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Diclofen Side Effects

Sep 2, 2010 | By Aironius French

Diclofenac is a generic drug classified as a non-steroidal anti-inflammatory, or NSAID. Diclofenac exists as either diclofenac potassium or diclofenac sodium, which was first brought to market in 1988 by the company, Novartis, under the branded name, Voltaren, according to Drugs.com. Diclofenac was approved by the FDA as a prescription drug to treat mild to moderate pain associated with arthritis and ankylosing spondylitis, although it is also used for migraine pain, tendonitis and menstrual cramps, as cited on Rxlist.com. The use of diclofenac, like all NSAIDs, can lead to certain negative side effects.

Gastrointestinal Tract Side Effects

Dailymed notes that all NSAIDs, including diclofenac, can cause serious negative effects on the stomach, small and large intestines and bowel. The most frequently reported problems are abdominal pain, constipation, diarrhea, dyspepsia, intestinal gas, heartburn, nausea and vomiting. More serious side effects occurring less commonly include acute gastritis, stomach and intestinal perforation, stomach and intestinal ulceration and gross gastrointestinal bleeding.

According to Druglib.com, gastrointestinal ulcers, bleeding or perforation caused by NSAIDs occur in about one percent of patients treated for three-to-six months, and in about two-to-four percent of patients treated for one year. This trend continues with longer duration of use, increasing the chances of developing serious gastrointestinal issues. It should be noted that perforations, ulcerations and bleeding can occur without much pain, so black tar-like stool, sudden weakness and a distended abdomen may be the only indications of internal bleeding. People with a history of gastrointestinal ulcers and the elderly should not take diclofenac products.

Renal Side Effects

NSAIDs, including diclofenac, reduce blood flow to the kidneys and impair their function. Dailymed points out that the use of NSAIDs, including diclofenac, beyond six months duration has resulted in renal failure due to papillary necrosis and other injuries. Kidney toxicity has also been noted in chronic users of Cataflam, which contains diclofenac. Druglib adds that in a six-month, double-blind study comparing Cataflam, Voltaren and ibuprofen, gastrointestinal, cardiovascular and kidney side effects all occurred and were similar in degree and frequency. People with reduced kidney function should not take diclofenac products.

Cardiovascular Side Effects

Druglib cites clinical studies of NSAIDs, including diclofenac, of up to three years duration that concluded there are increased risks of serious cardiovascular side effects, such as thrombotic events, heart attacks due to infarction, brain aneurysms and increased blood pressure. Thrombotic events occur when plaque build-up within blood vessels dislodges and becomes stuck within smaller vessels, causing blockages and leading to heart and brain infarctions. Pubmed cites a study on diclofenac, published in a 2006 edition of "Lancet," that confirmed the risks of thrombotic events and concluded the risks were about the same as a COX-2 anti-inflammatory. People with congestive heart failure, severe atherosclerosis or uncontrolled hypertension should not take diclofenac products.

Liver Side Effects

Dailymed cites clinical trials of diclofenac which showed liver AST enzyme elevations occurred in about two percent of the 5,700 patients studied. Druglib adds that other controlled studies found that up to four percent of patients studied exhibited increased liver ALT enzymes. Rashes and fluid retention were more common side effects reported from diclofenac use that could be related to liver dysfunction. Post-marketing reports of diclofenac from patients included incidences of liver necrosis, jaundice, acute hepatitis and sometimes liver failure leading to death.

References

Article reviewed by Jenna Marie Last updated on: Sep 2, 2010

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