Gastrointestinal Bleeding, Ulceration, And Perforation
NSAIDs, including Diclof, cause serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal. These serious adverse events can occur at any time, with or without warning symptoms, in patients treated with NSAIDs. Only one in five patients, who develop a serious upper GI adverse event on NSAID therapy, is symptomatic. Upper GI ulcers, gross bleeding, or perforation caused by NSAIDs occurred in approximately 1% of patients treated for 3-6 months, and in about 2%-4% of patients treated for one year.. However, even short-term therapy is not without risk.
More common side effects
The more common side effects that can occur with Diclof gel include:
- itching or rash at application site
- stomach pain
3. Who can take and can't take Diclof
Most adults can take Diclof.
Children may be prescribed Diclof to treat joint problems. Diclof tablets, capsules and suppositories are suitable for children aged 1 year and above.
Diclof isn't suitable for certain people.
Tell your doctor or pharmacist if you have:
- had an allergic reaction to Diclof or any other medicines in the past
- an allergy to aspirin or other non-steroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen or naproxen
- ever had signs of asthma (wheezing), a runny nose, swelling of the skin (angioedema) or a rash after taking NSAIDs
- ever had stomach ulcers, bleeding in the stomach or intestines, or a hole in your stomach
- high blood pressure (hypertension)
- heart failure, or severe liver disease or kidney disease
- Crohn's disease or ulcerative colitis
- a blood clotting disorder
Tell your doctor or pharmacist if you're pregnant, planning to become pregnant, or breastfeeding.
How should this medicine be used?
Diclof comes as a tablet, and liquid-filled capsule, a hard gelatin capsule, an extended-release (long-acting) tablet, a delayed-release (releases medication in the intestine) tablet, and as packets of powder for solution (to be mixed with water) and take by mouth. Diclof liquid-filled capsules are usually taken 4 times a day and Diclof hard gelatin capsules are usually taken three times a day on an empty stomach. Diclof extended-release tablets are usually taken once a day, and in rare cases are taken twice a day, if needed to control pain. Diclof tablets and Diclof delayed-release tablets are usually taken 2, 3, or 4 times a day. Diclof solution is taken without food as a one dose treatment to relieve the pain of migraine headaches. If you were told to take Diclof on a regular basis, take it at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Diclof exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Different Diclof products release the medication differently in your body and cannot be used interchangeably. Only take the Diclof product prescribed by your doctor and do not switch to a different Diclof product unless your doctor says that you should.
Your doctor may adjust the dose of your medication during your treatment depending on your response to the medication. Talk to your doctor about how you are feeling during your treatment with Diclof.
If you are taking the powder for solution, you will need to mix it with water before you take it. To mix the medication, first remove one packet from a row of three attached packets. Place 2 to 4 tablespoons (1 to 2 ounces; 30 to 60 mL) of water in a cup. Add the contents of the packet and mix well. Drink the entire mixture right away. Throw away the empty packet in a trash can that is out of the reach of children and pets.
COMMON BRAND(S): Voltaren
GENERIC NAME(S): Diclof Sodium
Nonsteroidal anti-inflammatory drugs (including Diclof) may rarely increase the risk for a heart attack or stroke. This effect can happen at any time while taking this drug but is more likely if you take it for a long time. The risk may be greater if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes). Do not take this drug right before or after heart bypass surgery (CABG).
Also, this drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning symptoms at any time while taking this drug. Older adults may be at higher risk for this effect. (See also Precautions and Drug Interactions sections.)
Stop taking Diclof and get medical help right away if you notice any of the following rare but serious side effects: bloody or black/tarry stools, persistent stomach/abdominal pain, vomit that looks like coffee grounds, chest/jaw/left arm pain, shortness of breath, unusual sweating, weakness on one side of the body, sudden vision changes, slurred speech.
Talk with your doctor or pharmacist about the risks and benefits of treatment with this medication.
Diclof is used to relieve pain, swelling (inflammation), and joint stiffness caused by arthritis. Reducing these symptoms helps you do more of your normal daily activities. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID).
If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain. See also Warning section.
See also Warning section.
Before taking Diclof, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), bleeding or clotting problems, heart disease (such as previous heart attack), high blood pressure, liver disease, growths in the nose (nasal polyps), stomach/intestinal/esophagus problems (such as bleeding, ulcers, recurring heartburn), stroke.
Kidney problems can sometimes occur with the use of NSAID medications, including Diclof. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana (cannabis).
This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.
This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.
Older adults may be more sensitive to the side effects of this drug, especially stomach/intestinal bleeding, kidney problems, and worsening heart problems.
Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.
This drug passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.
Q: Arthrotrec is known for weight gain due to fluid retention and renal difficulties. Should I consult a doctor for a diuretic to lose excess fluid weight?
A: Arthrotec is a combination of Diclof and misoprostol. Diclof belongs to the group of drugs known as nonsteroidal anti-inflammatory drug (NSAIDs) and has analgesic and anti-inflammatory effects. Misoprostol is a gastrointestinal protective agent that is used in combination with NSAIDs to reduce the risk of stomach or intestinal ulcers. Arthrotec is used for the treatment of the signs and symptoms of osteoarthritis or rheumatoid arthritis in patients who are at high risk of developing a stomach or intestinal ulcer with NSAID therapy. Patients who have had a stomach ulcer or gastrointestinal bleeding are at 10 times greater risk of having gastrointestinal bleeding when taking a NSAID. Other factors that increase the risk of gastrointestinal bleeding in patients taking NSAIDs include use of oral corticosteroids or blood thinners, longer duration of NSAID therapy, smoking, use of alcohol, older age, and poor general health status. The most common side effects of Arthrotec are abdominal pain, diarrhea, upset stomach, nausea, and gas. Arthrotec, like other NSAIDs, can cause heart, kidney, and/or liver problems. Patients should be aware of the signs and symptoms of these possible conditions, including chest pain, shortness of breath, weakness, slurring of speech, swelling, unexplained weight gain, nausea, fatigue, itching, yellowing of the skin or eyes, or right upper quadrant tenderness. If you develop these signs or symptoms, please consult with your health care provider for guidance based on your health status and current medications, particularly before taking any action. Michelle McDermott, PharmD
By Frieda Wiley, PharmD, CGP, RPh | Medically Reviewed by Robert Jasmer, MD
Latest Update: 2015-01-14 Copyright © 2014 Everyday Health Media, LLC