Diclofenac

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Diclofenac
Diclofenac 3D 2ek
Diclofenac sodium IV 75mg
Voltaren tablets

Diclofenac is a prominent member of the nonsteroidal antiinflammatory drugs (NSAIDs) family. As an oral medication, it serves as a valuable asset in the management of chronic arthritis conditions and is an effective remedy for mild-to-moderate acute pain.

General Information[edit | edit source]

Diclofenac is renowned in medical circles for its extensive use in treating pain and inflammation. It is particularly effective in addressing chronic forms of arthritis and other conditions characterized by inflammation and pain.

Liver Safety[edit | edit source]

While diclofenac is widely regarded for its therapeutic benefits, it is essential to approach its use with caution. Regular therapy at full doses can sometimes cause slight elevations in serum aminotransferase levels. In rare circumstances, the drug can lead to severe and clinically evident, either acute or chronic liver diseases.

Mechanism of Action[edit | edit source]

Belonging to the phenylacetic acid derivative class, diclofenac shares its class with other acetic acid NSAIDs like indomethacin, etodolac, ketorolac, nabumetone, tolmetin, and sulindac. Its mechanism of action revolves around the inhibition of cellular cyclooxygenases (Cox-1 and Cox-2). The result of this inhibition is a marked decrease in the production of pro-inflammatory compounds such as prostaglandin, prostacyclin, and thromboxane. These compounds play crucial roles in mediating inflammation and pain. Consequently, diclofenac showcases not just analgesic properties, but also antiinflammatory and antipyretic activities.

FDA Approval[edit | edit source]

The U.S. FDA gave its nod of approval for diclofenac in 1988. Today, it is estimated that more than 5 million prescriptions for this drug are issued annually in the country. The primary indications for its use encompass treatment for osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Moreover, it provides relief from symptoms of dysmenorrhea and other forms of mild-to-moderate pain.

Dosage and Administration[edit | edit source]

Available in a myriad of generic and branded formulations, diclofenac often comes combined with other analgesics or agents that protect the gastrointestinal mucosa, such as misoprostol. Notably, while it requires a prescription in the United States, it is available over-the-counter in several other countries. This widespread accessibility makes diclofenac one of the most commonly used NSAIDs globally.

Popular brand names containing diclofenac include Arthrotec, Cataflam, Duravolten, Novo-Difenac, Nu-Diclo, Voltaren, and Zorvoflex. It is accessible in multiple dosage forms, including 25, 50, and 75 mg tablets or capsules. For adults with chronic arthritis, the suggested dose stands at 50 mg, taken orally three times a day. Pain management typically requires lower and more intermittent dosages.

Side Effects[edit | edit source]

As with most medications, diclofenac has a potential side effect profile. Commonly reported adverse reactions encompass headache, dizziness, somnolence, rash, nausea, diarrhea, dyspepsia, abdominal discomfort, heartburn, gastrointestinal bleeding, peripheral edema, and hypersensitivity reactions.

Topical Form[edit | edit source]

Beyond its oral form, diclofenac has made its mark in topical applications as well:

  • Ophthalmic Solutions (0.1%): These are prescribed for alleviating pain or reducing inflammation following cataract or corneal surgeries.
  • Dermatological Gels: These target the treatment of actinic keratoses.
  • Dermatologic Patches: These are beneficial for managing acute pain resulting from minor strains, sprains, and contusions.
  • Gels & Creams: These serve as topical treatments for osteoarthritis, especially for specific joints that respond well to topical intervention.

Notable brand names for topical diclofenac include Flector patch, Pennsaid, Solaraze, Surpass, and Voltaren gel.

See Also:

Nonsteroidal Antiinflammatory Drugs (NSAIDs)

Acetaminophen, Celecoxib, Diclofenac, Diflunisal, Etodolac, Fenoprofen, Flurbiprofen, Ibuprofen, Indomethacin, Ketoprofen, Ketorolac, Mefenamic Acid, Meloxicam, Nabumetone, Naproxen, Nimesulide, Oxaprozin, Phenylbutazone, Piroxicam, Rofecoxib, Sulindac, Tolmetin

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Contributors: Prab R. Tumpati, MD