What is diclofenac?
Diclofenac is a non-steroid anti-inflammatory (NSAR/NSAID) and is one of the most commonly used painkillers worldwide. It acts to relieve pain, anti-inflammatory and fever.
The active ingredient is available in numerous dosage forms: tablets, retard capsules, gel, plasters and suppositories. Known brands are Voltaren® Resinat, Voltaren Emulgel and Arthotec® (combination with Misoprostol for gastric protection).
Diclofenac is used in acute and chronic pain, especially in joint complaints, back pain, sports injuries and rheumatic diseases.
Active Ingredients & Mechanism of Action
Active ingredient: Diclofenac(-Natrium / -Kalium)
Diclofenac inhibits the enzyme cyclooxygenase (COX-1 and COX-2):
Active mechanism:
- Blocks the formation of prostaglandins
- Prostaglandins are messengers that convey pain, inflammation and fever
- The inhibition weakens pain signals and reduces inflammation
Driving effect:
- Analgesic: Pain relief
- Antiphlogistic: Inflammation inhibition
- Antipyretic:
Topic application (gel): When used as a gel, Diclofenac passes directly into the underlying tissue. The systemic load is significantly lower than in tablets.
Who is it suitable for?
Diclofenac is suitable for:
- Acute and chronic joint pain
- back pain and disc discomfort
- Rheumatoid arthritis
- Sports injuries (prellations, disintegrations, upsets)
- Menstrual pain
- Postoperative pain
- Gout attacks
**Topic (Gel) especially at:* *
- Local muscle and joint pain
- Sports injuries
- Arthrosis of small joints
Not suitable:
- In gastric ulcers or gastrointestinal bleeding
- In severe heart, liver or kidney failure
- In the last third of pregnancy
Available Dosages
**Tablets / Retard capsules:* *
- 25 mg, 50 mg, 75 mg
- Retard form: 75 mg, 100 mg
Gel (topic):
- 1% or 2% gel (e.g. voltar emulgel)
Chapters:
- 50 mg, 100 mg
Combi preparation Arthotec®:
- Diclofenac 50 mg / 75 mg + Misoprostol 200 μ g
Overday dose oral:
- 50–150 mg, divided into 2–3 individual doses
- Low effective dose for the shortest necessary time
How to Take
Tablets:
- Take water with a glass
- Possible to or after a meal
- Do not chew or break tablets (retard forms)
**
- apply 2–4 g (approximately kirsch to walnut size) to the affected area
- Easy to massage, wash hands after
- 3–4 times a day, not on open wounds
General Notes:
- Apply as short as possible and in the lowest effective dose
- In case of gastric problems: proton pump inhibitor (PPI)
- Do not take together with other NSAR
Contraindications
**Diclofenac must not be taken at:* *
- Known hypersensitivity to Diclofenac or other NSAR
- Active gastrointestinal ulcers or bleeding
- Heavy heart failure (NYHA III–IV)
- Heavy liver or kidney failure
- Last trimenon of pregnancy
- condition after coronary bypass operation
Preview at:
- Cardiovascular risk factors (blood high pressure, diabetes, smoking)
- Older patients
- Asthma (ASS intolerance syndrome possible)
- Simultaneous intake of blood thinners
Pregnant period: In the 1st and 2nd Trimenon only with strict indication. In the 3rd Trimenon contraindicated. It is possible for a short period of time in the stilling time at a low dose.
Possible Side Effects
Family (1–10 %):
- stomach pain, nausea, diarrhea
- headache, dizziness
- Increased liver levels
** Occasionally (0.1-1 %):* *
- Gastric ulcer, gastrointestinal bleeding
- Skin rash, itching
- Edema (water retention)
Selten but severe:
- Cardiovascular events (heart attack, stroke) during long-term use
- Heavy skin reactions
- Kidney malfunction
- liver damage
Topic (Gel): Significantly fewer systemic side effects. Local: Skin irritations, redness, itching.
Interactions
Increased bleeding risk with:
- Anticoagulants (Marcumar, DOAKs)
- ASS, other NSAR
- SSRI antidepressants
- corticosteroids
Sustainability of:
- Blood pressure core (ACE inhibitors, sartans, diuretics)
Increased toxicity of:
- Methotrexate
- Lithium
- Digoxin
- Ciclosporin
Administration with:
- ACE inhibitors + diuretics (Triple-Whammy)
Frequently Asked Questions
Similar Medications
Is diclofenac right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.