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Nonsteroidal Anti-inflammatory Drug (NSAID) used in the treatment of ankylosing spondylitis, dysmenorrhea, gout, migraine, osteoarthritis, fever, rheumatoid arthritis and acute pain.

Usual Adult Dose for Osteoarthritis: Diclofenac free acid capsules: 35 mg orally 3 times a day Diclofenac potassium immediate-release tablets: 50 mg orally 2 or 3 times a day Diclofenac sodium enteric-coated tablets: 50 mg orally 2 or 3 times a day or 75 mg orally 2 times a day Maximum dose: 150 mg daily Diclofenac sodium extended-release tablets: 100 mg orally once a day Usual Adult Dose for Dysmenorrhea: Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day Comments: An initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief for some patients; initiate treatment upon appearance of the first symptoms and continue for a few days. Diclofenac potassium immediate-release tablets: 50 mg orally 3 or 4 times a day Diclofenac sodium enteric-coated and delayed-release tablets: 50 mg orally 3 to 4 times a day or 75 mg orally twice a day Maximum dose: 225 mg daily Diclofenac sodium extended-release tablets: 100 mg orally once a day Maximum dose: 100 mg orally 2 times a day; this would be for the rare patient in whom the benefits outweigh the clinical risks. Diclofenac potassium for oral solution packets: 50 mg (1 packet) orally once Comments: This drug is not indicated for the prophylactic therapy of migraine or for use in cluster headaches; the safety and efficacy of a second dose has not been established. Usual Adult Dose for Pain: Oral: Diclofenac potassium liquid-filled capsules: 25 mg orally 4 times a day Diclofenac free acid capsules: 18 mg or 35 mg orally 3 times a day Diclofenac potassium immediate-release tablets: 50 mg orally 3 times a day; an initial dose of 100 mg orally followed by 50 mg oral doses may provide better relief in some patients. Parenteral: 37.5 mg IV bolus over 15 seconds every 6 hours as needed for pain Maximum Dose: 150 mg per day

Get emergency medical help if you have signs of an allergic reaction to diclofenac (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath. Stop using this medicine and call your doctor at once if you have: the first sign of any skin rash, no matter how mild; flu-like symptoms; heart problems - swelling, rapid weight gain, feeling short of breath; kidney problems - little or no urinating, painful or difficult urination, swelling in your arms or legs, feeling tired or short of breath; liver problems - nausea, diarrhea, stomach pain (upper right side), tiredness, itching, dark urine, jaundice (yellowing of the skin or eyes); or signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds. Common diclofenac side effects may include: indigestion, gas, nausea, vomiting, stomach pain; diarrhea, constipation; headache, dizziness, drowsiness; abnormal lab tests; itching, sweating; stuffy nose; increased blood pressure; or swelling or pain in your arms or legs.

Avoid drinking alcohol. It may increase your risk of stomach bleeding. Avoid taking aspirin or other NSAIDs unless your doctor tells you to. Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to diclofenac (such as aspirin, ibuprofen, ketoprofen, or naproxen).

Pregnant and breastfeeding women are commonly exposed to NSAIDs. As described in NSAID class labeling, starting at 30 weeks gestation, diclofenac, and other NSAIDs, should be avoided by pregnant women as premature closure of the ductus arteriosus in the fetus may occur. Data on excretion of diclofenac into milk are poor, but the drug has a short half-life and little glucuronide metabolite formation. Most reviewers consider diclofenac to be acceptable during breastfeeding. Other agents having more published information may be preferred, especially while nursing a newborn or preterm infant. Maternal use of diclofenac topical gel or eye drops would not be expected to cause any adverse effects in breastfed infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.

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