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When using diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), it's crucial to be aware of the associated risks and safety precautions. Below are important safety considerations to keep in mind:

• Heart Attack and Stroke Risk: Diclofenac may increase the likelihood of a heart attack or stroke, particularly with prolonged use. This risk is heightened in individuals with heart disease or those undergoing heart bypass surgery. It is advised to use diclofenac for the shortest duration necessary and consult your healthcare provider about alternatives if surgery is planned.

• Stomach and Intestinal Bleeding: Diclofenac can cause serious bleeding in the stomach or intestines, which may occur without warning. This risk is greater in older adults and in those with a history of ulcers or stomach bleeding. Notify your doctor immediately if you experience persistent stomach pain, black or tarry stools, or vomit that appears like coffee grounds.

• Heart Problems: This medication can elevate blood pressure and exacerbate heart failure symptoms. Regular monitoring and discussions with your provider are recommended if you have pre-existing heart conditions.

• Kidney Function: Diclofenac may impair kidney function, potentially leading to kidney damage. Inform your healthcare provider if you notice symptoms such as irregular heartbeat or reduced urine output.

• Liver Concerns: The use of diclofenac can affect liver health. Report symptoms such as nausea, fatigue, or jaundice to your doctor, who may order liver function tests as needed.

• Serious Allergic Reactions: If you have had allergic reactions to aspirin or other NSAIDs, you may experience similar reactions to diclofenac. Seek immediate medical attention if you develop hives, difficulty breathing, or facial swelling.

• Severe Skin Reactions: Rarely, diclofenac can cause life-threatening skin reactions. Discontinue use and notify your healthcare provider if you have severe skin rashes or flu-like symptoms.

• Pregnancy Risk: Diclofenac is not recommended during pregnancy, especially after 20 weeks, due to potential harm to the unborn child. Pregnant individuals should discuss safer alternatives with their healthcare provider.

• Anemia Risk: Diclofenac may increase bleeding risk, potentially leading to anemia. Contact your healthcare provider if you experience symptoms such as fatigue, paleness, or dizziness.

• Safe Handling: Store diclofenac patches securely to prevent accidental exposure to children and pets. Avoid contact with eyes, and rinse immediately with water if exposure occurs.

• Drug Interactions: Avoid using diclofenac alongside other oral NSAIDs like ibuprofen or naproxen unless directed by your healthcare provider due to increased risk of bleeding and kidney issues.

If you suspect an overdose or experience any severe reactions, seek immediate medical help. Always consult with your healthcare provider for personalized advice and to address any concerns regarding the use of diclofenac.

Common side effects:

• Itching at the application site
• Burning at the application site
• Irritation at the application site
• Redness at the application site
• Dry skin at the application site
• Nausea
• Upset stomach
• Indigestion
• Changes in taste
• Vomiting
• Diarrhea
• Constipation
• Dry mouth

Less common but important to monitor:

• Headaches
• Sleepiness
• Dizziness
• Pins-and-needles sensation
• Numbness

Serious side effects:

• Liver problems
• Kidney issues
• Heart attack
• Heart failure
• Stroke
• Digestive tract bleeding
• Serious allergic reactions
• Serious skin reactions

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

• anti-platelet drugs such as Clopidogrel
• blood thinners such as Dabigatran, Enoxaparin, Warfarin

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

• Aliskiren
• ACE inhibitors such as Captopril, Lisinopril
• angiotensin II receptor blockers such as Losartan, Valsartan
• Cidofovir
• corticosteroids such as Prednisone
• Lithium
• Methotrexate
• diuretics such as Furosemide
• Aspirin and NSAIDs such as Celecoxib, Ibuprofen, Ketorolac