Class: NSAID
Dosage Forms. Tablet: 50 mg; Tablet, Extended Release: 25 mg, 50 mg, 75 mg, 100 mg; Capsule: 25 mg; Powder for Solution: 50 mg/packet
Common FDA Label Indication, Dosing, and Titration.
1. Osteoarthritis: 100 mg extended release po daily or bid
2. Rheumatoid arthritis: 100 mg extended release daily or bid
Off-Label Uses.
1. Pain: 100 mg extended release po daily
MOA. Nonselective inhibitor of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2), and reversibly alters platelet function and prolongs bleeding time.
Drug Characteristics: Diclofenac
Medication Safety Issues: Diclofenac
Drug Interactions: Diclofenac
Adverse Reactions: Diclofenac
Efficacy Monitoring Parameters. Decreased pain and improved range of motion.
Toxicity Monitoring Parameters. Monitor CBC, LFTs, SCr, fecal occult blood tests, severe skin rash, black tarry stools, chest pains, yellowing of eyes or skin, and change in urination.
Key Patient Counseling Points. Take with food or milk to decrease GI upset.
Clinical Pearls. Elderly patients are at increased risk of GI ulceration. Patients with underlying cardiac dysfunction are at increased risk of cardiovascular effects. Use lowest dose for shortest period of time to minimize toxicity. Available in both sodium and potassium salts, in combination with misoprostol, and in ophthalmic and topical products. Medication guide required at dispensing.