Diclofenac SR

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) widely prescribed for the relief of pain, inflammation, and swelling associated with musculoskeletal conditions.

It is commonly used to manage osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gout, and soft-tissue injuries such as sprains and strains.

The drug works by inhibiting cyclooxygenase (COX) enzymes, thereby reducing the production of prostaglandins that mediate pain, fever, and inflammation.

Diclofenac has a relatively balanced inhibition of both COX-1 and COX-2, which accounts for its potent anti-inflammatory action alongside its analgesic and antipyretic properties.

Diclofenac is available in several formulations, including oral tablets, enteric-coated tablets, dispersible tablets, suppositories, topical gels, and injectable preparations.

The choice of formulation depends on the condition being treated, the severity of symptoms, and individual patient factors such as gastrointestinal risk.

Topical preparations may be preferred when localised treatment is appropriate, as they deliver the drug directly to the affected site with lower systemic exposure.

Take diclofenac tablets by mouth with or after food to reduce the risk of stomach irritation. Swallow enteric-coated tablets whole without crushing or chewing.

For topical gel, apply a thin layer to the affected area and rub in gently; wash your hands afterwards unless treating the hands.

Use the lowest effective dose for the shortest duration necessary to control your symptoms. If you have been prescribed a suppository, follow the specific instructions provided by your pharmacist.

The usual oral dose for adults is 75 mg to 150 mg daily in two or three divided doses. For osteoarthritis, a typical maintenance dose is 75 mg to 100 mg daily.

Your prescriber may start at a lower dose and adjust according to response. The maximum recommended oral dose is 150 mg per day.

Topical gel is usually applied 3 to 4 times daily to the affected area. Doses should be individualised and reviewed regularly.

Very common (more than 1 in 10): headache, dizziness, nausea. Common (1 in 10 to 1 in 100): abdominal pain, dyspepsia, diarrhoea, flatulence, elevated liver enzymes, skin rash.

Uncommon (1 in 100 to 1 in 1,000): gastric or duodenal ulceration, gastrointestinal bleeding, drowsiness, vertigo. Rare (1 in 1,000 to 1 in 10,000): hepatitis, jaundice, asthma exacerbation.

Very rare (less than 1 in 10,000): severe skin reactions such as Stevens-Johnson syndrome, aplastic anaemia, myocardial infarction, stroke.

If you experience black or bloody stools, unexplained bruising, or severe abdominal pain, seek medical attention without delay.

All NSAIDs carry a small increased risk of cardiovascular thrombotic events, particularly at high doses and with prolonged use.

Diclofenac should be used with caution in patients with a history of heart disease, stroke, or significant cardiovascular risk factors.

Gastrointestinal bleeding, ulceration, and perforation may occur at any time during treatment, sometimes without warning.

Patients over 65 years of age, those with a history of peptic ulcer disease, and individuals taking anticoagulants or corticosteroids are at increased risk.

Renal function should be monitored, especially in elderly patients and those taking diuretics or ACE inhibitors concurrently.

Do not take diclofenac if you have an active peptic ulcer or gastrointestinal bleeding.

It is contraindicated in patients with severe heart failure, severe hepatic or renal impairment, and in the third trimester of pregnancy.

Patients with a history of hypersensitivity to aspirin or other NSAIDs, including asthma, urticaria, or rhinitis triggered by these agents, must not use diclofenac.

It is also contraindicated following coronary artery bypass graft surgery.