Who should not take diclofenac?
Diclofenac is not suitable for everyone. Do not take it if you:
- are allergic to any ingredient of the medicine (always check the packet for the inactive ingredients of the medicine if you
Who should not take diclofenac?
Diclofenac is not suitable for everyone. Do not take it if you:
- are allergic to any ingredient of the medicine (always check the packet for the inactive ingredients of the medicine if you know you have specific allergies).
- have ever had an allergic reaction after taking aspirin or other NSAIDs, such as ibuprofen or naproxen (or example an asthma attack, itchy rash, nasal inflammation (rhinitis) or swelling of the lips, tongue and throat).
- have an active peptic ulcer, perforation (hole) or bleeding in the gut; have had two or more episodes of this in the past; or have ever had bleeding or perforation in your gut as a result of taking an NSAID.
- have severe liver failure or kidney failure.
- are in the last three months of pregnancy.
- are trying to get pregnant. Diclofenac is not recommended because it can temporarily reduce female fertility.
- are taking any other NSAID painkillers, including ibuprofen, aspirin and COX-2 inhibitors such as celecoxib.
- have heart disease such as heart failure, angina or a history of heart attack.
- have ever had a stroke or mini-stroke (TIA).
- have poor blood circulation in your legs or feet (peripheral arterial disease).
In recent years research has shown that use of diclofenac is associated with a small increase in the risk of having a heart attack or stroke. The risks increase with higher doses and the longer diclofenac is taken. These risks are very rare and the benefits of the medicine for pain relief still outweigh these risks for most people. However, if you have existing heart or blood vessel disease the latest advice is that diclofenac is not suitable for you. Your doctor can prescribe you a different painkiller that has lower risks for you. If you have risk factors for heart disease or stroke, such as diabetes, high blood pressure, high cholesterol or smoking, your doctor will need to assess the overall benefits and risks before deciding if this medicine is suitable for you. Ask your doctor or pharmacist for further information.
- Diclofenac suppositories should not be used by people with inflammation of the rectum (proctitis).
Who might need a lower diclofenac dose or extra monitoring?
Some people may need a lower dose of diclofenac or extra monitoring from your doctor to minimise any risks. Make sure your doctor knows if you:
- are over 65 years old.
- have ever had a disorder affecting your stomach or intestines, such as ulceration, bleeding or inflammatory bowel disease such as Crohn's disease or ulcerative colitis.
Diclofenac can sometimes cause serious side effects such as ulceration or bleeding in the gut, so if you're aged over 65 or have a history of gut problems your doctor will want to monitor you more closely if you're prescribed diclofenac. They may also prescribe a medicine to protect your stomach. Problems are more likely with high doses and if you take diclofenac for long periods of time. If you get any sign of bleeding from your stomach or bowels while taking diclofenac, for example vomiting blood and/or passing black/tarry/bloodstained stools, you should stop taking it and consult your doctor immediately.
- have kidney or liver problems.
- have a type of life long inherited blood disease caused by a defect in the liver (hepatic porphyria).
- have a history of high blood pressure (hypertension).
- have raised levels of fats such as cholesterol in your blood (hyperlipidaemia).
- suffer from diabetes.
- are a smoker.
- have a history of asthma or allergies.
- have blood clotting disorders or are taking anticoagulant medicines.
- have a disease that affects your connective tissue, eg systemic lupus erythematosus.
Can I take diclofenac while pregnant or breastfeeding?
- Not unless you have been advised to by your doctor.
Diclofenac may increase the risk of miscarriage and malformations and should not be used during the first and second trimesters of pregnancy unless considered essential by your doctor. Diclofenac must not be taken in the third trimester because it may delay labour, increase the length of labour and cause complications in the newborn baby.
Diclofenac passes into breast milk in small amounts. At normal doses it is unlikely to harm the baby, however it is