Diclofenac

What it is

Diclofenac is a non-steroidal anti-inflammatory drug; in Poland's medicines register the injection and the stronger tablets go out on prescription, the lowest-strength packs over the pharmacy counter. It inhibits the cyclo-oxygenase enzymes, cutting production of the prostaglandins that keep pain and swelling going. It is used for pain and inflammation.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Pain
• Inflammation

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

It is taken with food, because the prostaglandins it suppresses also protect the stomach lining, and that is the reason for the bleeding warning. Diclofenac is watched more closely than most of its class for effects on the liver, so ALT and AST belong on the list alongside creatinine and eGFR for the kidney. It can move blood pressure and weaken lisinopril, losartan and furosemide, and taking it with prednisolone stacks two things that irritate the stomach lining. It is not taken with anticoagulants such as warfarin, and doubling up with ibuprofen or naproxen adds bleeding risk without adding pain relief.

When to see a doctor

Black or tarry stools, vomiting that looks like coffee grounds, or upper-abdominal pain that keeps returning point to bleeding and need a doctor promptly. Yellow eyes or skin, dark urine or lasting nausea point to the liver, and swollen ankles or falling urine output to the kidney; both mean see a doctor.

Worth knowing

• Raises the risk of stomach bleeding
• Watch liver enzymes
• Caution with kidney disease
• Can raise blood pressure

Markers to watch

• ALT
• AST
• Creatinine
• eGFR