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Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that requires careful use due to potential risks and side effects. Below are important safety and warning considerations to keep in mind:

• Risk of Heart Attack and Stroke: Diclofenac can increase the risk of heart attacks, strokes, and blood clots, particularly if used in high doses or over a long period. This risk is heightened in individuals with pre-existing heart conditions or those who have undergone heart bypass surgery. It is crucial to use the lowest effective dose for the shortest duration possible. If you experience chest pain, trouble breathing, or weakness, seek immediate medical assistance.

• Stomach Bleeding and Ulcers: The use of diclofenac may lead to serious stomach or intestinal bleeding and ulcers, sometimes without warning signs. The risk is higher for older adults, those with a history of stomach issues, or who are using certain medications like aspirin, corticosteroids, or blood thinners. If you notice signs such as black or bloody stools or persistent stomach pain, discontinue use and consult a healthcare provider.

• Liver Damage: Though rare, diclofenac can cause severe liver damage, potentially within the first month of treatment. The risk increases when combined with other liver-affecting drugs. Regular liver function tests may be necessary during prolonged use. Stop use and get medical help if you experience symptoms like jaundice, fatigue, or dark urine.

• High Blood Pressure and Heart Failure: Diclofenac may elevate blood pressure and cause fluid retention, worsening heart failure or leading to swelling. It can also reduce the effectiveness of blood pressure medications. Monitor blood pressure closely and inform your healthcare provider of any significant changes or symptoms like sudden weight gain or difficulty breathing.

• Kidney Damage and High Potassium Levels: Diclofenac can impair kidney function, especially in those with existing kidney issues or who are taking certain high blood pressure medications. Monitor kidney function and report any changes in urination frequency to your healthcare provider.

• Severe Asthma Attacks: Individuals with asthma, particularly those with a history of reactions to aspirin or NSAIDs, may experience severe asthma attacks. Seek immediate medical attention if breathing becomes difficult.

• Severe Allergic or Skin Reactions: Rare but serious allergic reactions may occur, presenting as rashes, blisters, or facial swelling. Discontinue use and seek urgent medical care if these symptoms arise.

• Harm to Unborn Babies: Diclofenac use during the latter stages of pregnancy can affect amniotic fluid levels and lead to kidney or heart issues in the unborn child. Discuss the risks with your healthcare provider if you are pregnant or planning to become pregnant.

• Contraindications: Diclofenac should not be used by individuals with a history of allergic reactions to aspirin or other NSAIDs, or those who have had heart bypass surgery.

Always consult with a healthcare professional to weigh the benefits and risks before starting diclofenac.

When using this medication, some individuals may experience mild side effects such as skin irritation, including dryness, redness, or stinging, as well as drowsiness or dizziness. These are common and generally not a cause for concern unless they persist or worsen. Additionally, mild digestive issues such as acid reflux, bloating, or stomach pain may occur. Contact dermatitis, which presents as redness, rash, or itchiness, has been reported by some users.

It's important to note that this medication may affect your blood pressure, so regular monitoring is advised. If you notice elevated readings, it is important to seek medical advice. While serious side effects are rare, they do require immediate attention. These include signs of kidney issues, such as changes in urine output, and symptoms of heart failure, like swelling of the ankles or feet, unusual tiredness, or sudden weight gain.

In very rare cases, the medication may cause severe liver disease. Seek urgent medical help if you experience persistent nausea or vomiting, loss of appetite, abdominal pain, jaundice, or dark urine. A serious allergic reaction is also a rare possibility, with symptoms such as fever, swollen lymph nodes, rash, or difficulty breathing. If any of these severe reactions occur, immediate medical care is crucial.

When using diclofenac, it is crucial to be aware of potential interactions with other medications. Some drugs that may interact with diclofenac include aliskiren, ACE inhibitors like captopril and lisinopril, and angiotensin II receptor blockers such as losartan and valsartan. Cidofovir, corticosteroids like dexamethasone and prednisone, lithium, methotrexate, and diuretics such as furosemide can also interact with diclofenac. These interactions may enhance the risk of side effects or reduce the effectiveness of treatments.

Furthermore, using diclofenac with medications that increase bleeding risk requires caution. These include anti-platelet drugs like clopidogrel and anticoagulants such as dabigatran, enoxaparin, and warfarin. Additionally, be vigilant when taking over-the-counter medications that contain pain relievers or fever reducers, like aspirin and NSAIDs (e.g., ibuprofen, ketorolac, naproxen), as they may amplify side effects similar to those caused by diclofenac.

If your doctor has prescribed low-dose aspirin for heart attack or stroke prevention, typically between 81-162 milligrams daily, continue its use unless advised otherwise by your healthcare provider. Always consult with your doctor or pharmacist if you have questions or need more information about potential drug interactions.