Experiences with
Diclofenac

ContraindicationsHow it's used (previously Dosage and administration)Side effectsPregnancyInteractions

Diclofenac is not suitable for some people. For example, check with your doctor if you have asthma or high blood pressure.

Diclofenac comes as tablets, capsules, gel, suppositories, plasters and patches. Follow the instructions that come with your medicine.

Side effects of diclofenac include feeling sick, being sick or feeling dizzy. More serious side effects can happen in rare cases.

Diclofenac is not usually recommended during pregnancy. Always check with a pharmacist or doctor.

It can cause problems to take or use diclofenac with other medicines, such as some antibiotics, anticoagulants and medicines for high blood pressure.

Who can take or use diclofenac

Most adults can take diclofenac.

Children may be prescribed diclofenac to treat joint problems. The type given depends on their age. Children can:

take diclofenac tablets, capsules and use suppositories from 12 months, for arthritis
use diclofenac gel if they're 14 years old or over
use diclofenac plasters and patches if they're 16 years old or over

Who may not be able to take or use diclofenac

Diclofenac is not suitable for some people. To make sure it's safe for you, tell your doctor or pharmacist before starting to take it if you:

have ever had an allergic reaction to diclofenac or any other medicine
have an allergy to aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
have asthma
have ever had side effects from taking NSAIDs, such as wheezing, a runny nose, swelling of the skin (angioedema) or a rash
have ever had stomach ulcers, bleeding in the stomach or intestines, or a hole in your stomach
have high blood pressure (hypertension)
have heart failure, severe liver disease or kidney disease
have Crohn's disease or ulcerative colitis
have lupus
have a blood clotting disorder
are pregnant, planning to get pregnant, or breastfeeding

How to take or use diclofenac

Swallow diclofenac tablets or capsules with a drink of milk. If you need to take them with water, take them after a meal or snack. Taking them with milk or food means they'll be less likely to upset or irritate your stomach.

You'll usually take diclofenac tablets or capsules 2 to 3 times a day.

If you have pain all the time, your doctor may recommend slow-release diclofenac tablets or capsules. These release the medicine into your body more slowly. If you're taking slow-release tablets or capsules twice a day, leave a gap of 10 to 12 hours between your doses.

Swallow tablets and capsules whole, do not crush, break or chew them.

Using suppositories

Suppositories are medicine that you push gently into your bottom (anus).

Go to the toilet beforehand if you need to.
Wash your hands before and after using the medicine. Also clean around your anus with mild soap and water, rinse and pat dry.
Unwrap the suppository.
Gently push the suppository (pointed end first) into your anus as far as possible.
Sit or lie still for about 15 minutes. The suppository will melt inside your anus. This is normal.

You'll usually do this 1, 2 or 3 times a day, depending on the strength of your medicine.

Using gel

Gently squeeze the tube, or press firmly and evenly on the nozzle of the dispenser, to get a small amount of gel.
Put the gel on the painful or swollen area and slowly rub it in. It may feel cool on your skin. Wash your hands afterwards.

You'll usually use the gel 2 to 4 times a day, depending on how strong it is. Check the packaging for more information or speak to your pharmacist.

If you're using the gel twice a day, use it once in the morning and once in the evening. If you're using it 3 or 4 times a day, wait at least 4 hours before putting on any more.

The amount of gel you need depends on the size of the area you want to treat. You'll usually use an amount about the size of a cherry or walnut (2 to 4 grams).

Do not use diclofenac gel more than 4 times in any 24-hour period.

Using plasters and patches

Stick the diclofenac plaster or patch over the painful area.
Apply gentle pressure with the palm of your hand until it's completely stuck to your skin.
When you want to take the plaster or patch off, it helps to moisten it with some water first. Once you have taken it off, wash the affected skin and rub it gently in circular movements to remove any leftover glue.

If you're using plasters or patches, only treat 1 painful area at a time.

When you need to use another, take the old patch or plaster off before you put the new one on.

You can use plasters and patches 2 times a day, once in the morning and again in the evening. Do not use more than 2 plasters or patches in 24 hours.

Common side effects of diclofenac

These common side effects of diclofenac tablets, capsules and suppositories happen in more than 1 in 100 people. There are things you can do to help cope with them:

Stick to simple meals and do not eat rich or spicy food. It might help to take or use your diclofenac after you've eaten.

If you're being sick, try small frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

If you take the combined contraceptive pill or the progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Drink lots of fluids, such as water or squash, to avoid dehydration. Speak to a pharmacist if you have signs of dehydration such as peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or the progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

If you feel dizzy or unsteady, stop what you're doing and sit or lie down until you feel better. Do not drive or cycle, or use tools or machinery if you're feeling dizzy or lightheaded.

As your body gets used to diclofenac, these side effects should wear off.

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend an alternative painkiller.

Talk to your doctor if headaches do not go away or are severe.

Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help.

If you are in a lot of pain, speak to your pharmacist or doctor.

Try not to eat foods that cause wind (like lentils, peas, beans and onions). Eat smaller meals, eat and drink slowly, and exercise regularly.

There are pharmacy medicines that can also help, such as charcoal tablets or simeticone.

Eat when you would usually expect to be hungry. If it helps, eat smaller meals more often than usual. Snack when you're hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts.

Use an emollient cream or ointment to moisturise, soothe and hydrate the affected area. If it does not get better within a week or you're worried, speak to a pharmacist or doctor.

Diclofenac and pregnancy

Diclofenac, and medicines that contain diclofenac, are not usually recommended in pregnancy.

This is because they can sometimes cause problems inside the womb. They can affect the way blood moves round your baby's body, or reduce the amount of amniotic fluid around your baby.

Your doctor will only advise taking diclofenac while you're pregnant if the benefits of taking the medicine outweigh the risks.

If you do need to take diclofenac, it should be for a short period only (a few days).

Paracetamol is generally the first choice of painkiller in pregnancy. Stronger painkillers are available which can be used in pregnancy after discussion with your doctor.

Diclofenac and breastfeeding

You can take or use diclofenac while breastfeeding. Only tiny amounts get into breast milk, so it should not cause any side effects in your baby.

Diclofenac has been widely used while breastfeeding for many years, with no reported problems.

If you use diclofenac gel, take care that your baby does not touch any areas of your body where you've used it. Wash your hands after using it and before picking up your baby.

If you notice that your baby is not feeding as well as usual, has a stomach upset, including being sick or diarrhoea, or if you have any other concerns about your baby, talk to your midwife, health visitor, pharmacist or doctor as soon as possible.

Cautions with other medicines

Some medicines affect the way diclofenac works and increase the chances of you having side effects. Speak to a doctor or pharmacist before starting to take diclofenac if you take any of these medicines:

antibiotics, such as ciprofloxacin, levofloxacin, moxifloxacin, nalidixic acid, norfloxacin or ofloxacin
anticoagulants (medicines that help to prevent blood clots) such as warfarin
medicines for heart problems, such as digoxin
medicines for high blood pressure
medicines to lower cholesterol, such as colestipol or cholestyramine
medicines to treat seizures, such as phenytoin
medicines that reduce the activity of your immune system (immunosuppressants), such as ciclosporin or tacrolimus
selective serotonin reuptake inhibitor (SSRI) antidepressants like citalopram or sertraline
steroid medicines, such as hydrocortisone or prednisolone
medicines that remove extra fluid from your body (diuretics), such as furosemide or bumetanide
lithium, which is used to treat mental health problems
methotrexate, which is used to treat some inflammatory diseases and cancers
mifepristone, which is used for ending a pregnancy (abortion)
zidovudine, which is used to treat HIV

Taking diclofenac with other painkillers

It's safe to take diclofenac with paracetamol or codeine.

Do not take diclofenac with similar painkillers, like aspirin, ibuprofen or naproxen, without talking to a doctor.

Diclofenac, aspirin, ibuprofen and naproxen all belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). Taking diclofenac together with other NSAIDs may increase your chances of getting side effects like a stomach ache.

NSAIDs are also used in medicines you can buy from pharmacies, such as cough and cold remedies.

Before taking any other medicines together with diclofenac, check the label to see if they contain ibuprofen, aspirin or other NSAIDs.