Patients should be informed of the signs of an anaphylactic reaction (e. If clinical signs and symptoms consistent with liver or renal disease develop, systemic manifestations occur (e. However, animal reproduction studies are not always predictive of human response. There are no adequate and wellcontrolled studies in pregnant women.

Consult your doctor or pharmacist for more details and to discuss other possible treatments (e. 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.

Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding. Food has no significant effect on the extent of diclofenac absorption. However, there is usually a delay in the onset of absorption of 1 to 4. Diclofenac is more than 99% bound to human serum proteins, primarily to albumin.

Voltaren (diclofenac sodium) is available as delayedrelease (entericcoated) tablets of 75 mg (light pink) for oral administration. The molecular weight is 318. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking diclofenac and seek medical attention or call your doctor at once if you have any of these serious side effects: chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance; black, bloody, or tarry stools; coughing up blood or vomit that looks like coffee.

Keep all doctor appointments and lab visits so your therapy can be monitored closely. Nondrug treatment for arthritis that is approved by your doctor (e. Consult your doctor for specific instructions. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule.

The elderly are at increased risk for serious stomach/intestinal bleeding. Drugs related to diclofenac have rarely caused blood clots to form, resulting 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 and with longer use of this medication.

Canadian residents should call their local poison control center directly. Symptoms of overdose may include: severe stomach pain, vomit that looks like coffee grounds, extreme drowsiness, slow/shallow breathing, seizures. 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.

Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. This medication may also be used to treat other painful conditions (e. However, if you have sudden severe pain and desire quick relief, it may be better to use other pain medications that are faster acting than this medication. Consult your doctor or pharmacist for more details.

Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors. The elderly may be more sensitive to the side effects of this drug, especially stomach/intestinal bleeding and kidney effects. This medication should be used only when clearly needed during the first 6 months of pregnancy.

Discuss the risks and benefits with your doctor or pharmacist. In certain conditions (e. If you wait until the pain has significantly worsened, the medicine may not work as well. Inform your doctor if your condition worsens.

Based on clinical trial data and postmarketing experiences, transaminases should be monitored within 4 to 8 weeks after initiating treatment with diclofenac. However, severe hepatic reactions can occur at any time during treatment with diclofenac. If abnormal liver tests persist or worsen, if clinical signs and/or symptoms consistent with liver disease develop, or if systemic manifestations occur (e. To minimize the possibility that hepatic injury will become severe between transaminase measurements, physicians should inform patients of the warning signs and symptoms of hepatotoxicity (e.

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Do not double the dose to catch up. 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.

Approximately 65% of the dose is excreted in the urine and approximately 35% in the bile as conjugates of unchanged diclofenac plus metabolites. Because renal elimination is not a significant pathway of elimination for unchanged diclofenac, dosing adjustment in patients with mild to moderate renal dysfunction is not necessary. No differences in the pharmacokinetics of diclofenac have been detected in studies of patients with renal impairment. Keep a list of your medicines to show to your healthcare provider and pharmacist.

This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events.

If you have any questions regarding the information, consult your doctor or pharmacist. Take this medication by mouth with a full glass of water (8 ounces or 240 milliliters) unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this drug. Swallow this medication whole.

This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs. This side effect can occur without warning at any time during treatment with diclofenac.

This product may contain 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 medication, tell your doctor or pharmacist your medical history, especially of:.

Talk to your doctor or pharmacist about the benefits and risks of treatment, as well as other possible medication choices. Stop taking diclofenac and seek immediate medical attention if you notice any of the following rare but very serious side effects: black 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. Reducing these symptoms helps you do more of your normal daily activities.

Elevations in transaminases were seen more frequently in patients with osteoarthritis than in those with rheumatoid arthritis. Almost all meaningful elevations in transaminases were detected before patients became symptomatic. Abnormal tests occurred during the first 2 months of therapy with diclofenac in 42 of the 51 patients in all trials who developed marked transaminase elevations. In postmarketing reports, cases of druginduced hepatotoxicity have been reported in the first month, and in some cases, the first 2 months of therapy, but can occur at any time during treatment with diclofenac.

Prostaglandins are chemicals that promote inflammation, pain, and fever. They also protect the lining of the stomach and intestines from the damaging effects of acid, and promote blood clotting by activating blood platelets. Prostaglandins also affect kidney function. Therefore, inflammation, pain, and f.

Serum protein binding is constant over the concentration range (0. Diclofenac diffuses into and out of the synovial fluid. Diffusion into the joint occurs when plasma levels are higher than those in the synovial fluid, after which the process reverses and synovial fluid levels are higher than plasma levels. It is not known whether diffusion into the joint plays a role in the effectiveness of diclofenac.

Gastrointestinal bleeding can occur. Hypertension, acute renal failure, respiratory depression and coma may occur, but are rare. There are no specific antidotes. Emesis and/or activated charcoal (60 to 100 g in adults, 1 to 2 g/kg in children) and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose (5 to 10 times the usual dose).

These laboratory abnormalities may progress, may remain unchanged, or may be transient with continued therapy. Borderline elevations (i. In clinical trials, meaningful elevations (i. In a large, openlabel, controlled trial of 3,700 patients treated for 26 months, patients were monitored first at 8 weeks and 1,200 patients were monitored again at 24 weeks.

It is not recommended for use during the last 3 months of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery. Discuss the risks and benefits with your doctor. This drug passes into breast milk. While there have been no reports of harm to nursing infants, consult your doctor before breastfeeding.

For the relief of osteoarthritis, the recommended dosage is 100150 mg/day in divided doses (50 mg b. For the relief of rheumatoid arthritis, the recommended dosage is 150200 mg/day in divided doses (50 mg t. For the relief of ankylosing spondylitis, the recommended dosage is 100125 mg/day, administered as 25 mg q. Protect from moisture.

Voltaren (diclofenac sodium) should be used with caution in patients with fluid retention or heart failure. However, even shortterm therapy is not without risk. Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of generic voltaren 75 perfusion. In these patients, administration of a nonsteroidal antiinflammatory drug may cause a dosedependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation.

Do not start, stop or change the dosage of any medicine before checking with them first. If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting diclofenac. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: antiplatelet drugs (e. These drugs are similar to this medication, so taking one of these drugs while also taking this medication may increase your risk of side effects.

Talk to your doctor. Call your doctor for medical advice about side effects. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.

Although serious skin reactions may occur without warning, patients should be alert for the signs and symptoms of skin rash and blisters, fever, or other signs of hypersensitivity such as itching, and should ask for medical advice when observing any indicative signs or symptoms. Patients should be advised to stop the drug immediately if they develop any type of rash and contact their physicians as soon as possible. Patients should promptly report signs or symptoms of unexplained weight gain or edema to their physicians. Patients should be informed of the warning signs and symptoms of hepatotoxicity (e.

Do not crush, chew, or break the tablets. Doing so can destroy the special coating on the tablet and may increase side effects. If you experience stomach upset with this medication, you may take it with food, milk, or an antacid. However, this may slow absorption and delay pain relief, especially if you are not taking this medication on a regular schedule.

Abrupt discontinuation of corticosteroids may lead to disease exacerbation. Patients on prolonged corticosteroid therapy should have their therapy tapered slowly if a decision is made to discontinue corticosteroids. Unlike aspirin, their effect on platelet function is quantitatively less, of shorter duration, and reversible. The use of aspirin in patients with aspirinsensitive asthma has been associated with severe bronchospasm which can be fatal.

Abnormal renal function, anemia, dizziness, edema, elevated liver enzymes, headaches, increased bleeding time, pruritus, rashes and tinnitus. This may indicate that they could enhance the toxicity of methotrexate. This response has been attributed to inhibition of renal prostaglandin synthesis. The mean minimum lithium concentration increased 15% and the renal clearance was decreased by approximately 20%.

Postmarketing surveillance has reported cases of severe hepatic reactions, including liver necrosis, jaundice, fulminant hepatitis with and without jaundice, and liver failure. Some of these reported cases resulted in fatalities or liver transplantation. Physicians should measure transaminases periodically in patients receiving longterm therapy with diclofenac, generic voltaren 75 severe hepatotoxicity may develop without a prodrome of distinguishing symptoms. The optimum times for making the first and subsequent transaminase measurements are not known.

Dosage is based on your medical condition and response to therapy. To minimize side effect risks (e. Do not increase your dose or take it more often than prescribed. For ongoing conditions such as arthritis, continue taking it as directed by your doctor.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, poorly controlled diabetes, stomach/intestine/esophagus problems (e.

Daily use of alcohol and tobacco may increase your risk for stomach bleeding, especially when combined with this medicine. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information. This medication may make you more sensitive to the sun.

Tell your doctor immediately if any of these unlikely but serious side effects occur: stomach pain, difficult/painful swallowing, swelling of the hands/feet, sudden/unexplained weight gain, vision changes, hearing changes (e. Tell your doctor immediately if any of these rare but very serious side effects occur: change in the amount of urine, easy bruising/bleeding, signs of infection (e. This drug may rarely cause serious (possibly fatal) liver disease. If you notice any of the following rare but very serious side effects, stop taking diclofenac and tell your doctor immediately: yellowing eyes/skin, dark urine, unusual/extreme tiredness, severe stomach/abdominal pain, persistent nausea/vomiting.

Before having surgery, tell your doctor or dentist that you are using this medication. This drug 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 medicine may cause stomach bleeding.

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 additional information.

The major diclofenac metabolite, 4'hydroxydiclofenac, has very weak pharmacologic activity. Both diclofenac and its oxidative metabolites undergo glucuronidation or sulfation followed by biliary excretion. In patients with renal dysfunction, peak concentrations of metabolites 4'hydroxyand 5hydroxydiclofenac were approximately 50% and 4% of the parent compound after single oral dosing compared to 27% and 1% in normal healthy subjects. Little or no free unchanged diclofenac is excreted in the urine.

Upset stomach, nausea, heartburn, diarrhea, constipation, headache, tiredness, drowsiness, and 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.

Voltaren (diclofenac sodium) should not be given to patients with the aspirin triad. Emergency help should be sought in cases where an anaphylactic reaction occurs. These serious events may occur without warning. Patients should be informed about the signs and symptoms of serious skin manifestations and use of the drug should be discontinued at the first appearance of skin rash or any other sign of hypersensitivity.