Diclofenac Gel 1%

Non-steroidal anti-inflammatory drug (NSAID) for pain and inflammation:

• Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis
• Acute gout
• Back pain, sprains, strains, tendinitis
• Period pain, dental pain, pain after surgery
• Migraine (potassium salt)
• Gel: local pain and swelling of muscles and joints
• Eye drops: inflammation after eye surgery

Adults (oral): 75–150 mg daily in 2–3 divided doses (e.g. 50 mg two or three times daily); SR/ER tablets 75–100 mg once or twice daily. Maximum 150 mg/day.

Injection (IM): 75 mg once (or twice daily in severe cases) for up to 2 days.

Suppository: 50–100 mg; total daily dose by all routes not more than 150 mg.

Gel: apply thinly to the painful area 3–4 times daily and rub in gently.

Children: only as prescribed (e.g. juvenile arthritis 1–3 mg/kg/day in divided doses).

• Take tablets with or after food with a glass of water; swallow SR/EC tablets whole.
• Use the lowest dose for the shortest time.

• Allergy to diclofenac, aspirin or other NSAIDs (asthma, hives, runny nose after NSAIDs)
• Active or past recurrent peptic ulcer or stomach bleeding
• Severe heart failure, established heart disease, stroke or peripheral arterial disease
• Severe kidney or liver failure
• Last 3 months of pregnancy

Common: indigestion, heartburn, stomach pain, nausea, diarrhoea, headache, dizziness, raised liver enzymes.

Less common: stomach ulcer or bleeding (black stools, vomiting blood), fluid retention, high blood pressure, rash.

Rare but serious: heart attack or stroke, kidney damage, liver inflammation, severe allergic and skin reactions.

Injection: pain or abscess at the injection site.

• Higher stomach-bleeding risk in the elderly, with steroids, blood thinners, SSRIs or alcohol — a stomach protector (PPI) may be advised.
• Use with caution in high blood pressure, heart disease, diabetes, smokers, asthma, kidney or liver disease.
• Stay well hydrated; avoid in dehydration.
• Gel: do not apply on broken skin, eyes or mucous membranes; avoid strong sunlight on treated skin.

Avoid in the first 6 months unless the doctor advises; must not be used in the last 3 months (can harm the baby's heart and kidneys and delay labour). Small amounts pass into breast milk — short-term use may be acceptable on medical advice.

• Other NSAIDs and aspirin (more stomach bleeding)
• Warfarin, clopidogrel, SSRIs (bleeding risk)
• ACE inhibitors, ARBs, diuretics (reduced effect, kidney risk)
• Lithium, methotrexate, digoxin (levels rise)
• Ciclosporin, tacrolimus (kidney toxicity)
• Corticosteroids (ulcer risk)

Nausea, vomiting, stomach pain, bleeding, drowsiness, headache; rarely seizures or kidney failure. Seek medical help.

Store below 30°C, away from moisture and light.