خواص دارویی و گیاهی
(diclofenac)
Diclofenac belongs to the class of medications known as non-steroidal anti-inflammatories (NSAIDs). It is used to reduce pain, swelling, and inflammation.
The diclofenac sodium tablet and suppository are used to relieve pain for people with rheumatoid arthritis, osteoarthritis, and degenerative joint diseases of the hip. The diclofenac potassium tablets are used for short-term relief of pain and inflammation, such as pain caused by sprains, surgery, dental work or menstrual cramps. The eye drop is used to reduce eye inflammation before and after eye surgery (e.g., cataract surgery) and in other cases of eye inflammation where infection is not present. The powder for oral solution is used for the treatment of migraine aches.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.
Tablets
Voltaren Rapide
Each reddish-brown, round, biconvex, sugar-coated tablet contains 5 mg diclofenac potassium. Nonmedicinal ingredients: cellulose, colloidal silicon dioxide, corn starch, ferric oxide, magnesium stearate, polyethylene glycol, povidone, sodium carboxymethyl starch, sucrose, talc, titanium dioxide, and tribasic calcium phosphate.
Delayed-release tablet
5 mg
Each light brown, round, slightly biconvex, enteric-coated, tablet, printed “VOLTAREN” on one side and “5” on the other, contains 5 mg diclofenac sodium. Nonmedicinal ingredients: black ink, castor oil derivatives, colloidal silicon dioxide, corn starch, hypromellose, iron oxides, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone, sodium starch glycolate, talc, and titanium dioxide.
Extended-release tablet
75 mg
Each light pink, triangular, biconvex, film-coated tablet, printed “VOLTAREN SR” on one side and “75” on the other, contains 75 mg diclofenac sodium. Nonmedicinal ingredients: black ink, carnauba wax, cellulose compounds, cetyl alcohol, colloidal silicon dioxide, hypromellose, magnesium stearate, polysorbate 8, povidone, red iron oxide, sucrose, talc, and titanium dioxide.
1 mg
Each pink, round, biconvex, film-coated tablet, printed “VOLTAREN SR” on one side and “1” on the other, contains 1 mg diclofenac sodium. Nonmedicinal ingredients: black ink, carnauba wax, cellulose compounds, cetyl alcohol, colloidal silicon dioxide, hypromellose, magnesium stearate, polysorbate 8, povidone, red iron oxide, sucrose, talc, and titanium dioxide.
Suppositories
5 mg rectal suppository
Each bullet-shaped suppository, white to yellowish-white in colour, with a smooth surface and a fat-like odour, contains 5 mg diclofenac sodium. Nonmedicinal ingredients: semi-synthetic glycerides.
1 mg rectal suppository
Each bullet-shaped suppository, white to yellowish-white in colour, with a smooth surface and a fat-like odour, contains 1 mg diclofenac sodium. Nonmedicinal ingredients: semi-synthetic glycerides.
Tablets: The usual adult dosage ranges from 5 mg to 1 mg daily. The immediate-release diclofenac sodium tablets are taken in 3 equally divided doses with food. Diclofenac potassium tablets are taken every 6 to 8 hours with food. The long-acting (sustained-release, or SR) tablets are taken in 1 or 2 daily doses with food or milk. The maximum recommended daily dose of diclofenac is 1 mg.
Tablets should be swallowed whole with some fluid. Do not crush or chew the tablets as this can change the way the medication is absorbed into your body. It may increase the risk of side effects, such as stomach irritation or bleeding.
Suppositories: The suppositories are usually used as a substitute for the last daily dose in a 5 mg or 1 mg strength, to a maximum total daily dose of 1 mg of diclofenac.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Do not take this medication if you:
Do not use diclofenac suppositories if you:
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Health Canada has issued new restrictions concerning the use of diclofenac. To read the full Health Canada Advisory, visit Health Canada’s web site at www.hc-sc.gc.ca.
Allergy: Some people who are allergic to other anti-inflammatory medications also experience allergic reactions to diclofenac. Before you take diclofenac, inform your doctor about any previous adverse reactions you have had to medications, especially ketorolac or ibuprofen. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.
Breathing problems: People who have asthma, long term breathing problems, or allergic conditions such as hay fever or nasal polyps are more likely to experience difficulty breathing and allergic reactions, caused by NSAIDs. If you have a history of allergic reactions to other substances, or respiratory illness, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Drowsiness/reduced awareness: Some people have reported ache, dizziness, lightedness, and confusion while taking this medication. Avoid operating motor vehicles and doing other potentially hazardous activities until you have determined how this medication affects you.
Fertility: As with other NSAIDs, this medication may make it more difficult for a couple to conceive if the woman is taking diclofenac. Stopping the medication allows the body’s chemistry to to normal which often resolves this issue.
Fluid retention: Diclofenac may cause fluid retention and swelling, possibly worsening high blood pressure, congestive heart failure, or decreased heart . If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you develop shortness of breath fatigue excessive weight gain chest pain or swelling of the legs, feet, or ankles while taking this medication, consult your doctor immediately.
Heart problems: Like other NSAID medications, diclofenac may increase the risk of heart attacks, strokes, and blood clots. The risk is greater with higher total daily doses and taking the medication for a long period of time. Due to this increased risk, people with the following conditions or risk factors should be closely monitored by their doctor if they use diclofenac:
If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Infection: This medication may hide the signs of an infection, such as a fever or generalized achiness.
Kidney : Long-term use of diclofenac may lead to a higher risk of reduced kidney . This is most common for people who already have kidney disease, liver disease, or heart failure for people who are take diuretics (water pills) and for seniors. If you experience signs of decreasing kidney , such as increased fluid retention or decreased amounts of urine being produced, see your doctor as soon as possible.
Liver : This medication may cause liver problems. If you have a liver condition, you may need more frequent checkups with your doctor. If you develop signs of a liver problem (such as yellow skin or eyes, dark urine, pale stools, abdominal pain, or itchy skin), stop taking the medication and see your doctor as soon as possible.
Potassium levels: Diclofenac may increase the risk of high potassium levels in the blood, especially for seniors, people who have conditions such as diabetes or kidney failure, or those taking certain other types of medications. Your doctor may order blood tests periodically during long-term treatment to monitor the amount of potassium in your blood. People who have been diagnosed with having high potassium levels in their blood should not take this medication.
Stomach problems: Stomach ulcers, perforation, and bleeding from the stomach have been known to occur during treatment with diclofenac. These complications can occur at any time, and are sometimes severe enough to require immediate medical attention. The risk of ulcers and bleeding are increased for people taking higher doses of NSAIDs for longer periods of time.
Diclofenac should be taken under close medical supervision by people prone to irritation of the stomach and intestines, particularly those who have had a stomach ulcer, bloody stools, or diverticulosis or other inflammatory disease of the stomach or intestines (such as ulcerative colitis or Crohn’s disease). In these cases, your doctor must weigh the benefits of treatment against the possible risks.
Stop taking the medication and contact your doctor immediately if you experience symptoms or signs suggestive of stomach ulcers or bleeding in the stomach (black, tarry stools). These reactions can occur at any time during treatment without warning.
Sun sensitivity: This medication may make your skin more sensitive to the sun. While you are using this medication, avoid excessive sun exposure, including tanning beds and sun lamps. If you experience sunburn with itching, swelling, and blistering, stop using this medication and contact your doctor.
Pregnancy: When diclofenac is taken during the last 3 months of pregnancy, there is an increased risk of the child developing heart problems and the mother having a longer labour to deliver the baby. If diclofenac is taken during the earlier stages of pregnancy, there is an increased risk of miscarriage. For these reasons, this medication is not recommended for use during pregnancy.
Breast-feeding: It is not known if diclofenac passes into breast milk. Due to the potential for harm to a baby if they are exposed to this medication, breast-feeding must be stopped before starting this medication.
Children: Diclofenac is not recommended for children under 16 years of age. The safety, effectiveness, and dosage of this medication for this age group have not been established.
Seniors: Seniors appear to have a higher risk of side effects with this medication. The lowest effective dosage should be used under close medical supervision.
There may be an interaction between diclofenac and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all preion, over-the-counter (non-preion), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 218. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Voltaren
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