Diclofenac (dye-KLOE-fen-ak)

Treats actinic keratoses. Also treats pain and swelling caused by arthritis, including osteoarthritis of the knee. This is an NSAID.

Brand Name(s):

Aleve Arthritis Pain, Aspercreme Arthritis Pain Reliever, DermacinRx Lixofen, Diclofono, Diclozor, Foster&Thrive Arthritis Pain, Good Neighbor Pharmacy Arthritis Pain, Good Sense Arthritis Pain, Klofensaid II, Leader Arthritis Pain Reliever, Motrin Arthritis Pain, Pennsaid, Pharmacist Choice Diclofenac Sodium, Profinac, Solaravix

When This Medicine Should Not Be Used:

How to Use This Medicine:

Gel/Jelly, Liquid

• Use your medicine as directed. There are several brands of this medicine. Make sure you understand how to use the brand you have been prescribed. Ask your doctor if you have any questions.
• The diclofenac 1% gel comes with a dosing card to measure the correct dose. If you do not receive or misplace your dosing card, call your pharmacist to ask for a new one.
• Voltaren® gel: Follow the instructions on the medicine label if you are using this medicine without a prescription.
• Use this medicine only on your skin. Rinse it off right away if it gets on a cut or scrape. Do not get the medicine in your eyes, nose, or mouth.
• Wash your hands with soap and water before and after you use this medicine.
• Apply a thin layer of the medicine to the affected area. Rub it in gently.
• Do not shower, bathe, or wash the affected area for at least 30 minutes after you apply Pennsaid® or Solaraze® or 1 hour after you apply Voltaren®.
• Wait until the medicine dries before you cover the treated skin with gloves or clothing. Do not let the treated skin touch any other person's skin until the medicine is completely dry.
• Do not use external heat or bandages on the treated skin or joint.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Apply a dose as soon as you can. If it is almost time for your next dose, wait until then and apply a regular dose. Do not apply 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 unless your doctor says it is okay. Some other NSAIDs are aspirin, diflunisal, ibuprofen, naproxen, or salsalate.
• Some medicines can affect how diclofenac works. Tell your doctor if you are using any of the following:
  • Acetaminophen, cyclosporine, digoxin, lithium, methotrexate, pemetrexed
  • Blood pressure medicine (including ACE inhibitors, ARBs, beta blockers)
  • Blood thinner (including warfarin)
  • Diuretic (water pill)
  • Medicine to treat depression (including SNRIs, SSRIs)
  • Steroids (including dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone)
• Do not put cosmetics or skin care products on the treated skin. You may use sunscreen, insect repellant, lotion, or other topical medicines after using Pennsaid®. However, wait until the medicine is completely dry before you apply anything else.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant. Do not use this medicine during the later part of a pregnancy, unless your doctor tells you to.
• Tell your doctor if you are breastfeeding, or if you have kidney disease, liver disease, asthma, bleeding problems, heart failure, high blood pressure, other heart or blood vessel problems, a recent heart attack, or a history of stomach ulcers or bleeding. Tell your doctor if you drink alcohol.
• This medicine may cause the following problems:
  • Higher risk of blood clot, heart attack, heart failure, or stroke
  • Stomach or bowel problems (including bleeding, ulcers, or perforation)
  • 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.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• 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
• 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:

• Dry, flaky, or scaly skin
• Mild headache
• Mild skin rash, itching, or redness

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