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Diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), can carry significant health risks. Below are the essential safety warnings and precautions for its use. If you have any questions or concerns, please consult a healthcare professional.

• Heart Attack and Stroke Risk: Diclofenac may increase the likelihood of heart attack or stroke, particularly with prolonged use. This risk is heightened in older adults or those with existing heart conditions or risk factors such as smoking, high blood pressure, or diabetes. Avoid using diclofenac immediately before or after coronary artery bypass graft (CABG) surgery. If you experience symptoms such as chest pain, shortness of breath, or sudden weakness, seek emergency medical assistance.

• Gastrointestinal Bleeding and Ulcers: Diclofenac may cause serious stomach or intestinal bleeding, which can occur without warning. Older individuals are at a higher risk. Seek medical help immediately if you experience persistent abdominal pain, black or bloody stools, or vomit that resembles coffee grounds.

• Liver Damage: Although rare, diclofenac can cause severe liver damage, especially when combined with other liver-affecting drugs like acetaminophen. Symptoms such as nausea, fatigue, jaundice, or dark urine should prompt immediate medical consultation. Regular liver function tests may be recommended.

• High Blood Pressure and Heart Failure: Diclofenac can exacerbate high blood pressure or lead to heart failure by causing fluid retention. This may also diminish the effectiveness of certain blood pressure medications. Monitor your blood pressure and report any significant changes or symptoms such as swelling or sudden weight gain.

• Kidney Damage and Hyperkalemia: Diclofenac may impair kidney function, especially in patients with existing kidney issues or those on specific blood pressure medications. Monitor for changes in urination frequency and consult your healthcare provider if necessary.

• Asthma and Allergic Reactions: Diclofenac can trigger severe asthma attacks or allergic reactions in sensitive individuals, particularly those with a history of such reactions to aspirin or other NSAIDs. Immediate medical attention is needed if you experience difficulty breathing.

• Serious Skin Reactions: Rare but severe skin reactions can occur. Discontinue use and seek medical help if you notice symptoms such as rash, blisters, or swelling.

• Anemia: Diclofenac may cause a decrease in red blood cell count, possibly due to bleeding. Inform your doctor of any history of blood disorders or use of medications that increase bleeding risk.

• Pregnancy Considerations: Avoid diclofenac after the 20th week of pregnancy due to potential harm to the unborn baby. Consult your healthcare provider for advice.

• Topical Use Only: Diclofenac should only be applied to the skin. Avoid oral ingestion and contact with eyes, nose, or ears. In case of accidental ingestion, contact Poison Control immediately at 1-800-222-1222.

• Flammability: Be cautious with the capsaicin component of diclofenac/capsaicin products, as it is flammable. Keep away from fire or heat sources.

Contraindications:

• Severe allergic reactions to NSAIDs.
• History of asthma or hives related to NSAID use.
• Recent major open-heart surgery.

These precautions are vital to ensure safe use of diclofenac. Always discuss your medical history and current medications with your healthcare provider before starting treatment.

When using this medication, some individuals may experience mild side effects such as dry skin, indigestion, stomach pain, and skin irritation, including burning, stinging, redness, and itching. These are generally not serious but consult your healthcare provider if they persist or worsen to ensure proper management and reassurance.

This medication may occasionally affect blood pressure, so it's advisable to monitor your readings regularly and inform your healthcare provider if they are elevated. Serious side effects are rare but require immediate medical attention. These include symptoms suggestive of kidney issues like changes in urine output, and signs of heart failure such as swelling of the ankles or feet, unusual fatigue, or sudden weight gain.

In very rare cases, this medication could lead to severe liver damage, which could be fatal. Be vigilant for symptoms like persistent nausea, loss of appetite, abdominal pain, yellowing of the skin or eyes, and dark urine, and seek medical help immediately if they occur. Allergic reactions are also rare but can be serious; symptoms like fever, swollen lymph nodes, rash, severe dizziness, or trouble breathing necessitate urgent medical attention. Always communicate with your healthcare provider about any unusual effects you may experience while using this medication.

Some medications that can interact with this drug include 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 like furosemide. Additionally, this drug may elevate the risk of bleeding if taken with other medications that also increase bleeding risk, such as anti-platelet drugs like clopidogrel and blood thinners including dabigatran, enoxaparin, and warfarin.

Be sure to check all your prescription and over-the-counter medications, as many contain pain relievers or fever reducers like aspirin and NSAIDs, such as ibuprofen, ketorolac, or naproxen. These are similar to diclofenac and could increase the likelihood of side effects if used together. However, if your doctor has advised you to take low-dose aspirin (typically 81-162 milligrams a day) to help prevent heart attack or stroke, continue as directed unless told otherwise by your doctor. If you have questions, consult your doctor or pharmacist for more information.