Generic and proprietary names
- Voltarol Rapid.
- Voltarol Retard.
- Diclomax SR.
- Diclomax Retard.
- There are also other brands of modified release or combined formulation diclofenac.
- Inhibits an enzyme needed for prostaglandin synthesis resulting in decreased levels.
- Non-steroidal anti-inflammatory drug (NSAID).
- Pain and inflammation in rheumatic disease, musculoskeletal disorders, acute gout and following surgery.
- Active peptic ulceration.
- Hypersensitivity including hypersensitivity to other NSAIDs or aspirin.
- Severe renal disease.
- Severe hepatic disease.
- History of peptic ulceration.
- Older people.
- Coagulation problems.
- Gastrointestinal problems including ulceration.
- Hypersensitivity reactions.
- Sleeping problems.
- Hearing disturbance.
- Fluid retention.
- Raised blood pressure.
- Papillary necrosis.
- Hepatic damage.
- Pulmonary eosinophilia.
- A recent study (Hippisley-Cox, 2005) has suggested an increased risk of myocardial infarction.
- Increased risk of renal impairment with ACE inhibitors.
- Increased risk of bleeding with some antidepressants or anticoagulant medications.
- The possible enhancement of phenytoin.
- May reduce excretion of methotrexate, baclofen, digoxin and lithium.
- Oral - tablets, dispersible tablets or capsules.
- Onset of pain relief is about one hour depending on route of administration. l Full anti-inflammatory effect may take up to three weeks.
- Take oral preparations with food and keep alcohol consumption low to decrease risk of stomach irritation.
- If using as a long-term treatment for arthritis, consult the prescribing professional before stopping it.
- Do not take any other NSAIDs.
- Evaluate therapeutic response by assessing pain, joint stiffness, joint swelling and mobility.
- Assess any worsening of asthma in appropriate patients.
- Regular full dosage has both lasting analgesic and anti-inflammatory effects, making it useful for continuous pain associated with inflammation.
- Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines.