Diclofenac for pain and inflammation

About diclofenac

What is diclofenac used for?

Diclofenac is a type of anti-inflammatory painkiller called non-steroidal anti-inflammatory drugs (NSAIDs), or just 'anti-inflammatories'.

It is used to treat painful conditions such as arthritis, sprains and strains, gout, migraine, dental pain, and pain after surgical operations. It eases pain and reduces inflammation.

Types of diclofenac

There are two forms of diclofenac - diclofenac sodium and diclofenac potassium. The main difference between the two is that diclofenac potassium is absorbed into the body more quickly than diclofenac sodium.

A quick action is useful where immediate pain relief is required, and a prolonged action is more useful in reducing inflammation.

Diclofenac is also formulated as skin gels and patches and as eye drops.

Some brands of diclofenac also contain a medicine called misoprostol. Misoprostol helps to protect the stomach against irritation which can be caused by taking diclofenac over a period of time.

How does diclofenac work?

Diclofenac works by blocking the effect of chemicals in your body, called cyclo-oxygenase (COX) enzymes. These enzymes help to make other chemicals in the body, called prostaglandins.

Prostaglandins are produced at sites of injury or damage, and cause pain and inflammation. By blocking the effect of COX enzymes, fewer prostaglandins are produced, which means pain and inflammation are eased.

Side effects of diclofenac

Common side effects of diclofenac are:

• Indigestion.

• Heartburn (acid reflux).

• Stomach pain.

• Feeling sick.

• Diarrhoea.

You will find a full list in the manufacturer's information leaflet supplied with your medicine.

How to manage diclofenac side effects

The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to diclofenac, speak with your doctor or pharmacist for further advice.

Who should not take diclofenac?

Some medicines aren’t suitable for everyone. Before taking diclofenac, it’s important your doctor knows:

• If you have asthma or any other allergic disorder.

• If you have ever had a stomach or duodenal ulcer, or if you have an inflammatory bowel disorder such as Crohn's disease or ulcerative colitis.

• If you have a heart condition, or a problem with your blood vessels or circulation.

• If you are pregnant or breastfeeding.

• If you have any risk factors for heart disease, including high blood pressure (hypertension), high cholesterol levels, diabetes or smoking.

• If you have any blood clotting problems.

• If you have a connective tissue disorder, such as a condition called systemic lupus erythematosus (SLE).

• If you have problems with the way your liver works, or problems with the way your kidneys work.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to any other NSAID (such as aspirin, naproxen, indometacin, and ibuprofen), or to any other medicine.

How to take diclofenac

• Before taking diclofenac, read the leaflet inside the pack for important information and possible side effects.

• Take diclofenac exactly as prescribed by your doctor or pharmacist. Follow the dose and timing on the label.

• Taking diclofenac with food or milk can help reduce stomach upset.

• Diclofenac comes in different forms. Follow the instructions for your specific type. Some tablets should be mixed with water, while others must be swallowed whole.

• If you miss a dose, take it when you remember unless it’s nearly time for the next dose. Do not take two doses at once.

• If using diclofenac mouthwash, rinse or gargle 15 ml two to three times a day. Use it for up to 7 days after dental treatment or 6 weeks after radiotherapy.

Getting the most from your treatment

• Your doctor will prescribe the lowest effective dose for the shortest time to reduce side effects. If you need diclofenac long term, you may be given another medicine to help protect your stomach.

• Keep any regular doctor appointments so your progress can be checked, especially with long-term use.

• If you have asthma and develop wheezing or breathing problems, stop taking diclofenac and see your doctor straight away.

• Check with a pharmacist before taking other medicines. Do not take diclofenac with other anti-inflammatory painkillers, including some cold and flu remedies.

• If you’re having surgery or dental treatment, tell them you are taking diclofenac.

How to store diclofenac

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Frequently asked questions

How long does it take for diclofenac to work?

Diclofenac usually starts to work within 30 minutes to 1 hour of taking a dose. Pain and inflammation may continue to improve over the next few hours or days, depending on the condition being treated.

Can you drink alcohol while taking diclofenac?

You should avoid or limit alcohol while taking diclofenac. Alcohol can increase the risk of stomach irritation, ulcers, and bleeding, and make other side effects worse.

Is it safe to take diclofenac during pregnancy?

Diclofenac is not recommended during pregnancy, especially after 20 weeks, as it may harm the unborn baby. Only take it during pregnancy if a doctor specifically advises it.

Can you buy diclofenac over-the-counter?

Yes. In the UK, low-dose diclofenac tablets (12.5 mg) and diclofenac gel are available from pharmacies without a prescription. Higher doses however require a prescription from a doctor.

Is diclofenac stronger than ibuprofen?

Yes, diclofenac is often considered stronger than ibuprofen for reducing inflammation and pain, but it may also have a higher risk of side effects, especially with long-term use.