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Diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), carries important safety considerations you should be aware of before use. Please review these precautions carefully and consult with your healthcare provider if you have any concerns.

• Heart Attack and Stroke Risk: Usage of diclofenac, including its topical form (Voltaren gel), can increase the risk of blood clots, heart attacks, or strokes. This risk can arise early in treatment and is heightened with long-term use, high doses, or if you have pre-existing heart conditions. It is crucial to use the smallest effective dose for the shortest duration. Avoid using diclofenac if you have had or plan to have heart bypass surgery. Seek immediate medical attention if you experience chest pain, trouble breathing, weakness on one side, or difficulty speaking.

• Gastrointestinal Bleeding and Ulcers: Diclofenac can cause serious stomach or intestinal bleeding and ulceration, which may occur without warning. The risk is higher in older adults and for those with a history of such issues. Use the lowest dose possible for the shortest time to mitigate this risk. Discontinue use and contact your healthcare provider immediately if you observe symptoms like persistent stomach pain, black stools, or vomit resembling coffee grounds.

• Liver Damage: Rarely, diclofenac can lead to severe liver damage. This risk increases if taken with other liver-affecting medications. Symptoms of liver damage include fever, fatigue, nausea, yellowing of the skin or eyes, and dark urine. Regular liver function tests may be necessary for long-term users. Stop use and consult your doctor if these symptoms occur.

• Blood Pressure and Heart Failure: Diclofenac may elevate blood pressure and exacerbate heart failure or cause fluid retention, leading to swelling. It may also reduce the efficacy of certain blood pressure medications. Monitor your blood pressure regularly and inform your provider of any significant changes or symptoms such as swelling or sudden weight gain.

• Kidney Damage and High Potassium Levels: The medication may impair kidney function, especially when used alongside certain blood pressure drugs or in the presence of pre-existing kidney issues. In severe cases, discontinue use unless benefits outweigh risks. Notify your doctor if you experience reduced urination frequency.

• Asthma and Severe Allergic Reactions: Diclofenac can provoke severe asthma attacks and allergic reactions, particularly in individuals with a history of NSAID-induced asthma. Symptoms include difficulty breathing and severe skin reactions. Seek emergency medical help if you experience such symptoms.

• Pregnancy Risks: Usage during the second or third trimester of pregnancy can harm the unborn child, potentially causing kidney and heart problems. Discuss the risks and benefits with your healthcare provider if you are pregnant or planning to become pregnant.

• Contraindications: Avoid diclofenac if you have asthma, hives, or allergic reactions related to aspirin or other NSAIDs, or if you are undergoing heart bypass surgery.

In case of overdose or adverse reactions, stop using the medication immediately and seek medical assistance. Always discuss the benefits and potential risks with your healthcare provider before starting diclofenac.

When using this medication, some individuals may experience mild side effects such as skin irritation, redness, or itchiness at the application site. These effects are generally not severe and often subside on their own, but if they persist or worsen, it is advisable to consult a healthcare provider. Other common side effects include dry skin and contact dermatitis, which occur in a small percentage of users. Additionally, some may experience acid reflux, bloating, or stomach pain.

While many people do not encounter serious side effects, it's important to be aware of potential risks. The medication can raise blood pressure, so regular monitoring is recommended. Serious side effects, although rare, include signs of kidney problems such as changes in urine output, symptoms of heart failure like swelling of the ankles or feet, unusual tiredness, or sudden weight gain. Immediate medical attention is necessary if these occur.

In very rare instances, this medication may cause significant liver damage. Symptoms to watch for include persistent nausea or vomiting, loss of appetite, abdominal pain, yellowing of the skin or eyes, and dark urine. A severe allergic reaction is also uncommon but requires urgent care if symptoms such as fever, swollen lymph nodes, rash, facial swelling, severe dizziness, or difficulty breathing appear. Always report any unusual side effects to a healthcare provider to ensure safe use of the medication.

When using Diclofenac sodium topical gel (Voltaren gel), be aware that it can interact with several medications. It is important to inform your healthcare provider about all medications and supplements you are taking, including prescriptions, over-the-counter drugs, and herbal supplements.

Some drugs may not be safe to use with Diclofenac and could lead your doctor to choose an alternative treatment. One such example is Ketorolac.

There are other medications that typically should not be combined with Diclofenac unless absolutely necessary, in which case your doctor might adjust the dosages. These include a wide range of drugs, such as blood thinners like Warfarin, Apixaban, and Rivaroxaban; diuretics like Furosemide; corticosteroids such as Prednisone and Dexamethasone; and various antidepressants like Amitriptyline and Citalopram.

Certain medications, like ACE inhibitors (e.g., Lisinopril) and angiotensin II receptor blockers (e.g., Losartan), may increase the risk of side effects when used with Diclofenac. If they are prescribed together, your healthcare provider may need to make adjustments to the treatment plan.

Additionally, be cautious of over-the-counter pain medications like Ibuprofen, Naproxen, and other NSAIDs, which are similar to Diclofenac and could heighten the risk of adverse effects. However, if your doctor has advised you to take low-dose Aspirin for heart health, continue taking it unless instructed otherwise. Always consult your doctor or pharmacist for detailed guidance.