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Home / Drugs / Starting with D / Diclofenac
 
Diclofenac
 

A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt. [PubChem]
BrandsAllvoran
Apo-Diclo
Assaren
Benfofen
Cataflam
Delphimix
Dichlofenac
Dichronic
Diclo-Phlogont
Diclo-Puren
Diclobenin
Diclord
Dicloreum
Dolobasan
Duravolten
Dyloject
Ecofenac
Effekton
Kriplex
Neriodin
Novapirina
Novo-Difenac
Novo-Difenac SR
Nu-Diclo
Pennsaid
Primofenac
Prophenatin
ProSorb-D
Rhumalgan
Solaraze
Solaraze T
Tsudohmin
Valetan
Voldal
Voltaren
Voltaren Ophtha
Voltaren Ophthalmic
Voltaren Rapide
Voltaren SR
Voltaren-XR
Voltarol
Xenid
CategoriesCyclooxygenase Inhibitors
Nonsteroidal Anti-inflammatory Agents (NSAIAs)
ManufacturersInstitut biochemique sa
Xanodyne pharmaceutics inc
Nautilus neurosciences inc
Novartis pharmaceuticals corp
Apotex inc
Mutual pharmaceutical co inc
Mylan pharmaceuticals inc
Sandoz inc
Teva pharmaceuticals usa inc
Watson laboratories inc
Nycomed us inc
Novartis consumer health inc
Akorn inc
Alcon inc
Apotex inc richmond hill
Bausch and lomb inc
Falcon pharmaceuticals ltd
Nexus pharmaceuticals inc
Mallinckrodt inc
Actavis elizabeth llc
Alphapharm party ltd
Carlsbad technology inc
Nostrum laboratories inc
Pliva inc
Roxane laboratories inc
Teva pharmaceuticals usa
Unique pharmaceutical laboratories
Biovail laboratories inc
Dexcel ltd
Packagers4uOrtho LLC
Actavis Group
Advanced Pharmaceutical Services Inc.
Advantage Dose LLC
Aidarex Pharmacuticals LLC
Akorn Inc.
Alcon Laboratories
Almirall Hermal GmbH
Alpharma Pharmaceuticals LLC
Altergon Italia SRL
Amerisource Health Services Corp.
Apotex Inc.
Apotheca Inc.
Apothecary Shop Wholesale
AQ Pharmaceuticals Inc.
A-S Medication Solutions LLC
Bausch & Lomb Inc.
Bioglan Pharmaceuticals Co.
Biovail Pharmaceuticals
Bryant Ranch Prepack
Cardinal Health
Carlsbad Technology Inc.
Ciba Vision Canada Inc.
Corepharma LLC
Dexcel Ltd.
Direct Dispensing Inc.
Dispensing Solutions
Diversified Healthcare Services Inc.
Endo Pharmaceuticals Inc.
Falcon Pharmaceuticals Ltd.
H.J. Harkins Co. Inc.
Heartland Repack Services LLC
Indoco Remedies Limited
Innoviant Pharmacy Inc.
J.B. Chemicals & Pharmaceuticals
Kaiser Foundation Hospital
Keltman Pharmaceuticals Inc.
Lake Erie Medical and Surgical Supply
Mckesson Corp.
Medvantx Inc.
Murfreesboro Pharmaceutical Nursing Supply
Mylan
Nautilus Neurosciences Inc.
Nexus Pharmaceuticals
Novartis AG
Novopharm Ltd.
Nucare Pharmaceuticals Inc.
Pack Pharmaceuticals
Palmetto Pharmaceuticals Inc.
Patheon Inc.
PCA LLC
PD-Rx Pharmaceuticals Inc.
Pharmaceutical Utilization Management Program VA Inc.
Pharmaderm
Pharmedix
Physicians Total Care Inc.
Pliva Inc.
Preferred Pharmaceuticals Inc.
Prepak Systems Inc.
Prescription Dispensing Service Inc.
Rebel Distributors Corp.
Redpharm Drug
Resource Optimization and Innovation LLC
Sandhills Packaging Inc.
Sandoz
Southwood Pharmaceuticals
St Mary's Medical Park Pharmacy
Stat Rx Usa
Teikoku Seiyaku Co. Ltd.
Teva Pharmaceutical Industries Ltd.
UDL Laboratories
Va Cmop Dallas
Watson Pharmaceuticals
Xanodyne Pharmaceuticals Inc.
Yung Shin Pharmaceutical Industry Ltd.
SynonymsDiclofenac Acid
Diclofenac Potassium
Diclofenac Sodium
ISV-205

indication

For the acute and chronic treatment of signs and symptoms of osteoarthritis and rheumatoid arthritis.

pharmacology

Diclofenac is an acetic acid nonsteroidal antiinflammatory drug (NSAID) with analgesic and antipyretic properties. Diclofenac is used to treat pain, dysmenorrhea, ocular inflammation, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and actinic keratosis

mechanism of action

The antiinflammatory effects of diclofenac are believed to be due to inhibition of both leukocyte migration and the enzyme cylooxygenase (COX-1 and COX-2), leading to the peripheral inhibition of prostaglandin synthesis. As prostaglandins sensitize pain receptors, inhibition of their synthesis is responsible for the analgesic effects of diclofenac. Antipyretic effects may be due to action on the hypothalamus, resulting in peripheral dilation, increased cutaneous blood flow, and subsequent heat dissipation.

toxicity

Symptoms of overdose include loss of consciousness, increased intracranial pressure, and aspiration pneumonitis. LD50=390mg/kg (orally in mice)

biotransformation

Hepatic

absorption

Completely absorbed from the gastrointestinal tract.

half life

2 hours

route of elimination

Diclofenac is eliminated through metabolism and subsequent urinary and biliary excretion of the glucuronide and the sulfate conjugates of the metabolites. Little or no free unchanged diclofenac is excreted in the urine. Approximately 65% of the dose is excreted in the urine and approximately 35% in the bile as conjugates of unchanged diclofenac plus metabolites.

drug interactions

Alendronate: Increased risk of gastric toxicity

Anisindione: The NSAID, diclofenac, may increase the anticoagulant effect of anisindione.

Colesevelam: Bile acid sequestrants may decrease the absorption of Nonsteroidal Anti-Inflammatory Agents. Monitor for decreased serum concentrations/therapeutic effects of nonsteroidal anti-inflammatory agents (NSAID) if coadministered with bile acid sequestrants. Separating the administration of doses by 2 or more hours may reduce (but not eliminate) the risk of interaction. The manufacturer of colesevelam recommends that drugs should be administered at least 1 hour before or 4 hours after colesevelam.

Cyclosporine: Monitor for nephrotoxicity

Dicumarol: The NSAID, diclofenac, may increase the anticoagulant effect of dicumarol.

Ginkgo biloba: Additive anticoagulant/antiplatelet effects may increase bleed risk. Concomitant therapy should be avoided.

Lithium: The NSAID, diclofenac, may decrease the renal excretion of lithium. Increased risk of lithium toxicity.

Methotrexate: The NSAID, diclofenac, may decrease the renal excretion of methotrexate. Increased risk of methotrexate toxicity.

Rifampin: Rifampin, a CYP2C9 inducer, may increase the metabolism of diclofenac.

Tacrine: The metabolism of Tacrine, a CYP1A2 substrate, may be reduced by Diclofenac, a CYP1A2 inhibitors. Monitor the efficacy and toxicity of Tacrine if Diclofenac is initiated, discontinued or if the dose is changed.

Telmisartan: Concomitant use of Telmisartan and Diclofenac may increase the risk of acute renal failure and hyperkalemia. Monitor renal function at the beginning and during treatment.

Timolol: The NSAID, Diclofenac, may antagonize the antihypertensive effect of Timolol.

Tizanidine: Diclofenac may decrease the metabolism and clearance of Tizanidine. Consider alternate therapy or use caution during co-administration.

Trandolapril: The NSAID, Diclofenac, may reduce the antihypertensive effect of Trandolapril. Consider alternate therapy or monitor for changes in Trandolapril efficacy if Diclofenac is initiated, discontinued or dose changed.

Treprostinil: The prostacyclin analogue, Treprostinil, may increase the risk of bleeding when combined with the NSAID, Diclofenac. Monitor for increased bleeding during concomitant thearpy.

Vilazodone: Increased risk of bleeding with concomitant use of NSAIDs with vilazodone.

Voriconazole: Voriconazole, a strong CYP2C9 inhibitor, may increase the serum concentration of diclofenac by decreasing its metabolism. Renal impairment may increase the risk of diclofenac adverse effects. Monitor for changes in therapeutic and adverse effects of diclofenac if voriconazole is initiated, discontinued or dose changed.

Warfarin: The antiplatelet effects of oral diclofenac may increase the bleed risk associated with warfarin. Consider alternate therapy or monitor for signs and symptoms of bleeding during concomitant therapy.