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Taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, may infrequently heighten the risk of heart attacks or strokes. This risk can arise at any point during treatment but is more probable with prolonged use. Individuals who are older, have existing heart conditions, or have risk factors for heart disease, such as smoking, a family history of heart disease, high blood pressure, or diabetes, may face a higher risk. Diclofenac should not be used immediately before or after coronary artery bypass graft (CABG) surgery.

Additionally, diclofenac can occasionally cause severe, potentially fatal, bleeding in the stomach or intestines, which might occur without prior symptoms and at any time during use. Older adults might be more susceptible to this adverse effect.

Please discontinue diclofenac and seek immediate medical attention if you experience any of the following rare but severe side effects:

• Persistent stomach or abdominal pain
• Black or bloody stools
• Vomit resembling coffee grounds
• Pain in the chest, jaw, or left arm
• Shortness of breath
• Unusual sweating
• Confusion
• Weakness on one side of the body
• Sudden vision changes
• Difficulty speaking

It is important to discuss the potential benefits and risks of using this medication with your healthcare provider or pharmacist.

When using this medication, some individuals may experience skin irritation or redness at the site of application. This is generally mild, but if it persists or worsens, it is important to consult a healthcare professional. Regular monitoring of blood pressure is advised, as this medication may cause an increase. Report any significant elevations to your healthcare provider.

There are rare but serious side effects that require immediate medical attention. Be alert for signs of kidney issues, such as changes in urination, or heart failure, which may manifest as swelling of the ankles or feet, unusual fatigue, or sudden weight gain. This medication has been associated with severe liver disease in rare instances. Seek urgent medical care if you experience persistent nausea or vomiting, loss of appetite, abdominal pain, yellowing of the skin or eyes, or dark urine.

Although a severe allergic reaction is uncommon, it is crucial to be aware of symptoms like fever, swollen lymph nodes, rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, or difficulty breathing. These warrant immediate medical intervention. While many people do not experience serious side effects, it's important to remain vigilant and report any unexpected reactions to your healthcare provider.

This medication can interact with a variety of other drugs, which may affect its effectiveness or increase side effects. Be cautious if you are also taking Aliskiren, ACE inhibitors like Captopril or Lisinopril, angiotensin II receptor blockers such as Losartan or Valsartan, Cidofovir, corticosteroids like Dexamethasone or Prednisone, Lithium, Methotrexate, and diuretics such as Furosemide. Additionally, applying other products to the same area of skin being treated may cause interactions.

Using this medication alongside other drugs that increase bleeding risk can be dangerous. Such medications include antiplatelet agents like Clopidogrel and blood thinners such as Dabigatran, Enoxaparin, or Warfarin, as well as Erlotinib.

It's important to review all your medications, including over-the-counter ones, since many contain pain relievers or fever reducers like Aspirin or NSAIDs (Ibuprofen, Naproxen, Ketorolac). These are similar to Diclofenac and may heighten the risk of side effects. If your healthcare provider has advised you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams daily), continue as directed unless instructed otherwise by your doctor. For further clarification, consult your doctor or pharmacist.