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diclofenac potassium
Cataflam

diclofenac sodium
Diclomax Retard§, Fenac‡, Voltaren, Voltaren XR, Voltaren Rapide†, Voltaren SR†, Voltarol§

Pregnancy Risk Category B

How supplied
Tablets:
50 mg
Tablets (enteric-coated):
25 mg, 50 mg, 75 mg
Tablets (extended-release):
100 mg
Suppositories:
50 mg†, 100 mg†

Action
Unknown. Produces anti-inflammatory, analgesic, and antipyretic effects, possibly by inhibiting prostaglandin synthesis.

Indications & dosage
Ankylosing spondylitis--

Adults:
25 mg P.O. q.i.d. (and h.s., p.r.n.)
Osteoarthritis
--
Adults:
50 mg P.O. b.i.d. or t.i.d., or 75 mg P.O. b.i.d. Maintenance dose is 100 mg P.O. daily (extended-release diclofenac sodium only).
Rheumatoid arthritis
--
Adults:
50 mg P.O. t.i.d. or q.i.d. Or, 75 mg P.O. b.i.d. (diclofenac sodium only), 100 mg P.O. daily (extended-release form), or 50 to 100 mg P.R. (where available) h.s. as substitute for last oral dose of the day. Not to exceed 225 mg daily.
Analgesia, primary dysmenorrhea
--
Adults:
50 mg P.O. t.i.d. (diclofenac potassium only).

Adverse reactions
CNS:
anxiety, depression, dizziness, drowsiness, insomnia, irritability, headache, aseptic meningitis.
CV:
heart failure, hypertension, edema, fluid retention.
EENT:
tinnitus, laryngeal edema, swelling of the lips and tongue, blurred vision, eye pain, night blindness, epistaxis, taste disorder, reversible hearing loss.
GI:
abdominal pain or cramps, constipation, diarrhea, indigestion, nausea, abdominal distention, flatulence, peptic ulceration, bleeding, melena, bloody diarrhea, appetite change, colitis.
GU:
proteinuria, acute renal failure, oliguria, interstitial nephritis, papillary necrosis, nephrotic syndrome, fluid retention.
Hepatic:
elevated liver enzyme levels, jaundice, hepatitis, hepatotoxicity.
Metabolic:
hypoglycemia; hyperglycemia.
Musculoskeletal:
back, leg, or joint pain.
Respiratory:
asthma.
Skin:
rash, pruritus, urticaria, eczema, dermatitis, alopecia, photosensitivity, bullous eruption, Stevens-Johnson syndrome (rare), allergic purpura.
Other:
anaphylaxis, anaphylactoid reactions, angioedema.

Interactions
Drug-drug.
Anticoagulants, including warfarin: possible increased incidence of bleeding. Monitor patient closely.
Aspirin:
may decrease effectiveness of diclofenac and increase GI toxicity. Concomitant use not recommended by manufacturer.
Beta blockers:
antihypertensive effects may be blunted. Monitor closely.
Cyclosporine, digoxin, lithium, methotrexate:
diclofenac may reduce renal clearance of these drugs and increase risk of toxicity. Monitor patient closely.
Diuretics:
decreased effectiveness of diuretics. Avoid concomitant use.
Insulin, oral antidiabetics:
diclofenac may alter requirements for antidiabetics. Monitor patient closely.
Phenytoin:
increased serum levels. Monitor for toxicity.
Potassium-sparing diuretics
: enhanced potassium retention and increased serum potassium levels. Monitor serum potassium level.
Drug-lifestyle.
Sun exposure: may cause photosensitivity reactions. Take precautions.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with hepatic porphyria or history of asthma, urticaria, or other allergic reactions after taking aspirin or other NSAIDs. Drug
isn't recommended for use during late pregnancy or breast-feeding.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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