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Diclofenac, a nonsteroidal anti-inflammatory drug, requires careful consideration due to its associated risks and necessary precautions. Below are the essential safety warnings and instructions for its use:

• Cardiovascular Risks: Diclofenac may increase the risk of heart attack or stroke, particularly with prolonged use. Individuals with heart disease, risk factors for heart disease, or older adults are at higher risk. Avoid taking this medication right before or after heart bypass surgery (CABG).

• Gastrointestinal Risks: There is a rare but serious risk of stomach or intestinal bleeding which can occur without warning. This risk may be higher in older adults. Immediate medical attention is required if you experience persistent stomach pain, black or tarry stools, or vomit resembling coffee grounds.

• Eye-related Risks (Eye Drops):

  • Bleeding: Diclofenac eye drops can cause bleeding after eye surgery, especially if you have a history of bleeding problems or are on blood thinners. Report any blood spots on your eye to your healthcare provider.
  • Delayed Healing: These eye drops can slow down healing from eye injuries, particularly if used with corticosteroid eye drops. Discuss appropriate treatment options with your provider if you have had recent eye surgery.
  • Cornea Issues: Use of diclofenac eye drops may lead to corneal redness, swelling, weakening, or injury, potentially impairing vision. Those with corneal problems, multiple eye surgeries, rheumatoid arthritis, or diabetes should exercise caution and undergo regular eye check-ups. Report any changes in vision or increased eye discomfort to your provider immediately.
  • Contact Lenses: Do not wear soft contact lenses while using diclofenac eye drops. Follow your provider's guidance on when it is safe to resume wearing them after surgery.

• Pre-existing Conditions and Interactions: Discuss the benefits and risks with your healthcare provider, especially if you have a history of heart disease, bleeding disorders, or other relevant medical conditions. Inform your provider of all medications you are taking to avoid harmful interactions.

• Emergency Actions in Case of Overdose: Seek immediate medical help if you experience symptoms suggestive of overdose, such as severe abdominal pain, difficulty breathing, or sudden changes in vision or consciousness.

Always consult your doctor or pharmacist for personalized advice and to ensure this medication is safe for your specific health needs.

Common side effects:

• Upset stomach
• Nausea
• Heartburn
• Diarrhea
• Constipation
• Gas
• Headache
• Drowsiness
• Dizziness
• Blurred vision
• Temporary stinging or burning of the eye
• Redness and swelling of the cornea
• Teary eyes
• Eye irritation
• Dry eyes
• Eye discharge
• Eyelid swelling

Less common but important to monitor:

• Increase in blood pressure
• High pressure inside the eye
• Redness and swelling of the iris

Serious side effects:

• Changes in hearing
• Mood alterations
• Easy bruising or bleeding
• Difficulty swallowing
• Signs of kidney problems
• Symptoms associated with heart failure
• Serious liver damage
• Persistent nausea or vomiting
• Loss of appetite
• Abdominal pain
• Jaundice
• Dark urine
• Severe allergic reaction
• Fever
• Swollen lymph nodes
• Rash
• Itching
• Severe dizziness
• Trouble breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Ketorolac

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Clopidogrel
• Warfarin
• Dabigatran
• Enoxaparin
• Ibuprofen
• Naproxen
• Dexamethasone
• Prednisone
• Lithium
• Methotrexate
• Lisinopril
• Losartan
• Furosemide