by Dr. Manura Nanayakkara

Created on: June 26, 2010   Last Updated: July 01, 2010

Diclofenac is a popular prescription only pain killer in the NSAIDs (Non-Steroidal Anti Inflammatory Drugs) family. It is prescribed in conditions with inflammation and pain such as joint pains, Rheumatoid arthritis, urinary stones and muscle pains. Main side effects are gastritis and gastric ulceration.

Two main problems common to all the NSAIDs are inhibition of blood clot formation by the platelets and increased gastric acid secretion. Earlier this medication is used to treat fever that is not responding to Acetaminophen alone. But some viral fevers can reduce platelet counts.In this scenario inhibition of platelet function by Diclofenac can cause life threatening bleeding. Due to this reason currently doctors do not prescribe this medication to control undiagnosed fevers and viral fever.

This medication is available as tablet, suppository, and in injection form.  Suppository form is used in the patients who cannot take tablets orally. But suppository form does not reduce the gastric side effects.

 *How side effects can be minimized*

As with any medication Diclofenac should be taken as a whole with full glass of water. It should be used in recommended dosage. It should not be crushed before use. Adverse effects like stomach irritation and ulceration can be minimized by taking the medication with milk or aluminum hydroxide and magnesium hydroxide tablets.

If you have bleeding disorder, kidney disease, liver disease, heart disease, history of NSAID allergy (including aspirin) or bronchial asthma, you should tell that to your prescribing doctor. If you have a history of troublesome gastritis, bleeding from the gastro intestinal tract, and passing dark color stools then you should tell that to your doctor as well. If you have fever for more than two days doctor will do blood tests to identify a cause before starting this medication.

 *Common side effects*

Burning stomach pain, gastro intestinal discomfort, nausea, bleeding and gastric ulceration are common. Patients who have a history of stomach ulceration and bleeding should not use this medication. These problems are more common in elderly patients. While on this medication, If you happen to pass dark color stools, got severe abdominal pain then you should consult your doctor immediately.

Some patients can have life threatening complication called the anaphylactic shock. This is characterized by sudden faintish ness, low blood pressure, wide spread hives, shortness of breath and pallor. In an anaphylactic shock drug should be discontinued immediately, and patient should seek emergency medical help.

This medication is known to cause fetal harm. So your doctor may not use this medication in pregnancy. Amount secreted to breast milk is too small to be harmful to the baby. But manufacturers’ advice to avoid this medication during breast feeding.

Sources

British National Formulary

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