diclofenac sodium at a glance
Medicine class
Non-steroidal anti-inflammatory drug (NSAID)
Available forms
Selected products include prolonged-release tablets or capsules, suppositories and skin gel.
Important safety point
Systemic diclofenac can cause gastrointestinal bleeding and has important cardiovascular, kidney and liver risks.
What is diclofenac sodium used for?
Licensed uses vary by formulation and product.
Systemic products: pain and inflammation associated with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute gout, musculoskeletal conditions, trauma or minor surgery.
Selected lower-strength suppositories: juvenile chronic arthritis and acute postoperative pain in specified paediatric age groups.
Selected gel: mild to moderate muscle pain, bruising and post-traumatic pain within its licensed age range.
How does diclofenac sodium work?
Diclofenac inhibits cyclo-oxygenase enzymes, reducing prostaglandins involved in inflammation and pain. Gel gives higher local tissue exposure with much lower blood concentrations than oral diclofenac, although systemic effects remain possible.
diclofenac sodium preparations and strengths
Gel
Route: Cutaneous
Strengths: 1%, 3%
Modified-release tablet
Route: Oral
Strengths: 75 mg, 100 mg
How to take diclofenac sodium
Follow the directions for the specific formulation supplied.
Swallow prolonged- or modified-release tablets and capsules whole with liquid; do not crush, break or chew them.
Take oral forms with or after food, or with milk, to reduce stomach irritation.
Suppositories are for rectal use only. Wash your hands, unwrap the suppository and insert it pointed end first.
Apply gel only to healthy, intact skin and rub it in gently. Wash your hands afterwards unless they are being treated.
Keep gel away from eyes and mucous membranes, do not swallow it, avoid airtight dressings and protect the treated area from sunlight.
diclofenac sodium side effects
Common or expected effects
- Oral or rectal forms: nausea, vomiting, diarrhoea, indigestion, abdominal pain, wind, headache, dizziness, vertigo and rash.
- Gel: itching, redness, eczema, contact dermatitis, dry skin, burning or sunlight reactions.
Get urgent medical advice
- Gastrointestinal ulceration or bleeding, including black stools or vomiting blood.
- Heart attack, stroke, worsening heart failure or significant fluid retention.
- Severe allergic reaction, bronchospasm or angioedema.
- Serious blistering or peeling skin reactions.
- Liver injury, including jaundice, or acute kidney injury.
diclofenac sodium in pregnancy
Diclofenac is not usually recommended during pregnancy unless a clinician decides it is necessary. Systemic use from week 20 can affect fetal kidney function, amniotic fluid and the ductus arteriosus. It is contraindicated during the third trimester, including topical gel under the selected product licence. Tell a doctor or midwife promptly about unsupervised use after week 20.
diclofenac sodium while breastfeeding
UK specialist advice considers diclofenac a preferred NSAID during breastfeeding when clinically appropriate because milk transfer is negligible and accumulation is unlikely in a healthy, full-term infant. Monitor for vomiting or diarrhoea and prevent the baby touching gel-treated skin. Some systemic product information is more restrictive.
diclofenac sodium interactions
Check all prescribed, pharmacy and herbal products, including combination cold and pain remedies.
Other NSAIDs, including ibuprofen, naproxen and anti-inflammatory doses of aspirin
Concurrent systemic use increases gastrointestinal and other NSAID adverse effects and should generally be avoided.
Anticoagulants and antiplatelet medicines
Bleeding risk can increase.
Corticosteroids or SSRI antidepressants
Gastrointestinal ulceration or bleeding may become more likely.
Common questions about diclofenac sodium
Answers are fully visible for fast scanning and source review.
Can I take ibuprofen with diclofenac sodium?
Do not combine them without medical advice. Both are NSAIDs, so taking them together increases adverse-effect risks.
Can I take paracetamol with diclofenac sodium?
Paracetamol can generally be taken with diclofenac, but check combination products and ask a pharmacist if unsure.
Can prolonged-release diclofenac sodium be crushed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.