexplained weight gain or swelling while taking this drug. Also, diclofenac should be used with caution in people with heart failure.
- Diclofenac can interact with certain medications (see Diclofenac Drug Interactions).
- Kidney damage can occur in people taking NSAIDs, including diclofenac. This occurrence is more common in the elderly, as well as in people with kidney disease, heart failure, liver problems, and those taking a diuretic or ACE inhibitor.
- NSAIDs, including diclofenac, have been reported to cause allergic reactions. Seek emergency medical attention immediately if you notice things such as difficulty breathing or swelling of the face and throat.
- In rare cases, people taking diclofenac can develop a serious rash. If you notice an unexplained rash or develop blisters, fever, or itchy skin, stop taking diclofenac and call your healthcare provider right away.
- There have been reports of anemia in people taking NSAIDs. Therefore, if you are taking diclofenac for an extended period of time and show signs of anemia (such as pale skin or extreme fatigue), talk to your healthcare provider.
- It is possible that diclofenac could worsen asthma, especially in people with aspirin-sensitive asthma.
- Diclofenac is a pregnancy Category C medicine, meaning that it might not be safe during pregnancy, although the full risks are currently unknown (see Diclofenac and Pregnancy for more information).
- It is unknown if diclofenac passes through breast milk. Therefore, if you are breastfeeding, check with your healthcare provider (or your child's healthcare provider) before taking diclofenac (see Diclofenac and Breastfeeding).