Diclofenac (Voltaren, Cataflam) is a popular prescription pain killer. It is used in arthritis, joint pains, urinary stones and inflammatory conditions.
This is a popular prescription only pain killer medication. It is a drug classified in the NSAID drug family. Doctors prescribe Diclofenac for painful conditions such as arthritis, severe headache, urinary stones, and muscle pains. Main side effects are gastric irritation and increased bleeding. In addition, long term use can result in renal failure. Most common brand names are Voltarol ®, Voltaren ®and Cataflam ®.
What are the uses of Diclofenac?
This drug is mainly used as a pain killer. Its use as a drug for fever is now abandoned, following reports of lethal increase in bleeding times, especially in viral fever’s, that cause problems in platelet function. Main conditions diclofenac is prescribed now are urinary stone disease, pain following trauma and surgery, severe tension headache, joint pain in osteoarthritis and rheumatic arthritis.
This medication is usually available as tablets, injections, local jells and suppositories. Suppositories are usually prescribed for pain relief in surgery and trauma. Local jells are prescribed for local painful conditions such as tendon sprains, and muscle pains. Local jells usually cause minimal problems. Contrary to the popular belief both suppositories and tablets cause similar gastric problems. In addition diclofenac preparations (eye drops) are prescribed in various eye problems.
What are the conditions that cause problems with Diclofenac?
Even though this is a commonly prescribed medication, the doctor needs to know whether the patient is having following diseases or conditions, before prescribing Diclofenac.
1. NSAIDs allergy
2. Fever lasting for more than two days
3. Bleeding problems
4. Gastrointestinal bleeding problems characterized by black tarry stools, bloody vomiting.
5. Kidney diseases
6. Liver diseases
7. Heart disease
8. Bronchial asthma
9. Troublesome gastritis or gastric ulcer disease
The doctor may not prescribe Diclofenac, if you have any of the above diseases. In addition, the doctor may not prescribe diclofenac for the problems not listed above.
What are the problems associated with Diclofenac?
Two main acute problems common to all the NSAIDs(including diclofenac) are inhibition of blood clot formation by the platelets and increased incidence of gastric ulcer disease.
In addition, diclofenac can cause renal failure in long term use. This is especially common in patients with chronic pain problems such as arthritis and fibromyalgia. Therefore, renal function monitoring is essential in patients with long term diclofenac use.
Since diclofenac is causing gastric acid problems, it is usually co prescribed with a proton pump inhibitor (cause reduction in gastric acid secretion) such as Omeprazole (Prisolec®).
How problems associated with diclofenac is minimized?
As with any medication Diclofenac should be taken as a whole with full glass of water. In addition, it should be taken in the recommended dosage. It should not be crushed before use.
What are other problems associated with diclofenac?
Rarely some patients can have a life threatening complication called anaphylactic shock. This is characterized by wide spread hives, sudden faintish ness, shortness of breath, low blood pressure and pallor. In an anaphylactic shock, diclofenac should be discontinued immediately, and patient should seek emergency medical help.
Is it safe during pregnancy and lactation?
This medication is known to cause serious harm to the unborn baby, especially if taken during the last three months and the first three months. Therefore, your doctor may not prescribe this medication during pregnancy, unless it is absolutely necessary.
In addition, amount secreted in breast milk is too small to be harmful to the baby. However, manufacturers are advising not to use diclofenac during breast feeding.
British National Formulary