Apo-Diclo

Brand Name:Apo-Diclo, Novo-Difenac, Nu-Diclo, Voltaren Rapide and in combined form, Athrotec

Prescription needed: Yes

What is this drug used for?

Diclofenac is used to relieve the pain, tenderness, inflammation, and stiffness caused by gout, arthritis (osteoarthritis, rheumatoid arthritis), and other inflammatory conditions (e.g. ankylosing spondylitis).

It can also be used to relieve other pain, including pain due to headaches (e.g. migraines), muscle/joint/tendon strains or sprains, menstrual cramps, dental work or surgery/procedures.

Is there any reason not to take this drug?

You should not take this drug if you have had asthma, itchiness, hives or other allergic reactions to diclofenac, aspirin or other similar drugs (e.g. diclofenac, ibuprofen). Tell your doctor if you have or have ever had:

  • angina (chest pain) or previous heart attack
  • asthma
  • congestive heart failure
  • high blood pressure
  • problems with your kidney or liver
  • problems with stomach ulcers, bleeding of the stomach or heartburn
  • problems with severe dehydration
  • problems with bleeding (e.g. easy bruising, nose bleeds)
  • problems with drinking a lot of alcohol
  • swelling of the ankles or legs

What about possible side effects?

The most common side effects are:

  • constipation
  • dizziness, lightheadedness
  • feeling tired
  • headache
  • nausea, gas, heartburn, stomach pain
  • skin rash, itching, increased sensitivity to the sun
  • swelling of the ankles or feet (this may make signs and symptoms of blood pressure or heart failure worse)

Some of these side effects are related to the dose and may go away with time.

Other less common and/or sometimes severe side effects include:

  • blurred vision
  • problems with hearing or ringing in the ears
  • problems with the kidney
  • Rare cases of hepatitis (inflammation of the liver) and jaundice (yellowing of skin and eyes) have been reported.– Call your doctor immediately
  • stomach ulcer with or without bleeding (contact your doctor immediately if you see blood in your vomit, bloody diarrhea or black, tarry stools)
  • may interfere with how well your blood can form clots

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

  • Other pain medications that include ASA & other anti-inflammatories (e.g. ibuprofen, voltaren, diclofenac) – this can increase your chances of having side effects, especially ulcers and/or bleeding
  • If you are taking medications to treat high blood pressure, this medication may interfere with how well your blood pressure medication can work and your blood pressure may increase. Your doctor will likely check your blood pressure periodically while you are taking this medication.
  • Water pills (e.g. hydrochlorothiazide, furosemide) – this medication may cause swelling of the ankles and feet and may interfere with how well the water pills can work.
  • If you are taking medications for congestive heart failure, this medication may make your symptoms of congestive heart failure worse and interfere with how well your medications can work. Call your doctor immediately if you notice that your symptoms of heart failure are getting worse
  • Lithium (may cause an increase in the amount of lithium in your blood)
  • Warfarin, clopidogrel (can increase your chances of bleeding)
  • Methotrexate (may increase the amount of methotrexate in your blood)
  • Glyburide, gliclizide, glimepiride, tolbutamide (may increase your chances of having low blood sugar)
  • Potassium supplements, triameterine, amiloride, spironolactone (may increase the amount of potassium in your blood).
  • Cyclosporine (may see increase amount of cyclosporine in your blood and increase the chances of having problems with the kidney)

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

Children: Reduced dose necessary.

Seniors: More sensitive to the side effects. Lower doses may be required

Pregnancy: Should be avoided in the last 3 months of pregnancy as it may prolong labour and could have an adverse effect on the baby’s heart. Talk to your doctor.

Women who are nursing: Can be used but talk to your doctor first.

People who drive or operate machinery: should experience no unusual problems.

Alcohol: should only be consumed in small amounts as it may increase your chances of having problems with your stomach.

Overdose: If you notice any unusual symptoms, call your doctor immediately.

Stopping the drug: If you have been taking this drug regularly, talk to your doctor before you stop. If you take it occasionally for short-term pain relief, you can safely stop when it is no longer required. Your symptoms may return when you stop the medication.

If you miss a dose: Take the missed dose as soon as you remember it unless it is within 2 hours of your next scheduled dose, in which case take the missed dose and skip the next scheduled dose. Never take a double dose of this medicine.

Storage conditions: closed container; cool, dry location away from excess moisture (not in the bathroom); always out of reach of children.

Dietary precautions: Since this medication may cause an upset stomach, take naproxen with food or milk.