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Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that requires careful consideration due to its associated risks. Below is essential safety and warning information to ensure its safe use:

• Cardiovascular Risks: Diclofenac may increase the risk of heart attack, stroke, and blood clots. This risk can arise early in treatment, especially in individuals with pre-existing heart conditions, those taking high doses, or using the drug long-term. Avoid use if you have had or will undergo heart bypass surgery. Seek immediate medical attention if you experience chest pain, difficulty breathing, weakness on one side, or trouble speaking.

• Gastrointestinal Risks: The medication can cause severe stomach bleeding or ulcers, potentially without prior symptoms. Older adults and those with a history of gastrointestinal issues or those taking certain medications (e.g., aspirin, corticosteroids) are at higher risk. Cease use and contact a healthcare provider if you notice persistent stomach pain, black stools, or vomit resembling coffee grounds.

• Liver Concerns: Diclofenac may rarely lead to significant liver damage, possibly occurring within the first month of treatment. Regular liver function tests are recommended if used long-term. Discontinue use and seek medical help if you experience symptoms like jaundice, dark urine, or clay-colored stools.

• Blood Pressure and Heart Failure: Diclofenac can elevate blood pressure and cause fluid retention, exacerbating heart failure. It may also reduce the effectiveness of certain heart medications. Monitor blood pressure regularly and consult with your provider if you experience sudden weight gain or swelling.

• Renal Implications: This drug can impair kidney function, especially in individuals with pre-existing kidney or liver problems, those on specific blood pressure medications, or older adults. Report any changes in urination frequency to your provider.

• Asthma and Respiratory Risks: Diclofenac may provoke severe asthma attacks, particularly in individuals with a history of NSAID-induced asthma. Avoid use if you have this sensitivity and seek immediate help if breathing becomes difficult.

• Allergic and Skin Reactions: Serious allergic reactions, including skin reactions, may occur. Avoid if allergic to NSAIDs or bovine products. Discontinue and seek medical help if you develop symptoms like rash, blisters, or facial swelling.

• Pregnancy Considerations: Use of diclofenac during the second and third trimesters can harm the unborn baby, causing kidney or heart problems. Discuss risks with your provider if you are pregnant or planning to become pregnant.

Contraindications:

• Do not use diclofenac if you have a history of allergic reactions to aspirin or other NSAIDs.
• Avoid starting diclofenac 10 to 14 days post-heart surgery.
• If taking diclofenac potassium (Zipsor), avoid use if allergic to bovine products.

Consult your healthcare provider to weigh the benefits and risks of using diclofenac, especially if you have pre-existing health conditions or are taking other medications. If an overdose occurs, seek emergency medical assistance immediately.

When taking this medication, some individuals may experience mild side effects such as upset stomach, nausea, heartburn, diarrhea, constipation, or gas. You might also encounter headaches, dizziness, drowsiness, or blurred vision. These effects are generally mild, but if they persist or worsen, it's advisable to consult your healthcare provider.

There are more serious side effects that require immediate medical attention. These include hearing changes like ringing in the ears, mental or mood changes, easy bleeding or bruising, and difficulty swallowing. Signs of potential heart failure, such as swelling of the ankles or feet, unusual tiredness, or sudden weight gain, should also be promptly addressed.

This medication can rarely lead to severe liver damage. Symptoms of liver issues include persistent nausea or vomiting, loss of appetite, abdominal pain, yellowing of the skin or eyes, and dark urine. Kidney problems might manifest as changes in urination or the presence of pink or bloody urine.

In rare cases, a serious allergic reaction may occur, characterized by fever, swollen lymph nodes, rash, itching, swelling of the face or throat, severe dizziness, or trouble breathing. Additionally, conditions such as heart attack, stroke, stomach bleeds, and severe asthma attacks are serious and warrant immediate medical help.

While these side effects are uncommon, it's crucial to be aware of them and seek medical advice if they occur. Always monitor for any unusual symptoms and maintain regular communication with your healthcare provider.

When taking diclofenac, it's important to be aware of potential interactions with other medications. Some drugs that might interact with diclofenac include:

1. Blood Pressure and Heart Medications: Aliskiren, ACE inhibitors (e.g., benazepril, lisinopril), and angiotensin II receptor blockers (e.g., losartan, valsartan). These may interact with diclofenac, potentially affecting its efficacy and the risk of side effects.

2. Anti-inflammatory and Pain Relievers: NSAIDs like ibuprofen, ketorolac, and naproxen are similar to diclofenac. Taking them together can increase the likelihood of adverse effects. If you are on low-dose aspirin for heart protection (81-162 mg daily), continue unless advised otherwise by your doctor.

3. Diuretics and Lithium: "Water pills" such as furosemide and lithium can interact with diclofenac, which may lead to increased side effects or altered effectiveness of the medications.

4. Bleeding Risk Medications: Anti-platelet drugs like clopidogrel and blood thinners such as dabigatran, enoxaparin, and warfarin can increase bleeding risk when used with diclofenac.

5. Methotrexate and Corticosteroids: These drugs, including dexamethasone and prednisone, may have interactions that require careful management.

Always inform your healthcare provider about all medications and supplements you are taking, whether they are over-the-counter, prescription, vitamins, or herbal products. Your doctor may need to adjust doses or monitor for side effects when diclofenac is combined with other treatments.