Side effects of diclofenac

Diclofenac topical

Generic Name: diclofenac topical (dye KLOE fen ak TOP ik al)
Brand Name: DST Plus Pak, Pennsaid, Solaraze, Voltaren Topical

Medically reviewed by Drugs.com on Oct 5, 2018 – Written by Cerner Multum

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What is diclofenac topical?

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID).

Diclofenac topical (for the skin) is used to treat joint pain caused by osteoarthritis. Pennsaid is for use on the knees. Voltaren Topical is for use on the hands, wrists, elbows, knees, ankles, or feet. diclofenac topical may not be effective in treating arthritis pain elsewhere in the body.

Solaraze is used to treat warty overgrowths of skin (actinic keratoses) on sun-exposed areas of the body.

Diclofenac topical may also be used for purposes not listed in this medication guide.

Important Information

Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using diclofenac, especially in older adults.

Before taking this medicine

Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking diclofenac topical.

Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using diclofenac, especially in older adults.

You should not use this medicine if you are allergic to diclofenac (Voltaren, Cataflam, Flector, and others), or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Diclofenac topical is not approved for use by anyone younger than 18 years old.

Tell your doctor if you have ever had:

  • heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;

  • a heart attack, stroke, or blood clot;

  • stomach ulcers, bleeding in your stomach or intestines;

  • asthma;

  • liver or kidney disease;

  • fluid retention.

Diclofenac can affect ovulation and it may be harder to get pregnant while you are using this medicine. However, using diclofenac topical during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

How should I use diclofenac topical?

Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.

Do not take by mouth. Topical medicine is for use only on the skin. Rinse with water if this medicine gets in your eyes or mouth.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Do not apply diclofenac topical to an open skin wound, or on areas of infection, rash, burn, or peeling skin.

Store at room temperature away from moisture and heat. Do not freeze. Store Pennsaid in an upright position.

What happens if I miss a dose?

Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not apply two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using diclofenac topical?

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to diclofenac (such as aspirin, ibuprofen, ketoprofen, or naproxen).

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid exposing treated skin to heat, sunlight, or tanning beds. Heat can increase the amount of diclofenac you absorb through your skin.

Avoid getting diclofenac topical in your eyes. If contact does occur, rinse with water. Call your doctor if you have eye irritation that lasts longer than 1 hour.

Do not use cosmetics, sunscreen, lotions, insect repellant, or other medicated skin products on the same area you treat with diclofenac topical.

Diclofenac topical side effects

Get emergency medical help if you have signs of an allergic reaction (hives, sneezing, runny or stuffy nose, wheezing or trouble breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Although the risk of serious side effects is low when diclofenac is applied to the skin, this medicine can be absorbed through the skin, which may cause steroid side effects throughout the body.

Stop using diclofenac and seek emergency medical attention if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.

Also call your doctor at once if you have:

  • the first sign of any skin rash, no matter how mild;

  • swelling, rapid weight gain;

  • severe headache, blurred vision, pounding in your neck or ears;

  • little or no urination;

  • liver problems–nausea, diarrhea, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • low red blood cells (anemia)–pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or

  • signs of stomach bleeding–bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Common side effects may include:

  • heartburn, gas, stomach pain, nausea, vomiting;

  • diarrhea, constipation;

  • headache, dizziness, drowsiness;

  • stuffy nose;

  • itching, increased sweating;

  • increased blood pressure; or

  • skin redness, itching, dryness, scaling, or peeling where the medicine was applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect diclofenac topical?

Ask your doctor before using diclofenac if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your current medicines, especially:

  • cyclosporine;

  • lithium;

  • methotrexate;

  • a blood thinner (warfarin, Coumadin, Jantoven);

  • heart or blood pressure medication, including a diuretic or “water pill”; or

  • steroid medicine (prednisone and others).

This list is not complete and many other drugs may affect diclofenac. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 10.01.

Medical Disclaimer

More about diclofenac topical

  • Side Effects
  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Drug Interactions
  • Pricing & Coupons
  • 369 Reviews
  • Drug class: topical non-steroidal anti-inflammatories
  • FDA Alerts (1)

Consumer resources

  • Diclofenac transdermal
  • Diclofenac Cream
  • Diclofenac Gel (1%)
  • Diclofenac Gel (3%)
  • Diclofenac Topical Patch
  • … +2 more

Other brands: Voltaren Gel, Pennsaid, Flector Patch, Diclozor, … +4 more

Professional resources

  • Diclofenac Sodium topical (AHFS Monograph)
  • … +4 more

Related treatment guides

  • Osteoarthritis
  • Keratosis
  • Pain

Voltaren Gel

SIDE EFFECTS

The following adverse reactions are discussed in greater detail in other sections of the labeling:

  • Cardiovascular Thrombotic Events
  • GI Bleeding, Ulceration and Perforation
  • Hepatotoxicity
  • Hypertension
  • Heart Failure and Edema
  • Renal Toxicity and Hyperkalemia
  • Anaphylactic Reactions
  • Serious Skin Reactions
  • Hematologic Toxicity

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.

During clinical development, 913 patients were exposed to VOLTAREN® GEL in randomized, double-blind, multicenter, vehicle-controlled, parallel-group studies in osteoarthritis of the superficial joints of the extremities. Of these, 513 patients received VOLTAREN® GEL for osteoarthritis of the knee and 400 were treated for osteoarthritis of the hand. Additionally, 583 patients were exposed to VOLTAREN® GEL in an uncontrolled, open-label, long-term safety trial in osteoarthritis of the knee. Of these, 355 patients were treated for osteoarthritis of 1 knee and 228 were treated for osteoarthritis of both knees. Duration of exposure ranged from 8 to 12 weeks for the placebo-controlled studies, and up to 12 months for the open-label safety trial.

Short-Term Placebo-Controlled Trials

Adverse reactions observed in at least 1% of patients treated with VOLTAREN® GEL:

Non-serious adverse reactions that were reported during the short-term placebo-controlled studies comparing VOLTAREN® GEL and placebo (vehicle gel) over study periods of 8 to 12 weeks (16 g per day), were application site reactions. These were the only adverse reactions that occurred in > 1% of treated patients with a greater frequency in the VOLTAREN® GEL group (7%) than the placebo group (2%).

Table 1 lists the types of application site reactions reported. Application site dermatitis was the most frequent type of application site reaction and was reported by 4% of patients treated withVOLTAREN® GEL, compared to 1% of placebo patients.

Table 1: Non-serious Application Site Adverse Reactions ( ≥ 1% VOLTAREN® GEL Patients) – Short-term Controlled Trials

In the placebo-controlled trials, the discontinuation rate due to adverse reactions was 5% for patients treated with VOLTAREN® GEL, and 3% for patients in the placebo group. Application site reactions, including application site dermatitis, were the most frequent reason for treatment discontinuation.

Long-Term Open-Label Safety Trial

In the open-label, long-term safety study, distribution of adverse reactions was similar to that in the placebo-controlled studies. In this study, where patients were treated for up to 1 year with VOLTAREN® GEL up to 32 g per day, application site dermatitis was observed in 11% of patients. Adverse reactions that led to the discontinuation of the study drug were experienced in 12% of patients. The most common adverse reaction that led to discontinuation of the study was application site dermatitis, which was experienced by 6% of patients.

Read the entire FDA prescribing information for Voltaren Gel (Diclofenac Sodium Gel)

Diclofenac is a pain reliever in the drug class NSAID (non-steroidal anti-inflammatory drug). It is available both over-the-counter and by prescription in the United States. Its common brand names are Voltaren, Cataflam and Zipsor.

“Diclofenac is a similar medicine to ibuprofen or Motrin, though it’s not as common or available over-the-counter,” said Dr. Stephen Neabore, a primary care doctor at the Barnard Medical Center in Washington, D.C. When it comes to NSAIDs, “there’s no best one, it’s whatever works best for you. People have different settings and sensitivities for pain medication and pain itself,” Neabore said.

Diclofenac is often used to treat pain, tenderness, swelling and stillness resulting from osteoarthritis, rheumatoid arthritis or ankylosing spondylitis (a form of arthritis that primarily affects the spine). Short-acting diclofenac (Cataflam and Zipsor) may be used to treat menstrual or other pains. Diclofenac gel or cream is sometimes used to treat actinic keratosis, a skin condition that may become cancerous if not treated. Diclofenac oral tablets or liquids may be prescribed to help with gout, joint inflammatory disease in children or young adults, and bursitis.

Diclofenac and other NSAIDs are primarily used to treat inflammatory pain rather than pain caused by trauma, said Ken Sternfeld, a New York-based pharmacist. In addition to being painful themselves, inflamed body parts, such as the disks in your spine, can put pressure on other areas and cause pain.

Recent studies, including a 2012 study in Journal of Bone and Mineral Metabolism, suggest that NSAIDs can be used in treating pain caused by broken bones and other trauma. Doctors previously thought that NSAIDs like diclofenac would harm bone healing. This is important news because narcotics are typically given to patients with trauma pain but those can lead to addiction. “I like diclofenac because it assists with pain management in a non-narcotic or addicting manner,” said Sternfeld.

Forms of diclofenac

Diclofenac is available in the following oral-route forms:

  • capsule
  • powder for solution
  • liquid-filled capsule
  • tablet
  • enteric-coated tablet
  • extended-release tablet

It is available in the following topical-route forms:

  • gel or cream
  • solution
  • extended-release patch

Whatever form you take, Neabore and Sternfeld emphasized following the dosage instructions. “Follow the prescribing advice. If you’ve used it for a little while and it is not working, talk to your doctor,” Neabore said. The doctor could change your type of NSAID or change the dose. Doctors often start out by prescribing lower doses in order to minimize side effects. This practice is especially common when doctors prescribe medicine for older people. “If someone is older, you don’t want to give them too much right off the bat because they might have a reaction and fall down,” he said.

Side effects

Stomach problems are the most well known complications of taking NSAIDs, Sternfeld said, but there are many more.

The NIH lists the following side effects of diclofenac oral as less severe, though a doctor should be consulted if they persist:

  • diarrhea
  • constipation
  • gas or bloating
  • headache
  • dizziness
  • ringing in the ears

The following are more severe side effects, and if experienced, a doctor should be consulted immediately, and use of the drug stopped:

  • unexplained weight gain
  • excessive tiredness
  • lack of energy
  • nausea
  • loss of appetite
  • itching
  • pain in the upper right part of the stomach
  • yellowing of the skin or eyes
  • flu-like symptoms
  • fever
  • blisters
  • rash
  • hives
  • swelling of the eyes, face, tongue, lips, throat, arms, hands, feet, ankles, or lower legs
  • difficulty breathing or swallowing
  • hoarseness
  • pale skin
  • fast heartbeat
  • cloudy, discolored, or bloody urine
  • back pain
  • difficult or painful urination

According to Sternfeld, you are less likely to experience side effects if you use a topical gel or cream form of diclofenac. “If you take it orally, it goes into your blood steam and it will work wherever it finds work to do, as opposed to a topical or targeted anti-inflammatory that you can put on exactly the spot where you have pain,” he said. “When you’re taking some drugs, like blood pressure drugs, you want them to work throughout your body. But with anti-inflammatories, often you don’t want them to be systemic within your body. They may be helping with sciatic pain but what is it doing to other areas of your body?”

Nevertheless, side effects from topical diclofenanc can occur. The NIH lists the following side effects of diclofenac topical gel or cream as less serious, though a doctor should be consulted if they persist:

  • dryness, redness, itching, swelling, pain, hardness, irritation, swelling, scaling, or numbness at application site
  • acne
  • stomach pain
  • constipation
  • gas
  • dizziness
  • numbness, burning, or tingling in the hands, arms, feet, or legs

The following are more serious and, if experienced, should receive immediate doctor consultation:

  • hives
  • itching
  • difficulty breathing or swallowing
  • swelling of the face, throat, arms, hands, feet, ankles, or lower legs
  • unexplained weight gain
  • wheezing
  • worsening of asthma
  • yellowing of the skin or eyes
  • nausea
  • extreme tiredness
  • unusual bleeding or bruising
  • lack of energy
  • loss of appetite
  • pain in the upper right part of the stomach
  • flu-like symptoms
  • dark-colored urine
  • rash
  • blisters on skin
  • fever
  • pale skin
  • fast heartbeat
  • excessive tiredness

The NIH warns that patients who take diclofenac or other NSAIDs besides than aspirin may have an increased risk of heart attack, stroke, ulcers, bleeding, or holes in the stomach or intestine. It is important for patients to tell their doctors if there is a family history of heart disease, heart attack, or stroke. Patients should also inform their doctors if they smoke, have or have had high cholesterol, high blood pressure, or diabetes.

Diclofenac sodium and diclofenac potassium

There are two main forms of the medication: diclofenac sodium and diclofenac potassium.

The body absorbs diclofenac sodium more slowly, which is useful when patients need to reduce inflammation. Diclofenac sodium’s brand name is Voltaren.

The body absorbs diclofenac potassium more quickly, which is useful when immediate pain relief is required. Forms of diclofenac potassium may be available over the counter in lower doses. Its brand names are Cataflam and Zipsor.

Voltaren (diclofenac sodium)

Voltaren is a prescription brand-name form of diclofenac sodium. It is available as a gel, as standard and extended release oral tablets, and as a suppository.

Voltaren Gel

Voltaren Gel is FDA-approved for treating osteoarthritis pain in joints amenable to topical treatment, such as knees, hands, wrists, feet, and elbows. It has not been studied for use on hips, spine, or shoulders.

Because the risk of side effects is lower with the topical route than with the oral one, people may be tempted to put Voltaren Gel on any place they have pain. Sternfeld advised against this. “You can only put it where the doctor prescribes,” he said. “It doesn’t work for headaches because they are caused from a different type of inflammation or swelling.”

Voltaren Gel comes with a dosing card made of clear polypropylene. The dosing card should be used for each application. The gel should be applied within the rectangular area of the dosing card. Typical dosage is 2 grams for each elbow, wrist, or hand and four grams for each knee, ankle, or foot. Voltaren Gel is typically applied four times a day. Total usage should not exceed 32 grams per day for all affected joints.

Patients should wash their hands after application of Voltaren Gel, unless the drug is used on the hands, in which case patients should wait one hour before washing their hands. All patients should not shower or bathe for at least one hour after drug application.

“Voltaren Gel may not be as effective in the short term because it is slower acting than the oral route or other forms of diclofenac and NSAIDs,” said Sternfeld.

Voltaren Oral

Voltaren Oral should be taken with water, and can be taken with food, milk, or an antacid if patients experience stomach pain. Taking it with anything but water may slow absorption and delay pain relief, however. It is important that patients do not lie down or crush, chew, or break the tablets. This can increase side effects.

Voltaren Oral can be taken on an as-needed basis or on a regular schedule, which is the more common approach to arthritis treatment. If taking it on an as needed basis, patients should use the lowest effective dose for the shortest possible length of time, in order to minimize side effects and other risks. If taking it regularly for arthritis, patients may not experience full benefits for up to two weeks.

Recreational use of diclofenac

It is not possible to get high off of diclofenac or other NSAIDs, and abuse of the drug is likely to cause serious side effects.

Additional resources

  • Drugs.com: Voltaren Gel Dosage
  • Mayo Clinic: Diclofenac (Uses, Precautions & Side Effects)
  • NIH: Diclofenac

Generic Name: diclofenac topical (dye KLOE fen ak TOP ik al)
Brand Names: Pennsaid, Solaraze, Voltaren Topical

Medically reviewed by Drugs.com. Last updated on Nov 7, 2018.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

What is Voltaren Gel?

Voltaren Gel contains diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Diclofenac works by reducing substances in the body that cause pain and inflammation.

Voltaren Gel is used to treat joint pain caused by osteoarthritis in the hands, wrists, elbows, knees, ankles, or feet.

Voltaren Gel may not be effective in treating arthritis pain elsewhere in the body.

You should not use Voltaren Gel if you have ever had asthma or a severe allergic reaction caused by aspirin, diclofenac (Cataflam, Voltaren), or another nonsteroidal anti-inflammatory drug (NSAID).

Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Voltaren Gel, especially in older adults.

Voltaren Gel can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while using Voltaren Gel. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

You should not use Voltaren Gel if you are allergic to diclofenac (Voltaren, Cataflam, Flector, and others), or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

To make sure Voltaren Gel is safe for you, tell your doctor if you have:

  • heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;

  • a history of heart attack, stroke, or blood clot;

  • a history of stomach ulcers or bleeding;

  • asthma;

  • liver or kidney disease;

  • fluid retention.

Using Voltaren Gel during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether diclofenac topical passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Voltaren Gel is not approved for use by anyone younger than 18 years old.

How should I use Voltaren Gel?

Use Voltaren Gel exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger amounts or for longer than recommended. Use the lowest dose that is effective in treating your condition.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Wash your hands after applying Voltaren Gel, unless you are treating the skin on your hands. Wait at least 10 minutes before dressing or wearing gloves. Wait at least 1 hour before you bathe or shower.

Do not apply to an open skin wound, or on areas of infection, rash, burn, or peeling skin. Do not cover treated skin with a bandage or expose it to heat from a hot tub, heating pad, or sauna. Heat or bandaging can increase the amount of diclofenac you absorb through your skin.

To treat osteoarthritis pain with Voltaren Gel: This medicine is supplied with dosing cards that show you how much gel to use for a 2-gram dose or a 4-gram dose. Squeeze the gel onto this card along the line for your dose. Use no more gel than will fit on the length of your dosing line. Wipe the card directly onto the treatment area and rub gently into the skin.

Store at room temperature away from moisture and heat. Do not freeze.

Voltaren Gel dosing information

Usual Adult Dose for Osteoarthritis:

1% Gel:
Lower Extremities: Apply 4 g to the affected foot, knee, or ankle 4 times a day and rub in gently; not to exceed 16 g/day to any single joint of the lower extremities
Upper Extremities: Apply 2 g to the affected hand, wrist, or elbow 4 times a day and rub in gently; not to exceed 8 g/day to any single joint of the upper extremities
Maximum dose: 32 g/day over all affected joints

-When used on the lower extremities, the gel should be applied to the entire affected foot, knee, or ankle; the entire foot includes the sole, the top of the foot, and the toes.
-When used on the upper extremities, apply to the entire affected hand, wrist, or elbow; the entire hand includes the palm, the back of the hands, and the fingers.
-The accompanying dosing card should be used for application; consult manufacturer product information for instructions.
Use: For the relief of pain associated with osteoarthritis of the joints amenable to topical treatment, such as the knees and those of the hands; this drug has not been evaluated for use on the spine, hip, or shoulder.

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Voltaren Gel?

Do not use cosmetics, sunscreen, lotions, insect repellant, or other medicated skin products on the same area you treat with Voltaren Gel.

Avoid exposing treated skin to heat, sunlight, or tanning beds.

Avoid getting Voltaren Gel near your eyes, nose, or mouth. If this does happen, rinse with water. Call your doctor if you have eye irritation that lasts longer than 1 hour.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin or other NSAIDs while you are using Voltaren Gel.

Ask a doctor or pharmacist before using any cold, allergy, or pain medication. Many medicines available over the counter contain aspirin or other medicines similar to diclofenac. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

Voltaren Gel side effects

Although the risk of serious side effects is low when diclofenac is applied to the skin, this medicine can be absorbed through the skin, which may cause steroid side effects throughout the body.

Get emergency medical help if you have signs of an allergic reaction to Voltaren Gel: sneezing, runny or stuffy nose; wheezing or trouble breathing; hives; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.

Stop using Voltaren Gel and call your doctor at once if you have:

  • the first sign of any skin rash, no matter how mild;

  • shortness of breath (even with mild exertion), swelling in your arms or legs;

  • signs of stomach bleeding – diarrhea, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • liver problems – nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • kidney problems – little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;

  • high blood pressure – severe headache, pounding in your neck or ears, nosebleed, anxiety, confusion;

  • low red blood cells (anemia) – pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

  • severe skin reaction – fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Voltaren Gel side effects may include:

  • indigestion, gas, stomach pain, nausea, vomiting;

  • diarrhea, constipation;

  • headache, dizziness, drowsiness;

  • stuffy nose;

  • itching, increased sweating;

  • increased blood pressure; or

  • skin redness, itching, dryness, scaling, or peeling where the medicine was applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Voltaren Gel?

Ask your doctor before using Voltaren Gel if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • cyclosporine;

  • lithium;

  • methotrexate;

  • a blood thinner (warfarin, Coumadin, Jantoven);

  • heart or blood pressure medication, including a diuretic or “water pill”; or

  • steroid medicine (prednisone and others).

This list is not complete. Other drugs may interact with diclofenac topical, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

More about Voltaren Gel (diclofenac topical)

  • Side Effects
  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Drug Interactions
  • Support Group
  • Pricing & Coupons
  • En Español
  • 210 Reviews
  • Drug class: topical non-steroidal anti-inflammatories
  • FDA Alerts (1)
  • FDA Approval History

Other brands: Pennsaid, Flector Patch, Diclozor, Solaraze, … +3 more

  • Voltaren Gel (FDA)
  • … +1 more

Other Formulations

  • Voltaren
  • Voltaren-XR
  • Voltaren Ophthalmic
  • Pain
  • Osteoarthritis

Diclofenac

Generic Name: diclofenac (dye KLOE fen ak)
Brand Names: Cambia, Cataflam, Voltaren-XR, Zipsor, Zorvolex, Voltaren, Dyloject

Medically reviewed by Kaci Durbin, MD Last updated on Jan 18, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Tips
  • Interactions
  • More

What is diclofenac?

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). 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. Voltaren is also indicated for the treatment of ankylosing spondylitis.The Cataflam brand of this medicine is also used to treat menstrual cramps.

Diclofenac powder (Cambia) is used to treat a migraine headache attack. Cambia will only treat a headache that has already begun. It will not prevent headaches or reduce the number of attacks.

Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.

Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults.

You should not use diclofenac if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Do not use Cambia to treat a cluster headache. Do not use Zipsor if you are allergic to beef or beef protein.

To make sure diclofenac is safe for you, tell your doctor if you have:

  • heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;

  • a history of heart attack, stroke, or blood clot;

  • a history of stomach ulcers or bleeding;

  • asthma;

  • liver or kidney disease;

  • fluid retention.

Taking diclofenac during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether diclofenac passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Diclofenac is not approved for use by anyone younger than 18 years old.

How should I take diclofenac?

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.

Call your doctor if your headache does not completely go away after taking Cambia. Do not take a second dose of diclofenac powder without your doctor’s advice. Overuse of migraine headache medicine can make headaches worse. Tell your doctor if the medicine seems to stop working as well in treating your migraine attacks.

If you use diclofenac long-term, you may need frequent medical tests.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking diclofenac?

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin or other NSAIDs while you are taking this medicine.

Ask a doctor or pharmacist before using any cold, allergy, or pain medication. Many medicines available over the counter contain aspirin or other medicines similar to diclofenac. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

What other drugs will affect diclofenac?

Ask your doctor before using diclofenac if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your current medicines and any you start or stop using, especially:

This list is not complete. Other drugs may interact with diclofenac, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use diclofenac only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 15.01.

Related questions

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