Diclofenac is a widely-used, nonsteroidal anti-inflammatory drug (NSAID) that has been helping millions of people around the world to manage pain and inflammation for decades. In this comprehensive guide, we’ll delve into the science behind diclofenac, its various formulations, potential side effects, and frequently asked questions to provide you with a complete understanding of this powerful medication.

What is Diclofenac?

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that is used to reduce inflammation and pain in conditions such as arthritis, acute injury, and menstrual cramps. It is sold under various brand names including Voltaren, Cataflam, and Zipsor.

Diclofenac works by inhibiting the activity of cyclooxygenase (COX) enzymes, which are responsible for producing prostaglandins. Prostaglandins are hormone-like substances that are involved in inflammation, pain, and fever. By blocking the production of prostaglandins, diclofenac reduces inflammation, pain, and fever.

Diclofenac is available in different forms, including tablets, capsules, injections, topical gels, and patches. The dose and route of administration depend on the condition being treated and the patient’s individual needs.

Diclofenac may cause side effects, such as stomach upset, headache, dizziness, and rash. It can also increase the risk of serious cardiovascular events, such as heart attack and stroke, especially when used at high doses or for long periods of time. Diclofenac also poses the risk of severe life threatening allergic reactions in rare cases known as anaphylaxis. Therefore, it is important to use diclofenac only as directed by a healthcare provider and to report any unusual symptoms promptly.

Diclofenac is a prescription medication and should only be used under the supervision of a qualified healthcare professional. It is not recommended for use during pregnancy or while breastfeeding.

How Does Diclofenac Work?

There are two types of COX enzymes: COX-1 and COX-2. COX-1 is involved in the production of prostaglandins that are involved in normal physiological processes, such as the protection of the stomach lining and the regulation of blood flow to the kidneys. COX-2, on the other hand, is involved in the production of prostaglandins that are involved in inflammation, pain, and fever.

Diclofenac inhibits the activity of both COX-1 and COX-2 enzymes, although it has a greater affinity for COX-2. By inhibiting the activity of these enzymes, diclofenac reduces the production of prostaglandins, which leads to a reduction in inflammation, pain, and fever.

Diclofenac is absorbed into the bloodstream and distributed throughout the body, where it reaches the sites of inflammation and pain. It is metabolized in the liver and excreted in the urine and feces.

Dosage and Forms of Diclofenac

Tablets: Diclofenac tablets are available in 25 mg, 50 mg, and 75 mg strengths. The usual adult dose is 50 mg to 75 mg two to three times a day, with a maximum daily dose of 150 mg.
Capsules: Diclofenac capsules are available in 18 mg, 25 mg, and 35 mg strengths. The usual adult dose is 35 mg two to three times a day, with a maximum daily dose of 150 mg.
Extended-release tablets: Diclofenac extended-release tablets are available in 100 mg strength. The usual adult dose is 100 mg once a day.
Gel: Diclofenac gel is available in 1% strength. The usual dose is to apply a small amount of gel to the affected area two to four times a day.
Topical application solution: Diclofenac topical solution is available in 1.5% strength. The usual dose is to apply a small amount of solution to the affected area two to four times a day.

Medical Conditions Diclofenac Is Prescribed For

Arthritis: Diclofenac is commonly used to reduce pain, inflammation, and stiffness associated with osteoarthritis, rheumatoid arthritis, and other forms of arthritis.
Back pain: Diclofenac can be used to relieve acute or chronic pain in the back, neck, or shoulders.
Migraine headaches: Diclofenac is sometimes used as part of a treatment regimen for migraine headaches.
Menstrual cramps: Diclofenac can be used to relieve the pain and discomfort associated with menstrual cramps.
Dental pain: Diclofenac can be used to relieve the pain and swelling associated with dental procedures or toothache.
Postoperative pain: Diclofenac can be used to relieve pain and swelling after surgery.
Ankylosing spondylitis: Diclofenac is sometimes used to treat ankylosing spondylitis, a type of arthritis that affects the spine.

Side Effects and Precautions

Diclofenac, like all medications, can cause side effects in some people. Common side effects of diclofenac include:

Drug Interactions

Diclofenac, like any other medication, can interact with other drugs, which may alter its effectiveness or increase the risk of side effects. Some of the significant drug interactions of diclofenac include:

Aspirin and other NSAIDs: The concurrent use of aspirin or other NSAIDs with diclofenac can increase the risk of gastrointestinal bleeding and ulcers.
Blood thinners: Diclofenac may interact with blood-thinning medications such as warfarin, increasing the risk of bleeding.
ACE inhibitors and diuretics: Concurrent use of diclofenac with ACE inhibitors or diuretics can lead to decreased kidney function or acute kidney failure.
Corticosteroids: Combining diclofenac with corticosteroids may increase the risk of gastrointestinal bleeding and ulcers.
Lithium: Diclofenac may increase the blood levels of lithium, increasing the risk of lithium toxicity.
Methotrexate: Diclofenac may increase the blood levels of methotrexate, increasing the risk of methotrexate toxicity.
Cyclosporine: Concurrent use of diclofenac with cyclosporine can increase the risk of kidney damage.
Digoxin: Diclofenac may increase the blood levels of digoxin, increasing the risk of digoxin toxicity.

It is important to talk to your healthcare provider about all the medications, supplements, and herbal products you are taking before starting treatment with diclofenac. Your doctor may need to adjust the dosage of diclofenac or change your medication regimen to prevent drug interactions. Additionally, it is essential to report any unusual symptoms or side effects while taking diclofenac to your healthcare provider immediately.

Diclofenac & Health Conditions

Blood Pressure

While diclofenac is generally safe and effective for most people, it may have some side effects, including an increased risk of high blood pressure (hypertension).

Studies have shown that diclofenac can cause an increase in blood pressure in some people, especially those with pre-existing high blood pressure or cardiovascular disease. This increase in blood pressure can be mild to moderate, but in some cases, it can be severe and lead to complications such as heart attacks, strokes, or kidney damage.

Therefore, it is important to talk to your doctor before taking diclofenac, especially if you have a history of high blood pressure or cardiovascular disease. Your doctor may monitor your blood pressure while you are taking the medication and adjust the dosage or prescribe an alternative medication if necessary.

If you experience symptoms such as headache, dizziness, blurred vision, or chest pain while taking diclofenac, seek medical attention immediately. These symptoms could be signs of a more severe increase in blood pressure.

Heart Health

While diclofenac can be effective in relieving pain and inflammation, it may have some negative effects on heart health. Studies have shown that diclofenac can increase the risk of heart attacks, stroke, and other cardiovascular events, especially in people with pre-existing heart conditions or risk factors for heart disease.

The exact mechanism by which diclofenac affects the heart is not fully understood, but it is thought to be related to the medication’s ability to inhibit the production of prostaglandins, which are substances that play a role in regulating blood flow and protecting the heart.

Therefore, it is important to talk to your doctor before taking diclofenac if you have a history of heart disease, high blood pressure, or other cardiovascular risk factors such as smoking, high cholesterol, or diabetes. Your doctor may monitor your heart health while you are taking the medication and adjust the dosage or prescribe an alternative medication if necessary.

If you experience symptoms such as chest pain, shortness of breath, or dizziness while taking diclofenac, seek medical attention immediately. These symptoms could be signs of a more severe cardiovascular event.

Diclofenac: Positive & Negative Effects On Sex and Sexual Health

While diclofenac is generally safe and effective when used as directed, it can have both positive and negative effects on sex and sexual health.

Positive Effects

Pain Relief: Diclofenac can help relieve pain, which can make sexual activity more comfortable and enjoyable.
Decreased Inflammation: Diclofenac can reduce inflammation, which can improve sexual function and help prevent sexual health problems.

Negative Effects

Erectile Dysfunction: Some studies have suggested that diclofenac may increase the risk of erectile dysfunction in men. This may be due to the drug’s effects on blood flow and blood vessel function.
Decreased Libido: Diclofenac can also decrease libido or sexual desire in both men and women.
Infertility: Long-term use of diclofenac has been associated with infertility in men. This is thought to be due to the drug’s effects on sperm production and quality.
Vaginal Dryness: Diclofenac can cause vaginal dryness in women, which can make sexual activity uncomfortable or painful.

Frequently Asked Questions

Q: Can I take diclofenac without a prescription?
A: Some low-dose diclofenac formulations are available over-the-counter (OTC) in certain countries. However, it is still important to consult with a healthcare professional before using any NSAID, including diclofenac, to ensure it is appropriate for your specific needs and medical history.

Q: Can I take diclofenac with other pain relievers, such as acetaminophen (paracetamol)?
A: In some cases, healthcare providers may recommend using diclofenac in combination with other pain relievers, such as acetaminophen, to achieve better pain control. However, always consult with your healthcare provider before combining any medications.

Q: How long does it take for diclofenac to work?
A: The onset of action for diclofenac varies depending on the formulation used. Oral tablets typically begin to work within 1-2 hours, while topical formulations may take longer to provide relief. Injectable diclofenac usually provides rapid pain relief.

Q: Can I take diclofenac if I’m pregnant or breastfeeding?
A: Diclofenac should generally be avoided during pregnancy, especially during the third trimester, due to potential risks to the unborn baby. If you are breastfeeding, consult with your healthcare provider, as diclofenac may pass into breast milk.

Q: Is it safe to take diclofenac with alcohol?
A: It is generally not recommended to consume alcohol while taking diclofenac, as it may increase the risk of gastrointestinal side effects, such as stomach bleeding or ulcers.

Diclofenac is a versatile and effective NSAID that has proven to be a valuable tool in managing pain and inflammation for a wide range of conditions. By understanding its mechanism of action, potential side effects, and drug interactions, you can use diclofenac safely and effectively. Remember to consult with your healthcare provider before starting any new medication, and always follow their guidance on dosing and administration.

Diclofenac: The Pain Reliever & It’s Association With Sexual Health