Diclofenac Sodium

This medication is used to treat arthritis of the knee(s). It reduces pain, swelling, and helps improve your ability to move and flex the joint. Diclofenac sodium is known as a nonsteroidal anti-inflammatory drug (NSAID).

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Read the Medication Guide if available, and the Patient Information Leaflet provided by your pharmacist before you start using diclofenac and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Apply this medication to clean, dry skin, usually 40 drops for each knee four times daily, or as directed by your doctor. Place 10 drops of this medication into the hand or directly onto the affected knee. Spread the medication evenly around the front, back, and sides of the knee. Repeat these steps until you have applied the prescribed dose to cover all surfaces of the knee. Repeat on the other knee if directed to do so by your doctor. Let the medication dry for several minutes. Do not use any other medication on the treated skin area. Consult your doctor or pharmacist if you have any questions on how to use this medication. Be sure to wash your hands before and after applying the medication. Avoid getting this medication in the eyes, nose, or mouth. Do not apply this medication to open wounds, infected, or damaged skin. Do not bandage or tightly cover the treated area unless you are instructed to do so by your doctor. It is important to use this medication regularly at evenly spaced intervals to get the most benefit from it. Use the exact dose prescribed by your doctor. Do not use it more often or for longer than prescribed. Do not use this medication for more than 3 months at a time unless directed by your doctor. Inform your doctor if your condition worsens.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: anti-platelet drugs (e.g., clopidogrel), "blood thinners" (e.g., warfarin), cidofovir, corticosteroids (e.g., prednisone), cyclosporine, desmopressin, digoxin, high blood pressure drugs (e.g., ACE inhibitors such as captopril, angiotensin II receptor antagonists such as losartan, and beta-blockers such as metoprolol), lithium, methotrexate, probenecid, SSRI antidepressants (e.g., fluoxetine), water pills (diuretics such as furosemide, spironolactone). Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, ketorolac, or naproxen). These medicines are similar to this medication and, if you use them together, your risk for side effects may increase. Low-dose aspirin (generally 81-325 milligrams per day), as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention, should be continued. Consult your doctor or pharmacist for more details. This product may interfere with certain lab tests. Make sure laboratory personnel and your doctors know you use this drug. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Do not share this medication with others. Laboratory and/or medical tests (such as complete blood count, liver and kidney function tests) should be performed periodically to check for side effects. Consult your doctor for more details. Keep all doctor appointments and lab visits so your therapy can be monitored closely. Non-drug treatment for arthritis that is approved by your doctor (e.g., weight loss if needed, strengthening and conditioning exercises) may help improve your flexibility (range of motion) and joint function. Consult your doctor for specific instructions.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. This medication may be harmful if swallowed. If accidentally swallowed, you may experience symptoms such as: slowed or shallow breathing, fainting, severe stomach pain, vomit that looks like coffee grounds, seizures.

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (e.g., ibuprofen, naproxen, celecoxib); or to dimethyl sulfoxide, or to propylene glycol; or if you have any other allergies. This product may contain other inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: aspirin-sensitive asthma (a history of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDs). Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, stomach/intestinal problems (e.g., bleeding ulcers, ulcerative colitis, Crohn's disease), bleeding or clotting problems, asthma, growths in the nose (nasal polyps), poorly controlled diabetes, heart disease (e.g., congestive heart failure), high blood pressure, swelling (edema, fluid retention), certain blood/immune disorders (e.g., porphyria, lupus). This medication may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. This medication may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medication, may increase your risk for stomach bleeding. Limit alcohol and quit smoking. Consult your doctor or pharmacist for more information. This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths and sunlamps. Use a sunscreen and wear protective clothing when outdoors. Caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially stomach bleeding and kidney effects. This medication should be used only when clearly needed during the first 6 months of pregnancy. It is not recommended for use during the last 3 months of pregnancy due to possible harm to an unborn baby. Discuss the risks and benefits with your doctor. Based on information from related drugs, this medication may pass into breast milk. Though there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.

Store at room temperature 59-77 degrees F (15-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

See also Warning section. Skin irritation (e.g., dryness, redness, stinging), drowsiness, or dizziness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: easy bruising or bleeding, fast/pounding heartbeat, sudden or unexplained weight gain, swelling of the hands/feet, change in the amount of urine, signs of infection (e.g., fever, persistent sore throat), persistent/severe headache, mental/mood changes, unexplained stiff neck, vision changes. This drug may rarely cause serious liver disease. If you notice any of the following rare but very serious side effects, stop using this medication and consult your doctor or pharmacist immediately: persistent nausea/vomiting, yellowing eyes/skin, dark urine, unusual/extreme tiredness. A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

This drug may infrequently cause serious (rarely fatal) bleeding from the stomach or intestines. This side effect can occur without warning at any time during treatment with diclofenac. The elderly are at increased risk for serious stomach/intestinal bleeding. Drugs related to diclofenac have rarely caused blood clots that result in serious (possibly fatal) heart attacks and strokes. This medication might also rarely cause similar problems. The risk of these serious side effects may increase if you have heart disease or if you use this medication for a longer time. Talk to your doctor or pharmacist about the benefits and risks of treatment, as well as other possible medication choices. Stop using diclofenac and seek immediate medical attention if you notice any of the following rare but very serious side effects: black/bloody stools, persistent stomach/abdominal pain, vomit that looks like coffee grounds, chest pain, shortness of breath, weakness on one side of the body, sudden vision changes, slurred speech. This medication should not be used right before or after heart bypass surgery.