Voltaren (Diclofenac) Dosage and Side Effects
Your health care provider has prescribed VOLTAREN or VOLTAREN SR for you to relieve pain and swelling in rheumatoid arthritis and osteoarthritis, including degenerative joint disease of the hip.
Proper Use of this medication
Take VOLTAREN or VOLTAREN SR only as directed by your health care provider. Do NOT take more of it, do NOT take it more often and do NOT take it for a longer period of time than your health care provider recommended. If possible, you should take the lowest dose of this medication for the shortest time period. Taking too much VOLTAREN or VOLTAREN SR may increase your chances of unwanted and sometimes dangerous side effects, especially if you are elderly and frail or if you have a low body weight, have other diseases or take other medications.
If you will be using VOLTAREN or VOLTAREN SR for more than 7 days, see your health care provider regularly to discuss whether this medicine is working for you and if it is causing you any unwanted effects.
Swallow the tablet whole with water, do not chew or divide the tablet. It is best to take your dose at the same time each day.
To help reduce the possibility of stomach upset you should take VOLTAREN or VOLTAREN SR tablets immediately after a meal or with food or milk. Also, you should remain standing or sitting upright (i.e. do not lie down) for about 15-30 minutes after taking the medicine. This helps to prevent irritation that may lead to trouble swallowing. If stomach upset (indigestion, nausea, vomiting, stomach pain or diarrhea) occurs and continues, contact your doctor.
VOLTAREN suppositories (50 and 100 mg) are wrapped in a plastic film. Make sure that the plastic wrapping is fully removed before inserting the suppository into the rectum. It is best to take the suppositories after emptying your bowels.
Do not take suppositories by mouth.
This medication has been prescribed specifically for you. Do NOT give it to anyone else. It may harm them, even if their symptoms seem to be similar to yours.
If you have accidentally taken more than the prescribed dose of VOLTAREN tablets, suppositories or VOLTAREN SR tablets, contact your doctor, pharmacist or poison control centre immediately or go to the hospital emergency unit at once. You may require medical attention.
If you forget to take your scheduled dose, you should not double the next scheduled dose to make up for the missed dose.
VOLTAREN or VOLTAREN SR may cause some side effects, especially when used for a long time or in large doses. When these side effects occur, you may require medical attention. Report all symptoms or side effects to your health care provider.
VOLTAREN or VOLTAREN SR may cause you to become drowsy or tired. Be careful about driving or participating in activities that require you to be alert. If you become drowsy, dizzy or light-headed after taking VOLTAREN or VOLTAREN SR, do NOT drive or operate machinery.
VOLTAREN or VOLTAREN SR may cause you to become more sensitive to sunlight. Any exposure to sunlight or sunlamps may cause sunburn, skin blisters, skin rash, redness, itching or discolouration, or vision changes. If you have a reaction from the sun, check with your health care provider.
Check with your health care provider IMMEDIATELY if you develop chills, fever, muscle aches or pains, or other flu-like symptoms, especially if they occur before or together with a skin rash. These symptoms may be the first signs of a SERIOUS ALLERGIC REACTION to this medication.
Warnings and Precautions
If you have, or previously had, any of the following conditions, see your health care provider to discuss treatment options other than VOLTAREN or VOLTAREN SR:
- Heart Attack or Angina
- Stroke or Mini-stroke
- Loss of Vision
- Current Pregnancy (less than 28 weeks)
- Congestive Heart Failure
- High Blood Pressure
- High Levels of Fats in Your Blood
It is important to take the lowest dose of VOLTAREN and VOLTAREN SR that relieves your pain and/or swelling and for the shortest time possible in order to keep your risk of side effects on the heart and blood vessels as small as possible.
Use of NSAIDS, such as VOLTAREN and VOLTAREN SR can result in increased blood pressure and/or worsening of congestive heart failure.
Use of NSAIDs, such as VOLTAREN and VOLTAREN SR, may cause stomach and bowel problems (such as ulceration, perforation, obstruction and bleeding).
Before taking this medication, tell your health care provider if you have any of the following:
- Disease of the heart or blood vessels (also called cardiovascular disease, including uncontrolled high blood pressure, congestive heart failure, established ischemic heart disease, or peripheral arterial disease), as treatment with VOLTAREN and VOLTAREN SR in these cases is not recommended.
- Risk factors for cardiovascular disease (see above) such as high blood pressure, abnormally high levels of fat (cholesterol, triglycerides) in your blood, diabetes, or if you smoke.
- Diabetes mellitus or on a low sugar diet
- Poor circulation to your extremities
- Kidney disease or urine problems
- Previous ulcer or bleeding from the stomach or gut
- Previous bleeding in the brain
- Bleeding problems
- Family history of allergy to NSAIDs, such as acetylsalicylic acid (ASA), celecoxib, diclofenac, diflunisal, etodolac, fenoprofen, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam, rofecoxib, sulindac, tenoxicam, tiaprofenic acid, tolmetin, or valdecoxib (NOT a complete list)
- Family history of asthma, nasal polyps, long-term swelling of the sinus (chronic sinusitis) or hives
Also, before taking this medication, tell your health care provider if you are pregnant or you are planning to get pregnant.
While taking this medication:
- Tell any other doctor, dentist, pharmacist or other health care professional that you see, that you are taking this medication, especially if you are planning to have heart surgery;
- Do NOT drink alcoholic beverages while taking this medication because you would be more likely to develop stomach problems;
- Fertility may be decreased. The use of VOLTAREN or VOLTAREN SR is not recommended in women trying to get pregnant. In women who have difficulty conceiving, stopping VOLTAREN or VOLTAREN SR should be considered;
- If you have cardiovascular disease or risks for cardiovascular disease, your doctor will periodically re-evaluate whether you should continue treatment with VOLTAREN or VOLTAREN SR.
- Your doctor will monitor your kidney function, your liver function and your blood count to decide if VOLTAREN or VOLTAREN SR needs to be discontinued or if the dose needs to be changed.
If, at any time while taking VOLTAREN or VOLTAREN SR you experience any signs or symptoms of problems with your heart or blood vessels such as chest pain, shortness of breath, weakness, or slurring of speech, contact your doctor immediately.
Long-term use of VOLTAREN or VOLTAREN SR might increase the risk of heart attacks or strokes.
VOLTAREN or VOLTAREN SR is NOT recommended for use in patients under 16 years of age since safety and effectiveness have NOT been established.
Interactions with this medication
What About Taking Other Drugs At The Same Time?
See your health care provider and pharmacist if you are taking any other medication (prescription or non-prescription) such as any of the following (NOT a complete list):
Acetylsalicylic Acid (ASA) or other NSAIDs
e.g. ASA, celecoxib, diclofenac, ibuprofen, indomethacin, ketorolac, meloxicam, naproxen
Selective Serotonin Reuptake Inhibitors (SSRIs)
e.g. citalopram, fluoxetine, paroxetine, sertraline
Blood pressure medications
ACE (angiotensin converting enzyme) inhibitors
e.g. enalapril, lisinopril, perindopril, ramipril
ARBs (angiotensin II receptor blockers)
e.g. candesartan, irbesartan, losartan, valsartan
Blood thinners (medicine used to prevent blood-clotting)
e.g. warfarin, ASA, clopidogrel
Corticosteroids (including glucocorticoids) (medicines used to provide relief for inflamed areas of the body)
Cyclosporine (a medicine primarily used in patients who have received organ transplants)
Digoxin (a medicine used for heart problems)
Diuretics (medicines used to increase the amount of urine)
e.g. furosemide, hydrochlorothiazide
Methotrexate (a medicine used to treat some kinds of cancer or arthritis)
Oral hypoglycemics (diabetes medications such as metformin)
Phenytoin (a medicine used to treat seizures).
Quinolone antibacterials (medicines used against infection)
Rifampin (an antibiotic medicine used to treat bacterial infections)
Sulfinpyrazone (a medicine used to treat gout)
Tacrolimus (a medicine primarily used in patients who have received organ transplants)
Trimethoprim (a medicine used to prevent or treat urinary tract infection)
Voriconazole (a medicine used to treat fungal infections)
Your health care provider may prescribe low dose ASA (acetylsalicylic acid) as a blood thinner to reduce your risk of having a heart attack or stroke while you are taking VOLTAREN or VOLTAREN SR. Take only the amount of ASA prescribed by your health care provider. You are more likely to upset or damage your stomach if you take both VOLTAREN or VOLTAREN SR and ASA than if you took VOLTAREN or VOLTAREN SR alone.