Diclofenac Sodium

Diclofenac Sodium is a non-steroidal anti-inflammatory drug (nsaid) medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

Diclofenac Sodium is used for pain with inflammation, including:

• Osteoarthritis, rheumatoid arthritis and ankylosing spondylitis
• Back pain, neck pain and sciatica
• Sprains, strains and sports injuries
• Dental pain and pain after surgery
• Period (menstrual) pain
• Migraine attacks
• Acute gout flares
• Pain from kidney stones (renal colic), usually as injection or suppository

It is for symptom relief; the underlying condition still needs proper diagnosis and treatment by a doctor.

Common side effects of Diclofenac Sodium include:

• Stomach pain, heartburn, nausea, indigestion or diarrhoea
• Headache or dizziness
• Raised blood pressure and fluid retention (swollen ankles)

Serious but less common effects include stomach or duodenal ulcers and bleeding (black stools, vomiting blood), kidney impairment, liver enzyme changes, severe allergic reactions and, with long-term high-dose use, a small increase in heart attack and stroke risk. Stop the medicine and see a doctor urgently if you notice black stools, chest pain, breathlessness or severe stomach pain.

Take these precautions with Diclofenac Sodium:

• Always take it with food; your doctor may add a gastric-protective medicine (e.g. a PPI)
• Avoid completely in dengue fever or any suspected dengue — it increases bleeding risk; use paracetamol instead
• Use with great care if you are elderly or have a history of ulcer, kidney disease, heart disease, high blood pressure, liver disease or asthma
• Avoid when dehydrated (vomiting, diarrhoea) — the kidney risk rises sharply
• Do not combine with other NSAIDs, including over-the-counter painkillers
• Use the lowest dose for the shortest time; do not take daily for months without review

Important interactions of Diclofenac Sodium include:

• Other NSAIDs and aspirin — greatly increase ulcer and bleeding risk
• Blood thinners (warfarin, rivaroxaban, clopidogrel) — higher bleeding risk
• Corticosteroids and SSRIs — added risk of stomach bleeding
• ACE inhibitors, ARBs and diuretics — the combination can damage the kidneys and blunt blood-pressure control
• Lithium, methotrexate, digoxin — diclofenac raises their blood levels and toxicity
• Ciclosporin and tacrolimus — increased kidney toxicity
• Diabetes medicines — occasional blood-sugar changes; monitor

Always tell your doctor and pharmacist about every medicine you take.

Do not take Diclofenac Sodium if you have:

• Active stomach or duodenal ulcer, or any active bleeding
• History of GI bleeding or perforation with NSAIDs
• Established heart disease (ischaemic heart disease, heart failure NYHA II–IV), stroke or peripheral arterial disease
• Severe kidney or liver failure
• Asthma, hives or allergic reaction triggered by aspirin or other NSAIDs
• Dengue fever or suspected dengue
• The last trimester of pregnancy
• Allergy to diclofenac or any component

Pregnancy: Diclofenac Sodium should be avoided in pregnancy, and is strictly contraindicated in the last three months — it can cause premature closure of a vessel in the baby's heart, kidney problems in the baby, and delayed labour with increased bleeding. In early pregnancy, use only if a doctor judges it essential; paracetamol is the preferred alternative.

Breastfeeding: Only small amounts pass into breast milk. Short courses are generally considered acceptable during breastfeeding, but take it only on your doctor's advice.

Store Diclofenac Sodium below 30°C in a cool, dry place, protected from light and moisture. Keep tablets in the original blister pack until use. Keep gels, suppositories and injections as directed on their labels. Keep all medicines out of the reach and sight of children, and never use after the expiry date printed on the package.