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When using diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), it is crucial to be aware of certain safety considerations to minimize the risk of serious side effects. Below is a summary of potential risks, precautions, and emergency actions associated with diclofenac use:

• Heart Attack and Stroke Risk: Diclofenac can increase the risk of heart attack or stroke, particularly with long-term use or in individuals with heart disease or risk factors such as smoking, family history, high blood pressure, or diabetes. Avoid use before or after heart bypass surgery (CABG). Seek immediate medical attention if you experience chest pain, shortness of breath, weakness on one side of the body, or trouble speaking.

• Gastrointestinal Bleeding: This medication can cause serious, potentially fatal bleeding in the stomach or intestines. This risk is higher in older adults and can occur without warning symptoms. Monitor for persistent stomach pain, black or bloody stools, or vomit that resembles coffee grounds and seek medical help promptly if these occur.

• Liver Damage: Diclofenac may rarely cause life-threatening liver damage, especially when used with other liver-impacting drugs like acetaminophen. Symptoms such as fever, jaundice, or dark urine warrant immediate medical consultation. Regular liver function tests may be advised.

• High Blood Pressure and Heart Failure: Diclofenac can cause fluid retention, leading to high blood pressure or worsening heart failure. Monitor blood pressure closely and report any swelling, shortness of breath, or sudden weight gain to your healthcare provider.

• Kidney Damage: Diclofenac may impair kidney function, especially in those with pre-existing kidney conditions or who are on certain blood pressure medications. Be vigilant for changes in urination and consult your provider if noted.

• Allergic Reactions and Asthma: This medication may cause severe allergic reactions or asthma attacks, particularly in individuals with a history of NSAID-triggered asthma. Immediate medical assistance is required if breathing difficulties arise.

• Serious Skin Reactions: Watch for signs of severe skin reactions, such as rashes, blistering, or swelling. Discontinue use and seek medical care if such symptoms develop.

• Anemia: Diclofenac may reduce red blood cell count, potentially leading to anemia. Monitor for symptoms such as fatigue or shortness of breath and ensure regular blood tests if indicated.

• Pregnancy Risks: Avoid diclofenac after 20 weeks of pregnancy due to potential harm to the unborn child. Discuss all risks with a healthcare provider if pregnant.

• Topical Use Only: Diclofenac is intended for use on the skin, not orally or in eyes, nose, or ears. In case of accidental ingestion, contact Poison Control immediately.

• Flammability: Diclofenac combined with capsaicin cream is flammable. Avoid exposure to flames or heat sources during application and storage.

Consult with your healthcare provider regarding the benefits and risks of using diclofenac, especially if you have underlying health conditions or are taking other medications. Always use the lowest effective dose for the shortest possible duration.

When taking this medication, some individuals may experience mild side effects such as skin irritation, including dryness, redness, burning, stinging, or itching. Occasionally, users report indigestion, stomach pain, or dizziness. These effects are usually temporary, but if they persist or worsen, it's important to consult your healthcare provider for guidance.

This medication has been noted to potentially increase blood pressure; thus, regular monitoring is advised. Should you notice elevated readings, inform your healthcare provider. Rarely, more serious side effects may occur, such as signs of kidney problems (e.g., changes in urine output) or symptoms of heart failure, which include swelling of the ankles, unexpected fatigue, or sudden weight gain. Should these symptoms arise, seek medical attention promptly.

In extremely rare cases, this drug may lead to serious liver disease. Symptoms like persistent nausea, vomiting, loss of appetite, abdominal pain, yellowing of the skin or eyes, and dark urine require immediate medical intervention. Additionally, although a severe allergic reaction is uncommon, symptoms such as fever, swollen lymph nodes, rash, severe dizziness, or trouble breathing necessitate urgent care. Always remain observant for any other unlisted effects and consult your healthcare provider if they occur.

This medication interacts with several other drugs, which can affect how it works or increase the risk of side effects. Notably, it may interact with aliskiren, ACE inhibitors like captopril and lisinopril, angiotensin II receptor blockers such as losartan and valsartan, cidofovir, corticosteroids like dexamethasone and prednisone, lithium, methotrexate, and diuretics, commonly known as "water pills," such as furosemide. Additionally, using this medication alongside other drugs that increase bleeding risk, like anti-platelet medications (e.g., clopidogrel) and blood thinners (e.g., dabigatran, enoxaparin, warfarin), may elevate your bleeding risk.

It's important to check all your medications, both prescription and over-the-counter, for pain relievers or fever reducers like aspirin and NSAIDs (e.g., ibuprofen, ketorolac, naproxen), as they are similar to this medication and may heighten the chance of side effects if combined. However, if your healthcare provider has advised you to take low-dose aspirin (81-162 mg daily) for heart attack or stroke prevention, continue as directed unless instructed otherwise by your healthcare provider. Always consult your doctor or pharmacist for more detailed information.