$Unique_ID{BRK01924}
$Pretitle{}
$Title{DICLOFENAC}
$Subject{Voltaren (Ciba-Geigy)}
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Copyright (C) 1991 Publications International, Ltd.


DICLOFENAC
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BRAND NAME (Manufacturer):
     Voltaren (Ciba-Geigy)
TYPE OF DRUG:
     Nonsteroidal anti-inflammatory analgesic
INGREDIENT:
     diclofenac
DOSAGE FORM:
     Enteric-coated tablets (25 mg, 50 mg, 75 mg)
STORAGE:
     This medication should be stored in a tightly closed container at room
       temperature away from heat and direct sunlight.

USES

     Diclofenac is used to treat the inflammation (pain, swelling, and
stiffness) of arthritis and ankylosing spondylitis.  Diclofenac has been shown
to block the production of certain body chemicals, called prostaglandins, that
may trigger pain.  However, it is not yet fully understood how it works.

TREATMENT

     You should take this medication on an empty stomach 30 to 60 minutes
before meals or two hours after meals, so that it gets into your bloodstream
quickly.  To decrease stomach irritation, your doctor may want you to take
this medication with food or antacids.
     Do not break, crush, or chew the tablets before swallowing.  They should
be swallowed whole to lessen side effects.
     It may take two weeks before you feel the full effects of this
medication.  Diclofenac does not cure arthritis or ankylosing spondylitis, but
it will help to control the condition as long as you continue to take it.
     It is important that you take diclofenac on schedule and do not miss any
doses.  If you do miss a dose, take it as soon as possible, unless it is
almost time for your next dose.  In that case, do not take the missed dose at
all; just return to your regular dosing schedule.  Do not double the next
dose.

SIDE EFFECTS

     Minor.

     Abdominal cramps, constipation, diarrhea, dizziness, headache,
indigestion, or nausea.  As your body adjusts to the drug, these side effects
should disappear.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).
     If you become dizzy, sit or lie down; get up slowly from a
sitting or reclining position, and be careful on stairs.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
bloody or black, tarry stools; blurred vision; confusion; difficult or painful
urination; palpitations; a problem with hearing, or ringing or buzzing in your
ears; skin rash, hives, or itching; stomach pain; swelling of the feet or
hands; tightness in the chest; unexplained sore throat and fever; soreness of
the tongue or mouth; unusual fatigue or weakness; unusual weight gain;
wheezing or difficulty in breathing; or yellowing of the eyes or skin.

INTERACTIONS

     Diclofenac interacts with several other types of medications:
     1. Anticoagulants (blood thinners such as warfarin) can lead to an
increase in bleeding complications.
     2. Aspirin, other salicylates, and other anti-inflammatory medications
can increase stomach irritation.  Aspirin may also decrease the effectiveness
of diclofenac.  Therefore, aspirin should not be used concurrently with
diclofenac.
     3. Diclofenac can decrease the elimination of digoxin, methotrexate, and
lithium from the body, which can lead to serious side effects.
     4. The activity of diuretics (water pills) and drugs to lower blood
pressure (propranolol, metoprolol) may be inhibited by diclofenac.
     5. Diclofenac may alter a diabetic patient's response to insulin, oral
hypoglycemic agents, or antiseizure medication (phenytoin).
     Before starting to take diclofenac, BE SURE TO TELL YOUR DOCTOR about any
medications you are taking, especially any of those listed above.

WARNINGS

     * Before you start to take this medication, it is important to tell your
doctor if you have ever had unusual or allergic reactions to diclofenac or to
any of the other chemically related drugs (aspirin, other salicylates,
diflunisal, fenoprofen, flurbiprofen, indomethacin, ketoprofen, meclofenamate,
mefenamic acid, naproxen, oxyphenbutazone, phenylbutazone, piroxicam,
sulindac, or tolmetin).
     * Tell your doctor if you now have or if you have ever had asthma,
bleeding problems, colitis, stomach ulcers or other stomach problems,
epilepsy, heart disease, high blood pressure, kidney disease, liver disease,
mental illness, or Parkinson's disease.
     * If diclofenac makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * Because this drug can prolong your bleeding time, it is important to
tell your doctor or dentist that you are taking this drug before having
surgery or any other medical or dental treatment.
     * Stomach problems are more likely to occur if you take aspirin regularly
or drink alcohol while being treated with this medication.  These should,
therefore, be avoided (unless your doctor directs you to do otherwise).
     * Be sure to tell your doctor if you are pregnant or planning to become
pregnant.  This medication can cause unwanted effects on the heart or blood
flow of the fetus.  Studies in animals have also shown that this medicine, if
taken late in pregnancy, may increase the length of pregnancy, prolong labor,
or cause other problems during delivery.  Also tell your doctor if you are
breast-feeding an infant.  Small amounts of diclofenac can pass into breast
milk.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
