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Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) with potential risks and important safety considerations. Please review the following information carefully and consult your healthcare provider if you have any questions or concerns.

• Risk of Heart Attack and Stroke: Diclofenac may increase the likelihood of heart attacks or strokes, particularly in those with pre-existing heart conditions, those using high doses, or those taking the medication for extended periods. The risk can arise early in treatment. Avoid using diclofenac before or after heart bypass surgery. If you experience symptoms like chest pain, difficulty breathing, weakness on one side of your body, or trouble speaking, seek immediate medical attention.

• Stomach Bleeding and Ulcers: This medication can cause severe, potentially fatal stomach bleeding or ulcers without prior warning. The risk is higher in older adults and those with a history of stomach issues, those taking certain medications (e.g., aspirin, corticosteroids), or those who consume alcohol or smoke. Discontinue use and contact your healthcare provider if you notice persistent stomach pain, black stools, or vomit resembling coffee grounds.

• Liver Damage: Rarely, diclofenac may lead to life-threatening liver damage, potentially occurring within the first month of treatment. Those taking other liver-affecting medications are at higher risk. Regular liver function tests may be necessary if the medication is used long-term. If symptoms like jaundice, dark urine, fatigue, or clay-colored stools appear, stop taking the medication and consult your provider promptly.

• High Blood Pressure and Heart Failure: Diclofenac can elevate blood pressure and cause fluid retention, leading to or worsening heart failure. It may also interfere with blood pressure medications. Monitor your blood pressure regularly and report any changes or symptoms such as swelling, weight gain, or breathlessness to your provider.

• Kidney Damage: Diclofenac can impair kidney function, especially in individuals with pre-existing kidney or liver issues or those using certain blood pressure medications. If you notice changes in urination, contact your healthcare provider. It is not recommended for those with severe kidney problems.

• Severe Asthma Attacks: Diclofenac can trigger asthma attacks, particularly in individuals with a history of NSAID-induced asthma. Avoid this medication if you have experienced such reactions before. Seek immediate medical help if you experience tightness in the throat or difficulty breathing.

• Allergic Reactions: Diclofenac may cause serious allergic reactions, including severe skin reactions. Avoid Zipsor (diclofenac potassium) if you have a bovine allergy. If you develop symptoms like rash, fever, or swelling of the face, stop taking the medication and seek medical attention immediately.

• Pregnancy Risks: Diclofenac can harm an unborn baby, especially if taken during the second and third trimesters, potentially leading to amniotic fluid reduction and kidney or heart issues in the baby. Discuss potential risks with your healthcare provider if you are pregnant or planning to become pregnant.

Contraindications:

• Do not use diclofenac if you have a history of asthma or allergic reactions to aspirin or other NSAIDs, if you've recently had heart surgery, or if you have a bovine (cow) allergy (specific to diclofenac potassium capsules).

Always discuss the benefits and risks of diclofenac with your healthcare provider to ensure safe and effective use.

When taking this medication, you may experience some common side effects that are generally mild. These include headaches, dizziness, nausea, vomiting, heartburn, upset stomach, constipation, diarrhea, gas, and rash. You might also notice dry, itchy skin or experience ringing in the ears. While these are not typically severe, it's important to consult your healthcare provider if they persist or worsen.

There are more serious side effects to be aware of, such as increased blood pressure, which should be monitored regularly. Rarely, this medication can lead to serious liver disease. Symptoms of liver damage include persistent nausea or vomiting, loss of appetite, abdominal pain, yellowing of the skin or eyes, and dark urine. Seek medical attention immediately if you experience any of these symptoms.

Some individuals may experience severe side effects like symptoms of heart failure, such as unexpected swelling of the ankles or feet, unusual tiredness, and sudden weight gain. There is also a risk of heart attack or stroke, with symptoms like dizziness, chest pain, or blurred vision. Additionally, look out for signs of kidney problems, such as changes in urine output or pink/bloody urine, and severe asthma attacks characterized by difficulty breathing or wheezing.

A very serious allergic reaction is rare but requires immediate medical attention. Symptoms might include fever, rash, itching/swelling of the face, tongue, or throat, severe dizziness, and trouble breathing. Though these severe reactions are uncommon, it's crucial to be informed and vigilant. Always contact your healthcare provider if you encounter any concerning symptoms.

When taking Diclofenac, it's important to be aware of potential interactions with other medications. Inform your doctor and pharmacist about all medications and supplements you are using, including over-the-counter drugs and herbal products. Some drugs that may interact with Diclofenac include:

• Aliskiren, ACE inhibitors (e.g., benazepril, lisinopril), and angiotensin II receptor blockers (e.g., losartan, valsartan). These combinations might require dose adjustments or special monitoring.
• Medications like cidofovir, corticosteroids (e.g., dexamethasone, prednisone), lithium, methotrexate, and diuretics (e.g., furosemide) can also interact, potentially leading to increased side effects.
• Diclofenac may elevate bleeding risks if used with anti-platelet drugs such as clopidogrel, or blood thinners like dabigatran, enoxaparin, and warfarin. This is crucial for those on anticoagulation therapy.
• Avoid combining Diclofenac with other NSAIDs (e.g., ibuprofen, ketorolac, naproxen) and aspirin, as this can heighten the risk of adverse effects.

If you're using low-dose aspirin for heart attack or stroke prevention, continue only if advised by your doctor. Always consult your healthcare provider for guidance specific to your situation.