$Unique_ID{BRK03124} $Pretitle{} $Title{diclofenac} $Subject{Voltaren Ciba-Geigy Nonsteroidal anti-inflammatory analgesic diclofenac inflammation pain swelling stiffness arthritis ankylosing spondylitis chemicals prostaglandins} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. diclofenac ------------------------------------------------------------------------------ BRAND NAME (Manufacturer) Voltaren (Ciba-Geigy) TYPE OF DRUG Nonsteroidal anti-inflammatory analgesic INGREDIENT diclofenac DOSAGE FORM Enteric-coated tablets (25 mg, 50 mg, and 75 mg) STORAGE This medication should be stored in a tightly closed container at room temperature away from heat and direct sunlight. USES Diclofenac is used to treat the inflammation (pain, swelling, and stiffness) of arthritis and ankylosing spondylitis. Diclofenac has been shown to block the production of certain body chemicals, called prostaglandins, that may trigger pain. However, it is not yet fully understood how it works. TREATMENT You should take this medication on an empty stomach 30 to 60 minutes before meals or two hours after meals, so that it gets into your bloodstream quickly. To decrease stomach irritation, your doctor may want you to take this medication with food or antacids. Do not break, crush, or chew the tablets before swallowing. They should be swallowed whole to lessen side effects. It may take two weeks before you feel the full effects of this medication. Diclofenac does not cure arthritis or ankylosing spondylitis, but it will help to control the condition as long as you continue to take it. It is important that you take diclofenac on schedule and do not miss any doses. If you do miss a dose, take it as soon as possible, unless it is almost time for your next dose. In that case, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. SIDE EFFECTS Minor. Abdominal cramps, constipation, diarrhea, dizziness, headache, indigestion, or nausea. As your body adjusts to the drug, these side effects should disappear. To relieve constipation, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). If you become dizzy, sit or lie down; get up slowly from a sitting or reclining position, and be careful on stairs. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about bloody or black, tarry stools; blurred vision; confusion; difficult or painful urination; palpitations; a problem with hearing, or ringing or buzzing in your ears; skin rash, hives, or itching; stomach pain; swelling of the feet or hands; tightness in the chest; unexplained sore throat and fever; soreness of the tongue or mouth; unusual fatigue or weakness; unusual weight gain; wheezing or difficulty in breathing; or yellowing of the eyes or skin. INTERACTIONS Diclofenac interacts with several other types of medications: 1. Anticoagulants (blood thinners, such as warfarin) can lead to an increase in bleeding complications. 2. Aspirin, other salicylates, and other anti-inflammatory medications can increase stomach irritation. Aspirin may also decrease the effectiveness of diclofenac. Therefore, aspirin should not be used concurrently with diclofenac. 3. Diclofenac can decrease the elimination of digoxin, methotrexate, and lithium from the body, which can lead to serious side effects. 4. The activity of diuretics (water pills) and drugs to lower blood pressure (propranolol, metoprolol) may be inhibited by diclofenac. 5. Diclofenac may alter a diabetic patient's response to insulin, oral hypoglycemic agents, or antiseizure medication (phenytoin). Before starting to take diclofenac, BE SURE TO TELL YOUR DOCTOR about any medications you are taking, especially any of those listed above. WARNINGS * Before you start to take this medication, it is important to tell your doctor if you have ever had unusual or allergic reactions to diclofenac or to any of the other chemically related drugs (aspirin, other salicylates, diflunisal, fenoprofen, flurbiprofen, indomethacin, ketoprofen, meclofenamate, mefenamic acid, naproxen, oxyphenbutazone, phenylbutazone, piroxicam, sulindac, or tolmetin). * Tell your doctor if you now have or if you have ever had asthma, bleeding problems, colitis, stomach ulcers or other stomach problems, epilepsy, heart disease, high blood pressure, kidney disease, liver disease, mental illness, or Parkinson's disease. * If diclofenac makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous machinery. * Because this drug can prolong your bleeding time, it is important to tell your doctor or dentist that you are taking this drug before having surgery or any other medical or dental treatment. * Stomach problems are more likely to occur if you take aspirin regularly or drink alcohol while being treated with this medication. These should, therefore, be avoided (unless your doctor directs you to do otherwise). * Be sure to tell your doctor if you are pregnant or planning to become pregnant. This medication can cause unwanted effects on the heart or blood flow of the fetus. Studies in animals have also shown that this medicine, if taken late in pregnancy, may increase the length of pregnancy, prolong labor, or cause other problems during delivery. Also tell your doctor if you are breast-feeding an infant. Small amounts of diclofenac can pass into breast milk. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.