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Diclofenac by Laura Potter

Mode of operation

Member of arylalkanoic acid group of NSAIDs (but consider it to have properties similar to propionic acid derivates like ibuprofen and naproxen).  Advantage over these is less side effects and consequently tried first.  Diclofenac is available by prescription only.

Formulations:

Voltarol trade name for Diclofenac (Novartis)

Arthrotec Diclofenac + misoprostol.  Used in prophylaxis against NSAID-induced GI ulcers when long-term diclofenac use is indicated.  Misoprostol is a PGE1-derivative.

Indications:

Diclofenac is indicated in:

Pain and inflammation in rheumatic disease (including juvenile arthritis)

Other musculoskeletal disorders

Acute gout

Ureteric colic

Post-operative pain

Side effects (all NSAIDs):

(Diclofenac intermediate risk of severe upper GI side effects)

Gastrointestinal:

Nausea

Diarrhoea

Bleeding and ulceration

Hypersensitivity reactions:

Bronchospasm

Angiooedema

Rashes

Renal:

Renal failure provoked if renal impairment pre-existing

Other:

Headache

Dizziness

Nervousness

Depression

Drowsiness

PR route rectal irritation

IV route injection site reactions

Reducing side effects:

Take oral formulations with milk/food

Use enteric-coated formulations

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