NSAIDs is the abbreviation that stands for non-steroidal anti-inflammatory drugs. They are a class of drugs used for treatment of arthritis, headaches, sports injuries, cold and flu, and cramps during menstrual cycle. NSAIDs are many and perhaps the most renowned of which are Diclofenac, Ibuprofen, Paracetamol, and aspirin.
Diclofenac sodium, a form of Diclofenac is known commercially as Voltaren or Cataflam. It belongs to NSAIDs and so, it’s used for reducing pain, inflammation, and swelling. Diclofenac has great efficacy against stiffness caused by different types of arthritis as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It is a good choice for treating soft tissue inflammations due to tendinitis and bursitis. Diclofenac can be used for treating dysmenorrhea as well.
■ Prostaglandins and inflammation: the synthesis, effects, and functions
Optimum dose of Diclofenac
Diclofenac should be taken with food to reduce stomach irritation. The recommended dose should not be increased above 100-200 mg daily. Dose spacing, or time between successive doses, relies mainly on the Diclofenac formulation. A tablet dose might differ from that of effervescent granules. The severity of condition whether mild or severe, accounts a lot management of doses.
Diclofenac, as other NSAIDs, causes likely several interactions which affect the action of other drugs. So the patient is apt to drug-drug interactions if administering other drugs at the same time with Diclofenac.
- Diclofenac + Aminoglycoside antibiotic (as streptomycin, or garamycin)
The aminoglycoside blood level may increase due to decreasing its elimination because of Diclofenac. This may lead to more aminoglycoside-related side effects.
- Administering NSAIDs (as Diclofenac and Aspirin) with Methotrexate
This could reduce the elimination of methotrexate from body and result in increased side effects of methotrexate.
- Diclofenac with hypertensive and hypotensive medications
Diclofenac may reduce the blood pressure and so decreases the effects of a hypertensive medication as digitalis. It’s able to potentiate the actions of hypotensive agents like Nifedipine. In either cases, it’s a horrible risk. This can occur as prostaglandins play an important role in the regulation of blood pressure.
- Diclofenac with an oral anticoagulant like Warfarin
They must never be taken together as they both have a blood thinning effect, and excessive blood thinning will cause bleeding.
Pregnancy and breast feeding
Diclofenac should be absolutely avoided during pregnancy. It may affect the cardiovascular system of the fetus. However, for nursing mothers it is not known whether Diclofenac is excreted in breast milk or not. To be in the safe side, it’s much better that a nursing mother avoids taking Diclofenac.
Side effects of Diclofenac
Though not everyone who takes the drug can experience side effects, Diclofenac has sometimes serious side effects. But in fact, most people tolerate it quite well. The most common side effects of Diclofenac involve the gastrointestinal system.
- It can cause stomach pain, nausea, constipation, ulcers, abdominal burning, cramping, gastritis, gas, heart burn, or dyspepsia.
- People who are allergic to other NSAIDs should not use Diclofenac. NSAIDs reduce the flow of blood to the kidneys and impair the renal function. This impairment is most likely to occur in patients with already reduced kidney function or congestive heart failure (CHF). The use of NSAIDs for these patients should be done cautiously.
- Patients with asthma are more likely to experience allergic reactions to Diclofenac and other NSAIDs. Blood clots, hypertension, heart attacks, and heart failure have also been associated with the use of NSAIDs.
- People using NSAIDs, including the Diclofenac sodium, may be at higher risk for heart attacks or strokes than those who do not take NSAIDs. This warning does not apply to those who take aspirin though. This risk may be higher in people who have been taking NSAIDs for a long time. These complications can occur without warning and may lead to death.
Be sure to tell your physician if you have or have ever had:
- A stroke, heart disease or heart attack
- Diabetes, hypertension, or high cholesterol level
- Asthma, liver disease or failure, or bleeding problems
- Stomach ulcers, renal disease or failure, or allergy to some medications
Also your physician should be informed if you are smoking, drinking alcohol frequently, pregnant, or a nursing mother. And never forget to tell your doctor about all medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.