1. About diclofenac
Diclofenac is a medication that reduces swelling (irritation) and ache. It is used to deal with aches and pains, in addition to issues with joints, muscular tissues and bones. These embrace:
- rheumatoid arthritis and osteoarthritis
- sprains and strains in muscular tissues and ligaments
- again ache
ankylosing spondylitis – this causes irritation of the backbone and different components of the physique
Diclofenac comes as tablets and capsules, together with slow-release tablets and capsules, and suppositories. These can be found on prescription solely. Diclofenac gel and plasters for joint ache are that can be purchased from pharmacies.
It will also be given as an injection or as eyedrops. These are often solely given in hospital. A excessive power diclofenac gel (containing 3% diclofenac) is used to deal with actinic keratoses (dry, scaly patches of pores and skin attributable to solar harm). This remedy is often began after evaluation by a dermatologist and isn’t coated right here.
2. Key info
- It is best to take the bottom dose of diclofenac for the shortest time to manage your signs.
- Take diclofenac tablets or capsules with a meal or snack, or simply after consuming.
- Frequent unwanted side effects are abdomen ache, feeling or being sick and rashes.
- Diclofenac gel and plasters can be utilized twice a day to focus on ache in a specific space of your physique.
3. Who can and can’t take diclofenac
Most adults can take diclofenac.
- Youngsters could also be prescribed diclofenac to deal with joint issues. Diclofenac tablets, capsules and suppositories are appropriate for kids aged 6 months and above.
- Diclofenac gel is appropriate for kids aged 14 and above. Diclofenac plasters and patches are appropriate for younger folks aged 16 and above.
- Diclofenac just isn’t appropriate for some folks. To ensure it is secure for you, inform your physician or pharmacist in the event you:
- have ever had an allergic response to diclofenac or another medicines
- have an allergy to aspirin or different non-steroidal anti-inflammatory medicines (NSAIDs) resembling ibuprofen or naproxen
- have ever had unwanted side effects from taking NSAIDs, resembling wheezing or different indicators of bronchial asthma, a runny nostril, swelling of the pores and skin (angioedema) or a rash
- have ever had abdomen ulcers, bleeding within the abdomen or intestines, or a gap in your abdomen
- have hypertension (hypertension)
- have coronary heart failure, extreme liver illness or kidney illness
- have Crohn’s illness or ulcerative colitis
- have lupus
- have a blood clotting dysfunction
- are pregnant, planning to get pregnant, or breastfeeding
4. How and when to take or use diclofenac
All the time observe the recommendation of a pharmacist or physician, and the directions that include your medication.
Diclofenac tablets, capsules and suppositories
You may often take diclofenac tablets, capsules or suppositories 2 to three instances a day.
The standard dose is 75mg to 150mg a day, relying on what your physician prescribes for you. Comply with your physician’s recommendation on what number of tablets to take, and what number of instances a day.
In case your physician prescribes diclofenac in your little one, they’re going to use your kid’s weight to work out the correct dose for them.
In case you have ache on a regular basis, your physician might suggest slow-release diclofenac tablets or capsules. You may often take these both as soon as a day within the night, or twice a day. When you’re taking slow-release diclofenac twice a day, depart a niche of 10 to 12 hours between your doses.
How you can take tablets and capsules
Swallow diclofenac tablets or capsules with a drink of milk. If you want to take them with water, take them after a meal or snack. Taking them with milk or meals means they’re going to be much less more likely to upset or irritate your abdomen.
Swallow them entire, don’t crush, break or chew them.
How you can use suppositories
- Suppositories are medication that you just push gently into your anus (backside).
- Go to the bathroom beforehand if you want to.
- Wash your palms earlier than and after utilizing the medication. Additionally clear round your anus with delicate cleaning soap and water, rinse and pat dry.
- Unwrap the suppository.
- Gently push the suppository into your anus with the pointed finish first. It must go in about 3 centimetres (1 inch).
- Sit or lie nonetheless for about quarter-hour. The suppository will soften inside your anus. That is regular.
You may often use the gel 2 to 4 instances a day, relying on how sturdy it’s. Examine the packaging for extra data or communicate to your pharmacist.
When you’re utilizing the gel twice a day, use it as soon as within the morning and as soon as within the night. When you’re utilizing it 3 or 4 instances a day, wait a minimum of 4 hours earlier than placing on any extra.
The quantity of gel you want will depend on the scale of the realm you need to deal with. You may often use an quantity in regards to the dimension of a 1 penny or 2 pence piece (2 to 4 grams).
Necessary: Most dose for diclofenac gel
Don’t use diclofenac gel greater than 4 instances in any 24-hour interval.
How you can use the gel
Gently squeeze the tube, or press firmly and evenly on the nozzle of the dispenser, to get a small quantity of gel. Put the gel on the painful or swollen space and slowly rub it in. It might really feel cool in your pores and skin. Wash your palms afterwards.
Diclofenac plasters and patches
Deal with just one painful space at a time. Don’t use greater than 2 medicated plasters or patches in any 24-hour interval.
How you can use plasters and patches
- Stick a medicated plaster or patch over the painful space twice a day, as soon as within the morning and as soon as within the night. Take the outdated patch off earlier than you set the brand new one on.
- Apply mild stress with the palm of your hand till it is utterly caught to your pores and skin.
- If you need to take the plaster or patch off, it helps to moisten it with some water first. Upon getting taken it off, wash the affected pores and skin and rub it gently in round actions to take away any leftover glue.
What if I overlook to take it?
When you overlook to take diclofenac, take it as quickly as you keep in mind, except it is almost time in your subsequent dose. On this case, skip the missed dose and take the subsequent one on the typical time. By no means take a double dose to make up for a forgotten dose.
When you typically overlook doses, it could assist to set an alarm to remind you. You may additionally ask your pharmacist for recommendation on different methods that can assist you keep in mind your medication.
What if I take an excessive amount of?
Taking greater than your prescribed dose of diclofenac tablets, capsules or suppositories will be harmful. It will possibly trigger unwanted side effects resembling:
- abdomen ache
- feeling or being sick (vomiting)
- black poo or blood in your vomit – an indication of bleeding in your abdomen
- ringing in your ears (tinnitus)
Pressing recommendation: Contact 111 for recommendation if:
- you’re taking too many diclofenac tables, capsules or suppositories
- Go to 111.nhs.uk or name 111
- When you want recommendation for a kid below the age of 5 years, name 111.
- If you want to go to hospital, take the diclofenac packet or the leaflet inside it, plus any remaining medication, with you.
- Discover your nearest A&E
What if I take advantage of too many plasters or patches or an excessive amount of gel?
When you use too many plasters or patches or an excessive amount of gel by mistake, it is unlikely to do you any hurt. However in the event you use an excessive amount of and get any unwanted side effects, inform your physician right away.
5. Taking diclofenac with different painkillers
It is secure to take diclofenac with paracetamol or codeine. Don’t take diclofenac with comparable painkillers, like aspirin, ibuprofen or naproxen, with out speaking to a health care provider.
Diclofenac, aspirin, ibuprofen and naproxen all belong to the identical group of medicines referred to as non-steroidal anti-inflammatory medicine (NSAIDs). Taking diclofenac along with different NSAIDs might enhance your probabilities of getting unwanted side effects like a abdomen ache.
NSAIDs are additionally utilized in medicines you should purchase from pharmacies, resembling cough and chilly treatments.
Earlier than taking another medicines along with diclofenac, examine the label to see in the event that they include ibuprofen, aspirin or different NSAIDs.
6. Unintended effects
Like all medicines, diclofenac could cause unwanted side effects, though not everybody will get them.
Frequent unwanted side effects
Frequent unwanted side effects of diclofenac tablets, capsules and suppositories occur in additional than 1 in 100 folks.
Speak to your physician or pharmacist if these unwanted side effects hassle you or don’t go away:
- feeling sick (nausea)
- being sick (vomiting) or diarrhoea
- feeling dizzy or vertigo
- abdomen ache, wind or lack of urge for food
- delicate rash
- You are much less more likely to have unwanted side effects with diclofenac gel or plasters. It’s because much less medication will get into your physique. However you should still get the identical unwanted side effects, particularly in the event you use loads on a big space of pores and skin.
- Utilizing diclofenac gel or plasters can have an effect on your pores and skin. It will possibly make your pores and skin
- extra delicate to daylight than regular
- develop a rash the place you utilized the gel or plaster
- dry or irritated (eczema)
- itchy or infected (dermatitis)
Critical unwanted side effects
These severe unwanted side effects are uncommon and occur in lower than 1 in 1,000 folks.
Name your physician right away if:
- you’ve blood in your vomit or black poo – these could possibly be indicators of bleeding in your abdomen or intestine
- you’ve extreme indigestion, heartburn or abdomen ache, vomiting or diarrhoea – these will be indicators of an ulcer or irritation in your abdomen or intestine
- the whites of your eyes or your pores and skin flip yellow, though this can be much less apparent on brown or black pores and skin – this generally is a signal of liver issues
- you’ve a raised, itchy rash, or swollen or puffy pores and skin – these will be indicators of hives (urticaria) or oedema (swelling)
- you’ve breathlessness, tiredness and swollen legs or ankles – these will be indicators of coronary heart failure
Rapid motion required: Name 999 or go to A&E if:
you’ve chest ache, shortness of breath, really feel weak or lightheaded, or have an awesome feeling of tension – these will be indicators of a coronary heart assault
you’ve weak point on one aspect of your physique, bother talking or considering, lack of stability or blurred eyesight – these will be indicators of a stroke
Critical allergic response
In uncommon circumstances, it is doable to have a severe allergic response (anaphylaxis) to diclofenac.
Rapid motion required:
- you get a pores and skin rash which will embrace itchy, crimson, swollen, blistered or peeling pores and skin
- you are wheezing
- you get tightness within the chest or throat
- you’ve bother respiratory or speaking
- your mouth, face, lips, tongue or throat begin swelling
- You may be having a severe allergic response and may have quick remedy in hospital.
- These should not all of the unwanted side effects of diclofenac. For a full record, see the leaflet inside your medication packet.
- You possibly can report any suspected aspect impact utilizing the Yellow Card security scheme.
- Go to Yellow Card for additional data.
7. How to deal with unwanted side effects of diclofenac
What to do about:
feeling sick (nausea) – take diclofenac with or after a meal or snack. It might additionally assist in the event you keep away from wealthy or spicy meals.
being sick (vomiting) or diarrhoea – drink loads of water or different fluids. When you’re being sick, strive small frequent sips of water. Communicate to a pharmacist in case you have indicators of dehydration, resembling peeing lower than typical or having darkish, strong-smelling pee. Communicate to a health care provider if being sick or diarrhoea lasts for longer than 3 days. Don’t take another medicines with out talking to a pharmacist or physician.
feeling dizzy or vertigo – in the event you really feel dizzy or unsteady, cease what you are doing and sit or lie down till you are feeling higher. Don’t drive or cycle, or use instruments or equipment, in the event you’re feeling dizzy or lightheaded. As your physique will get used to diclofenac, these unwanted side effects ought to put on off.
complications – ensure you relaxation and drink loads of fluids. Don’t drink an excessive amount of alcohol. Ask your pharmacist to suggest an alternate painkiller. Complications ought to often go away after the primary week of taking diclofenac. Speak to your physician in the event that they last more than every week or are extreme.
abdomen ache, wind or lack of urge for food – strive to not eat meals that trigger wind (like peas, lentils, beans and onions). Eat smaller meals, eat and drink slowly, and train recurrently.
a light rash and dry or irritated, itchy or infected pores and skin – use an emollient cream or ointment to moisturise, soothe and hydrate the affected space. If it doesn’t get higher inside every week otherwise you’re anxious, communicate to a pharmacist or physician.
pores and skin being extra delicate to daylight – keep out of vivid solar and use a excessive issue solar cream (SPF 15 or above), even on cloudy days. Don’t use a sunlamp or sunbeds.
8. Being pregnant and breastfeeding
Diclofenac and being pregnant
- Diclofenac just isn’t often advisable in being pregnant.
- It’s because diclofenac might trigger issues in your unborn child. For instance it may have an effect on your child’s circulation and it may trigger you to have too little amniotic fluid surrounding your child within the womb.
- Your physician will solely advise you to take diclofenac whilst you’re pregnant if the advantages of taking the medication clearly outweigh the dangers.
- There could also be different remedies which are safer for you. Paracetamol is mostly one of the best painkiller to take throughout being pregnant.
Diclofenac and breastfeeding
You possibly can take diclofenac whereas breastfeeding. Solely very small quantities get into breast milk that are unlikely to trigger unwanted side effects in your child. Many breastfeeding moms have used it with none issues.
When you discover that your child just isn’t feeding in addition to typical, or in case you have another considerations about your child, speak to your midwife, well being customer, pharmacist or physician as quickly as doable.
Non-urgent recommendation: Inform your physician in the event you’re:
- attempting to get pregnant
- For extra details about how this medication can have an effect on you and your child, learn this leaflet on diclofenac on the Greatest Use of Medicines in Being pregnant (BUMPs) web site.
9. Cautions with different medicines
There are some medicines that have an effect on the way in which diclofenac works. Inform your physician in the event you’re taking:
- different anti-inflammatory medicines, resembling aspirin or ibuprofen
- antibiotics, resembling ciprofloxacin, levofloxacin, moxifloxacin, nalidixic acid, norfloxacin or ofloxacin
- anticoagulants (generally referred to as “blood thinners”), resembling warfarin
- medicines for coronary heart issues, resembling digoxin, and medicines for hypertension
- medicines to decrease ldl cholesterol, resembling colestipol and cholestyramine
- medicines to deal with seizures, resembling phenytoin
- medicines that cut back the exercise of your immune system (immunosuppressants), resembling ciclosporin or tacrolimus
- selective serotonin reuptake inhibitor (SSRI) antidepressants like citalopram or sertraline
- steroid medicines, resembling hydrocortisone or prednisolone
- tablets that make you pee extra (diuretics), resembling furosemide or bumetanide
- lithium, which is used to deal with psychological well being issues
- methotrexate, which is used to deal with some inflammatory ailments and cancers
- mifepristone, which is used for ending a being pregnant (abortion)
- zidovudine, which is used to deal with HIV
Mixing diclofenac with natural treatments or dietary supplements
It is not doable to say that complementary medicines or natural treatments are secure to take with diclofenac. They are not examined in the identical means as prescription medicines or medicines offered in pharmacies. They’re usually not examined for the impact they will have on different medicines.
Necessary: Medication security
Inform your physician or pharmacist in the event you’re taking another medicines, together with natural medicines, nutritional vitamins or dietary supplements.
10. Frequent questions on diclofenac
How does diclofenac work?
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). It really works by decreasing hormones that trigger irritation and ache within the physique.
If you apply diclofenac gel, plasters or patches to your pores and skin, it really works in the identical means as whenever you take it as a pill or capsule. However the gel, plaster or patch solely works on the realm you've put it on.
When will I really feel higher?
Diclofenac takes 20 to half-hour to work in the event you take it as tablets or capsules. Suppositories take a couple of hours to work. There is not any distinction in how effectively the tablets, capsules or suppositories work. The doses of diclofenac are the identical for every.
When you're utilizing diclofenac gel, plasters or patches in your pores and skin, it often takes 1 to 2 days to work. For arthritis, chances are you'll want to make use of the gel for as much as 7 days on the painful joint to really feel the complete impact.
How lengthy will I take it for?
Relying on why you are taking diclofenac, chances are you'll solely must take it for a short while. For instance, in case you have a sore again or toothache, chances are you'll solely must take diclofenac for 1 or 2 days.
Chances are you'll must take it for longer in case you have a long-term situation, resembling rheumatoid arthritis. If you want to take diclofenac tablets or capsules for a very long time, your physician might prescribe a medication to guard your abdomen from unwanted side effects. It is best to take the bottom dose of diclofenac for the shortest time to manage your signs.
Speak to your physician in the event you're not sure how lengthy you want to take it for.
Is it secure to take long run?
Diclofenac tablets and capsules could cause an ulcer in your abdomen or intestine in the event you take them for a very long time or in large doses.
There's additionally a small threat of coronary heart failure or kidney failure in the event you take very large doses (150mg a day) for a very long time.
It is best to take the bottom dose that works for the shortest doable time. If you want to take diclofenac fairly often otherwise you're taking a giant dose, speak to your physician about one of the best ways to deal with your ache.
Are there different painkillers I can strive?
The kind of painkiller that is finest will depend on what kind of ache you've and the reason for your ache.
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). Ibuprofen and naproxen additionally belong to this group of painkillers.
If you want to take an NSAID long run, your physician or pharmacist might suggest ibuprofen or naproxen as a substitute of diclofenac. It's because they're much less more likely to trigger coronary heart issues. If NSAIDs don't eliminate your ache, you may strive painkillers that you may purchase from pharmacies and retailers, resembling paracetamol or co-codamol (paracetamol mixed with low-dose codeine).
If the medication you purchase just isn't controlling your ache, your physician might suggest further remedy to assist your ache, resembling train or physiotherapy. Diclofenac doesn't work for some varieties of ache, resembling nerve ache. Your physician should prescribe a distinct medication to deal with peripheral neuropathy (nerve ache).
Why do I should be cautious about abdomen ulcers?
Diclofenac tablets and capsules could cause an ulcer in your abdomen or intestine in the event you take them for a very long time or in large doses, or in the event you're aged or in poor common well being.
Your physician might let you know to not take diclofenac in case you have a abdomen ulcer or have had one prior to now. If you want to take diclofenac however you are prone to getting a abdomen ulcer, your physician might prescribe one other medication so that you can take alongside diclofenac to guard your abdomen.
It is vital to take your diclofenac tablets or capsules after a meal or snack, or with a drink of milk. They're going to be much less more likely to upset or irritate your abdomen.
The most typical symptom of a abdomen ulcer is a burning or gnawing ache within the centre of the abdomen. However, abdomen ulcers should not at all times painful and a few folks might produce other signs, resembling indigestion, heartburn, and feeling sick.
When you're susceptible to abdomen ulcers or have had one earlier than, take paracetamol as a substitute of diclofenac because it's gentler in your abdomen.
Is it addictive?
No, diclofenac just isn't addictive, nevertheless it's vital to at all times take it as prescribed.
What's going to occur if I cease taking it?
If you cease taking diclofenac tablets or capsules, or cease utilizing the suppositories, the consequences will put on off after about 15 hours. If you cease utilizing the gel, plasters or patches, the consequences will put on off after 1 or 2 days.
Will it have an effect on my fertility?
Taking anti-inflammatory medicines, like diclofenac, in massive doses or for a very long time can have an effect on ovulation in girls. This will likely make it harder to get pregnant. Don't take diclofenac in the event you're attempting to get pregnant, or in the event you're having assessments for infertility. Paracetamol is a greater painkiller in these conditions.
Will it have an effect on my contraception?
Diclofenac won't have an effect on any contraceptives, together with the mixed capsule or emergency contraception.
Can I drink alcohol with it?
Sure, you may drink alcohol whereas taking diclofenac. However ingesting an excessive amount of alcohol might irritate your abdomen. Attempt to maintain to the advisable tips of not more than 14 models of alcohol every week. An ordinary glass of wine (175ml) is 2 models. A pint of lager or beer is often 2 to three models of alcohol.
Is there any meals or drink I must keep away from?
Other than not ingesting an excessive amount of alcohol, you may eat and drink usually whereas taking diclofenac.
Can I drive or journey a motorbike?
It occurs hardly ever, however some folks can really feel drained, dizzy or sleepy after they take diclofenac. They could even have issues with their eyesight. If diclofenac impacts you on this means, don't drive or journey a motorbike till it passes and you are feeling OK once more.
Necessary: Abdomen ulcers
Cease taking diclofenac and get in touch with your physician in the event you suppose you could have signs of a abdomen ulcer. These can embrace intense ache within the centre of your abdomen, indigestion, heartburn and feeling sick.
- Ankylosing spondylitis
- Rheumatoid arthritis