Tablets or gel – what is better?

This depends on the kind of complaints. In local pain (e.g. knee, ankle) gel is often sufficient and protects the stomach. Tablets are more effective with stronger or systemic pain.

How long can I take Diclofenac?

Basically as short as possible. For acute complaints usually 3–7 days. Long-term use should only be carried out under medical control, ideally with gastric protection.

Is Diclofenac bad for the heart?

For longer use, Diclofenac can easily increase the risk of heart attack and stroke, especially in pre-disorders. For short-term use, the risk is low. Talk to your doctor about your individual situation.

Arthotec® combines Diclofenac with Misoprostol, a stomach protectant. It is particularly suitable for patients who need diclofenac, but have an increased risk of stomach problems.

diclofenac

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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

Naproxen

Etoricoxib

Ibuprofen

Celecoxib

Is diclofenac right for you?

A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.

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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. Read the package leaflet before use.