Diclofenac (dye-KLOE-fen-ak)

Treats pain. Also treats migraines. This medicine is an NSAID.

Brand Name(s):

Cambia, Cataflam, Lofena, Zipsor, Zorvolex

When This Medicine Should Not Be Used:

How to Use This Medicine:

Capsule, Liquid, Tablet, Coated Tablet, Long Acting Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Oral solution: Mix the packet contents with 1 to 2 ounces (30 to 60 mL) of water. Do not use any liquid other than water for mixing the medicine. Mix well and drink it immediately on an empty stomach.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. .

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use any other NSAID (including aspirin, diflunisal, ibuprofen, naproxen, or salsalate) unless your doctor says it is okay.
• Some medicines and foods can affect how diclofenac works. Tell your doctor if you are also using any of the following:
  • Cyclosporine, digoxin, lithium, methotrexate, pemetrexed, rifampin, voriconazole
  • Blood pressure medicine (including ACE inhibitors, ARBs, beta blockers)
  • Blood thinner (including warfarin)
  • Diuretic (water pill)
  • Medicine to treat depression (including SNRIs, SSRIs)
  • Steroid medicine
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding. Do not use this medicine during the later part of a pregnancy, unless your doctor tells you to.
• Tell your doctor if you have kidney disease, liver disease, asthma, heart failure, high blood pressure, or heart or blood vessel problems, or a history of stomach ulcers or bleeding problems. Tell your doctor if you have phenylketonuria (PKU). Also tell your doctor if you drink alcohol.
• This medicine may cause the following problems:
  • Increased risk of blood clots, heart attack, stroke, or heart failure
  • Bleeding problems, including stomach or bowel bleeding or ulcer
  • Liver problems
  • High blood pressure
  • Kidney problems
  • Serious skin reactions, including Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS)
• This medicine may cause a delay in ovulation for women and may affect their ability to have children. If you plan to have children, talk with your doctor before using this medicine.
• Tell any doctor or dentist who treats you that you are using this medicine.
• Your headaches may become worse if you use a headache medicine for 10 or more days per month. Write down how often your headaches occur and how often you use this medicine.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Bloody or black, tarry stools, severe stomach pain, vomiting blood or material that looks like coffee grounds
• Change in how much or how often you urinate
• Chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, unusual sweating, faintness
• Confusion, uneven heartbeat, trouble breathing, numbness or tingling in your hands, feet, or lips
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Numbness or weakness in your arm or leg, or on one side of your body, pain in your lower leg, sudden or severe headache, or problems with vision, speech, or walking
• Rapid weight gain, swelling in your hands, ankles, or feet
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Constipation, diarrhea, stomach upset, passing gas
• Mild headache, dizziness, drowsiness
• Runny or stuffy nose, sneezing

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088