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Diclofenac

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Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used to reduce pain, swelling, and joint stiffness. It is frequently prescribed for conditions such as arthritis, gout, and acute musculoskeletal injuries. It works by inhibiting enzymes that produce pain-inducing chemicals in the body.


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Delivery Time
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Active Ingredient(s)
Diclofenac Sodium
Reference Brand
Voltarol
Product Form
Tablets, Suppositories, Gel, Injection
Regulatory Classification
Rx
Primary Category
Pain Relief, Anti-inflammatory
Product Category
Anti-inflammatory and antirheumatic products, non-steroids, Acetic acid derivatives
Pharmacological Class
NSAID
Manufacturer Description
A powerful anti-inflammatory painkiller used to treat aches and pains, as well as joint and muscular conditions.
Mechanism of Action
It blocks the production of prostaglandins, which are chemicals in the body that signal pain and cause inflammation. By reducing these, it effectively lowers pain and swelling.
Route of Administration
Oral
Onset Time
30-60 minutes (oral)
Duration
8-12 hours
Contraindications
Stomach ulcers, Heart failure, Severe kidney or liver disease, Last trimester of pregnancy, Allergy to aspirin or other NSAIDs
Severe Adverse Events
Gastrointestinal bleeding, Heart attack or stroke risk, Liver toxicity, Severe allergic reactions, Kidney dysfunction
Common Side Effects
Dizziness, Stomach upset, Heartburn
Uncommon Side Effects
Headache, Nausea, Diarrhoea, Skin rash
Drug Interactions
Warfarin, Methotrexate, Lithium, Other NSAIDs, ACE inhibitors
Pregnancy Safety Warnings
Avoid, especially in the third trimester.
Age Restrictions
Varies by formulation; generally not for children unless directed
Storage Guidelines
Store at room temperature in a dry place.
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Diclofenac FAQ

Can I bring diclofenac tablets through airport security?

Yes, you may travel with diclofenac tablets if they are in their original packaging with the prescription label visible. Carry a copy of the prescription or a letter from your doctor to avoid delays at security checkpoints.

Does taking diclofenac affect blood pressure readings?

Diclofenac can cause fluid retention and may raise blood pressure, especially in people with pre-existing hypertension. Regular monitoring is advisable when starting or increasing the dose.

What do diclofenac tablets look like, and how can I identify them?

In the UK, 50 mg tablets are typically round, white, and may have a debossed imprint such as “D50”. The 100 mg tablets are often larger, oval, and imprinted with “D100”. Check the packaging for the exact imprint code.

Will diclofenac show up on a drug test for sports?

Standard anti-doping tests do not target NSAIDs like diclofenac. However, some organisations may test for prohibited substances specific to certain sports; always verify with your governing body.

Is it safe to take diclofenac while drinking alcohol?

Alcohol can increase the risk of gastrointestinal bleeding when combined with diclofenac. It is best to limit alcohol consumption and discuss your drinking habits with a healthcare professional.

Can diclofenac be used for migraine relief?

Diclofenac has limited evidence for acute migraine treatment and is not a first-line therapy. If you experience migraines, discuss appropriate migraine-specific medications with your doctor.

How does diclofenac compare with ibuprofen for arthritis pain?

Both are NSAIDs, but diclofenac is often considered more potent on a per-milligram basis. Individual response varies; some patients find one more effective or better tolerated. A clinician can help decide which is appropriate for you.

What was one of the key clinical trials that supported diclofenac’s approval?

The “DELPHI” trial demonstrated that diclofenac 50 mg three times daily provided significant pain reduction in osteoarthritis of the knee compared with placebo, with an acceptable safety profile.

Is it necessary to keep diclofenac tablets in a child-proof container?

Yes. Diclofenac tablets should be stored in a child-resistant bottle to prevent accidental ingestion, which can lead to serious toxicity in children.

Do I need to refrigerate diclofenac tablets?

No. Diclofenac tablets should be stored at room temperature, away from excessive heat and moisture. Refrigeration is not required.

Diclofenac Sodium: Generic Medication Overview

Diclofenac sodium belongs to the pain-relief category of medicines and is available as oral pills. In the United Kingdom it is a prescription-only medicine (POM) and is supplied in strengths of 50 mg and 100 mg. The medication is formulated as a solid tablet that is swallowed whole. Diclofenac works by reducing the production of inflammatory chemicals in the body, thereby relieving pain and lowering swelling.

How Diclofenac Sodium Works in the Body

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). It blocks the activity of the cyclo-oxygenase enzymes COX-1 and COX-2, which are required for the synthesis of prostaglandins. Prostaglandins sensitize nerve endings to pain and promote inflammation, fever, and swelling. By limiting prostaglandin formation, diclofenac decreases the sensation of pain, reduces swelling, and helps lower fever. Onset of pain relief typically occurs within 30 minutes after a dose, with peak effect around 1-2 hours; the drug’s half-life is roughly 1-2 hours, allowing convenient twice-daily dosing.

Conditions Treated by Diclofenac Sodium

  • Acute musculoskeletal pain (sprains, strains, sports injuries)
  • Osteoarthritis and rheumatoid arthritis pain and stiffness
  • Ankylosing spondylitis
  • Dysmenorrhoea (menstrual pain)
  • Post-operative pain following minor surgery
  • Gout flares (short-term use)

These uses are authorised by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. The medication is intended for adults; paediatric use is limited to specific circumstances and must be prescribed by a specialist.

Patient Suitability and Contraindications

Ideal Candidates

  • Adults with moderate to severe inflammatory or mechanical pain who have no major cardiovascular, gastrointestinal or renal disease.
  • Patients who can take the medication with food and can attend regular monitoring appointments when prescribed long-term.

Absolute Contraindications

  • Known hypersensitivity to diclofenac, any other NSAID, or excipients in the tablet.
  • Active or history of gastrointestinal ulceration or bleeding.
  • Severe heart failure (NYHA class III-IV), recent myocardial infarction, or stroke.
  • Third-trimester pregnancy (risk of premature closure of the fetal ductus arteriosus).
  • Severe hepatic or renal impairment (e.g., eGFR < 30 mL/min/1.73 m²).

Relative Contraindications

  • Controlled hypertension, mild-to-moderate renal or hepatic disease - dose should be reduced and monitoring intensified.
  • Elderly patients (≥ 65 years) - higher risk of gastrointestinal and cardiovascular adverse events.
  • Breast-feeding mothers - diclofenac passes into breast milk; a risk-benefit assessment is required.

Safety Profile and Interactions

Common Side Effects

  • Stomach upset, nausea or dyspepsia
  • Headache or mild dizziness
  • Diarrhoea or constipation
  • Skin rash or mild itching

Serious Adverse Events

  • Gastro-intestinal ulceration or bleeding, which may be fatal
  • Cardiovascular events such as myocardial infarction or stroke, especially with long-term use or in high-risk patients
  • Hepatic injury (elevated liver enzymes, jaundice)
  • Acute kidney injury, particularly in dehydrated individuals or those on diuretics
  • Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
  • Anaphylaxis (rare)

Major Drug Interactions

  • Anticoagulants (warfarin, direct oral anticoagulants): increased bleeding risk.
  • Other NSAIDs or corticosteroids: additive gastrointestinal toxicity.
  • ACE inhibitors, ARBs, diuretics: may impair renal function; monitor serum creatinine and potassium.
  • Lithium: diclofenac can raise lithium levels, leading to toxicity.
  • Methotrexate: reduced clearance may cause hematologic toxicity.
  • Cyclosporine: higher risk of nephrotoxicity.
  • Selective serotonin reuptake inhibitors (SSRIs): enhanced bleeding tendency.

Diclofenac is primarily metabolised by the hepatic enzyme CYP2C9; drugs that inhibit or induce this enzyme (e.g., fluconazole, rifampicin) may alter diclofenac concentrations.

Food and Lifestyle Interactions

  • Take tablets with food or a full glass of water to minimise stomach irritation.
  • Avoid excessive alcohol, which can increase gastrointestinal bleeding risk.
  • Dizziness may occur; exercise caution when driving or operating machinery.

If a patient is uncertain about a possible interaction, the safest approach is to disclose all medicines, supplements and herbal products to the prescribing clinician.

How to Take Diclofenac Sodium

  • Standard dosing: 50 mg taken two to three times daily, not exceeding 150 mg per day. For short-term, high-intensity pain, a single 100 mg tablet may be prescribed once daily.
  • Renal impairment (eGFR 30-60 mL/min): Reduce dose to 50 mg once daily; avoid if eGFR < 30 mL/min unless under specialist supervision.
  • Hepatic impairment: Use the lowest effective dose, generally 50 mg once daily, and monitor liver enzymes.
  • Elderly patients: Start with 50 mg once daily; increase only if tolerated.
  • Administration: Swallow the tablet whole; do not crush or chew. The pill may be taken with or without food, but food reduces gastrointestinal discomfort.
  • Missed dose: Take the missed dose as soon as remembered unless the next scheduled dose is within 2 hours; do not double-dose.
  • Overdose: Symptoms may include nausea, vomiting, abdominal pain, dizziness, or cardiac arrhythmia. Seek emergency care; activated charcoal may be administered by professionals.
  • Discontinuation: For long-term therapy, tapering is advisable to avoid rebound inflammation; consult a prescriber for an appropriate taper schedule.

Monitoring and Follow-Up

  • Baseline tests: Full blood count, liver function tests (ALT, AST, bilirubin), renal function (creatinine, eGFR), and blood pressure.
  • During therapy: Repeat renal and hepatic panels every 3 months for chronic use, or sooner if clinical signs arise.
  • Cardiovascular monitoring: Assess blood pressure and signs of chest pain or dyspnoea periodically, especially in patients with existing heart disease.
  • Gastro-intestinal vigilance: Promptly report any black stools, abdominal pain, or unexplained vomiting.

Storage and Handling

  • Keep tablets in the original container, tightly closed, at a temperature not exceeding 30 °C.
  • Store away from moisture, direct sunlight and out of reach of children.
  • Do not use the medication after the expiry date printed on the pack.
  • Dispose of unused tablets via a pharmacy take-back scheme or following local NHS waste guidelines.

Medication-Specific Glossary

Cyclo-oxygenase (COX)
Enzymes (COX-1 and COX-2) that convert arachidonic acid into prostaglandins, mediators of inflammation and pain.
Prostaglandin
Lipid compounds that amplify pain signals, promote fever, and increase blood flow to inflamed tissues.
Stevens-Johnson syndrome
A rare, severe skin reaction characterised by widespread blistering and detachment of the epidermis; requires immediate medical attention.
Therapeutic window
The dosage range in which diclofenac provides effective pain relief without causing unacceptable side effects.

Medical Disclaimer

This article provides educational information about diclofenac sodium and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Information for Diclofenac is sourced from established medical standards and updated frequently. It is provided for general guidance and should be confirmed with a healthcare professional before use.
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