diclofenac potassium: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
diclofenac potassium: clinical details
Prescribing considerations
- Assess gastrointestinal, cardiovascular, renal, hepatic, respiratory and bleeding risks.
- Use particular caution in older or frail people and those with inflammatory bowel disease, asthma, hypertension, mild heart failure, or renal or hepatic impairment.
- Consider gastroprotection for increased gastrointestinal risk.
- Diclofenac may mask infection symptoms and reversibly inhibit platelet aggregation.
- Review use when trying to conceive because prostaglandin inhibition may impair female fertility.
Contraindications and cautions
- Active gastrointestinal ulcer, bleeding or perforation; recurrent peptic ulcer or haemorrhage; or previous NSAID-related gastrointestinal bleeding or perforation
- Established ischaemic heart disease, peripheral arterial disease, cerebrovascular disease or NYHA class II–IV heart failure
- Renal failure or hepatic failure
- Previous aspirin- or NSAID-triggered asthma, angioedema, urticaria or acute rhinitis
- Hypersensitivity to diclofenac or an excipient
- Third trimester of pregnancy
Monitoring
- Consider baseline blood pressure, renal function and full blood count; assess liver function where hepatic impairment is present.
- After initiation or a clinically relevant change, consider renal function, blood count, blood pressure and haemoglobin in patients at gastrointestinal risk.
- For ongoing use, individualise monitoring according to risk and interacting medicines.
Clinical pharmacology
The potassium salt is rapidly and completely absorbed, highly albumin-bound and extensively metabolised on first pass. Diclofenac inhibits prostaglandin biosynthesis and has analgesic, anti-inflammatory and antipyretic effects.
Formulation and product differences
- This product is an immediate-release coated diclofenac potassium tablet intended for short-term treatment.
- Diclofenac products are not automatically interchangeable: salts and immediate-, gastro-resistant- and modified-release formulations have different release characteristics and licensed uses.
- This tablet contains sucrose and is essentially sodium-free.
diclofenac potassium preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg
diclofenac potassium interactions
Ask a prescriber or pharmacist to review other medicines, particularly:
Other systemic NSAIDs, including ibuprofen, naproxen and aspirin used for pain
Combining NSAIDs increases gastrointestinal and other adverse effects and should generally be avoided.
Warfarin, antiplatelets, corticosteroids or SSRIs
These combinations can increase bleeding, particularly from the stomach or intestine.
ACE inhibitors, beta-blockers and diuretics
Diclofenac may reduce blood-pressure control and increase kidney injury risk.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.