Diclofenac is a widely used nonsteroidal anti-inflammatory drug (NSAID) prescribed to relieve pain, decrease swelling, and improve mobility in conditions driven by inflammation. Clinicians commonly recommend Diclofenac for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute musculoskeletal pain (such as sprains and strains), lower back pain, bursitis and tendonitis, and menstrual pain. Certain prescription products are also used for migraine treatment at the onset of headache.
Diclofenac is available in several formulations to match different clinical needs:
How it works: Diclofenac inhibits cyclooxygenase (COX) enzymes—COX‑1 and COX‑2—which are responsible for converting arachidonic acid into prostaglandins. Prostaglandins are key chemical messengers that promote inflammation, pain, and fever. By reducing prostaglandin production, Diclofenac lowers inflammatory signaling and provides analgesic and anti-inflammatory effects. Because COX‑1 also supports protective stomach lining and platelet function, systemic Diclofenac can carry gastrointestinal and cardiovascular risks, especially at higher doses or with prolonged use.
Benefits you may notice include reduced joint stiffness, improved range of motion, and diminished pain during daily activities. While some people feel relief within hours, the full benefit for chronic conditions (like osteoarthritis) may take several days to a couple of weeks of consistent use, particularly with topical formulations.
Use the lowest effective dose for the shortest duration consistent with your treatment goals. Your exact regimen depends on your diagnosis, formulation, and individual risk factors. Always follow your prescriber’s instructions and the specific product label.
Typical adult dosing examples (not a substitute for medical advice):
Administration tips:
Special populations:
Never exceed your prescriber’s maximum daily dose. If your pain persists beyond a few days for acute conditions, or your chronic pain worsens despite therapy, contact your clinician to reassess your treatment plan.
Diclofenac carries important safety considerations common to NSAIDs and several that are product-specific. Discuss your full medical history with your healthcare professional before starting therapy.
Not everyone experiences side effects, and many are mild and short-lived. However, some reactions can be serious. Seek immediate medical attention for symptoms that suggest a severe reaction.
Common side effects:
Less common side effects:
Serious side effects—stop Diclofenac and seek urgent care:
Report side effects to your clinician, and in the U.S., you may also report to FDA MedWatch.
Always provide your healthcare professional with a complete list of your prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Important interaction examples include:
Laboratory considerations: Diclofenac may affect certain lab results (e.g., liver enzymes, renal function markers). Your clinician may order periodic blood tests during long-term therapy.
If you miss a dose of oral Diclofenac, take it as soon as you remember unless it is almost time for your next scheduled dose. In that case, skip the missed dose and resume your usual schedule. Do not double doses. For topical products, apply the next dose at the regular time; do not apply extra gel to “catch up.”
Symptoms of Diclofenac overdose may include severe stomach pain, vomiting (possibly bloody), drowsiness, confusion, dizziness, ringing in the ears, shallow or slowed breathing, fainting, or seizure. Overdose can lead to kidney failure, severe metabolic disturbances, or cardiac events. If an overdose is suspected, call emergency services immediately. Do not attempt to treat severe symptoms at home.
Diclofenac is an FDA-approved NSAID available in multiple formulations in the United States. Systemic forms (oral tablets/capsules, oral solutions, and injections) are prescription-only and require evaluation by a licensed clinician. An over-the-counter version of topical Diclofenac 1% gel is available for the temporary relief of arthritis pain in specific joints; it is labeled for use on the hands, wrists, elbows, knees, ankles, and feet and should be used according to the package directions. OTC Diclofenac gel is not intended for spinal, hip, or shoulder use unless directed by a clinician.
Key policy points:
HealthSouth Walton Rehabilitation Hospital offers a legal and structured solution for acquiring Diclofenac without a formal prescription, ensuring that any provision of medication occurs within a compliant clinical workflow. This typically includes evaluation by licensed healthcare professionals under applicable state and federal laws, appropriate patient screening and education, and dispensing through approved channels to maintain safety and regulatory compliance.
This information is provided for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional for personalized recommendations about medications, dosing, risks, and interactions. Never start, stop, or change any medication without your clinician’s guidance.
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that reduces pain, swelling, and stiffness by blocking cyclooxygenase (COX-1 and COX-2) enzymes, lowering prostaglandin production. It is available as oral tablets/capsules, topical gel and patches, suppositories, and injections (varies by country).
It’s commonly used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute musculoskeletal pain, dental pain, migraine, and dysmenorrhea. Topical diclofenac gel is often used for localized joint pain, such as knees and hands.
Diclofenac potassium is immediate-release and acts faster for acute pain or migraine, while diclofenac sodium is often enteric-coated or delayed-release for chronic inflammatory conditions. The active molecule is the same; the salt form affects absorption speed, not overall effectiveness.
Immediate-release diclofenac potassium can start relieving pain within 30–60 minutes. Enteric-coated or extended-release tablets may take longer to kick in, and topical gel can take several days of regular use for full benefit.
Doses vary by formulation and indication, but oral regimens often total 75–150 mg per day in divided doses or extended-release once daily. Always use the lowest effective dose for the shortest time, and follow product-specific directions for topical gel (e.g., measured grams per joint, up to daily maximums).
Yes. Taking diclofenac with food or milk can reduce stomach upset, though it may slightly delay absorption. Do not crush or chew enteric-coated or extended-release tablets.
Upset stomach, heartburn, nausea, headache, dizziness, and fluid retention are common. Skin irritation can occur with topical gel. Most effects are mild and temporary, but report persistent or severe symptoms.
Diclofenac can cause gastrointestinal bleeding or ulcers, kidney problems, elevated liver enzymes, fluid retention, high blood pressure, severe skin reactions, and increased risk of heart attack or stroke. Avoid use right before or after coronary artery bypass graft (CABG) surgery and in people with known NSAID allergies.
People with a history of NSAID-induced asthma or severe allergic reactions, active GI bleeding or ulcers, severe heart failure, advanced kidney disease, or late pregnancy should generally avoid it. Discuss risks if you have liver disease, cardiovascular disease, high blood pressure, or a history of GI problems.
Risky combinations include anticoagulants (e.g., warfarin), antiplatelets (aspirin, clopidogrel), SSRIs/SNRIs, corticosteroids, other NSAIDs, certain blood pressure medicines (ACE inhibitors/ARBs/diuretics), lithium, methotrexate, and cyclosporine/tacrolimus. Alcohol increases GI bleeding risk. Always review your medication list with a clinician.
Chronic use carries higher risks (GI, cardiovascular, kidney, liver). If long-term therapy is needed, use the lowest effective dose, consider gastroprotection (e.g., PPI) in at-risk patients, and schedule periodic monitoring.
Yes. Like many NSAIDs, diclofenac may raise the risk of heart attack and stroke, especially at higher doses and with prolonged use. Those with cardiovascular disease or risk factors should discuss alternatives or protective strategies.
People at risk should have kidney function, blood pressure, and liver enzymes checked, especially in the first months of therapy and periodically during long-term use. Report symptoms like dark urine, jaundice, swelling, or shortness of breath promptly.
Yes, acetaminophen can usually be combined with diclofenac for additional pain relief because it works by a different mechanism and lacks NSAID side effects. Do not combine diclofenac with other NSAIDs unless instructed by a clinician.
Topical gel delivers the medicine to the local area with much lower bloodstream levels, reducing systemic risks like GI bleeding and cardiovascular events. It’s a good option for localized osteoarthritis, especially in older adults or those with comorbidities.
NSAIDs can temporarily affect ovulation and may reduce fertility while you’re taking them. This effect is reversible when the medication is stopped.
If you take diclofenac on a schedule, take the missed dose when remembered unless it’s close to the next dose; don’t double up. If you use it as needed, simply take it when pain occurs, within prescribed limits.
Store at room temperature away from moisture and heat. Keep topical gel capped, and keep all forms out of reach of children and pets.
Some people experience dizziness or drowsiness. Until you know how it affects you, use caution with driving or operating machinery.
Alcohol increases the risk of stomach irritation and bleeding with NSAIDs. If you drink, do so sparingly and avoid binge drinking; people with a history of ulcers or GI bleeding should avoid alcohol while using diclofenac.
Avoid diclofenac in the third trimester due to risks of fetal kidney problems, low amniotic fluid, and premature closure of the ductus arteriosus. From 20 weeks onward, most NSAIDs are discouraged; earlier use should be only if clearly needed and under medical advice. Topical forms also have systemic absorption.
Diclofenac appears in very low levels in breast milk and is generally considered compatible with breastfeeding when used at standard doses. Avoid applying topical gel to the breast, and prevent infant skin contact with treated areas.
Yes, many surgeons recommend stopping NSAIDs several days before procedures to lower bleeding risk; timing varies by operation and formulation. Follow your surgeon or dentist’s specific instructions.
Use diclofenac cautiously or consider alternatives. If it’s necessary, combine with gastroprotection (e.g., a proton pump inhibitor), avoid alcohol and smoking, and consider topical diclofenac to lower GI risk.
Those with aspirin-exacerbated respiratory disease (AERD) or NSAID-sensitive asthma should avoid diclofenac due to risk of bronchospasm. Others with asthma should use it cautiously and stop if wheezing or breathing symptoms worsen.
NSAIDs can reduce kidney blood flow and worsen renal function, particularly in dehydration or with ACE inhibitors/ARBs/diuretics. Many patients with chronic kidney disease should avoid diclofenac or use it only under close supervision with monitoring.
Diclofenac can raise blood pressure and cardiovascular risk. If you have heart disease or risk factors, discuss safer options, consider topical formulations, and use the lowest effective dose for the shortest possible duration.
Try to avoid taking diclofenac after binge drinking because the combined effect increases the chance of gastritis and GI bleeding. If pain relief is needed, consider non-NSAID options such as acetaminophen within safe dosing limits, provided you are not drinking further and have no liver disease.
Do not apply topical diclofenac to open wounds, infected skin, or immediately after dermatologic procedures. Wait until the skin barrier has healed and your clinician says it’s safe.
Both are NSAIDs, but diclofenac is often considered slightly more potent for inflammation at prescription doses, while ibuprofen is widely used OTC with a strong safety record at low doses. Diclofenac may carry higher cardiovascular and liver enzyme elevation risks; ibuprofen may require more frequent dosing.
Naproxen lasts longer (twice-daily dosing) and may have a more neutral cardiovascular risk profile. Diclofenac can act faster in immediate-release forms and may be preferred for targeted anti-inflammatory effect, but can carry higher CV risk; GI risks are present with both.
Celecoxib is more COX-2 selective, which generally lowers GI ulcer risk compared with diclofenac, especially without a PPI. However, COX-2 selectivity can carry cardiovascular risk; choice depends on your GI and heart risk and response.
Meloxicam is once daily and relatively COX-2 preferential, with potentially fewer GI side effects for chronic use. Diclofenac may provide faster relief for acute flares; meloxicam can be a steadier option for ongoing arthritis.
Ketorolac is very potent for short-term acute pain and is limited to a maximum of 5 days due to high risks of GI bleeding and kidney injury. Diclofenac is used for both acute and chronic conditions with more flexible dosing but still shares NSAID risks.
Indomethacin is powerful for inflammatory conditions like gout and pericarditis but commonly causes CNS side effects (headache, dizziness). Diclofenac tends to be better tolerated, with similar anti-inflammatory effectiveness for many musculoskeletal conditions.
Aspirin is unique for its irreversible antiplatelet effect and is used at low doses for cardiovascular protection, not routine pain control due to bleeding risk. Diclofenac is preferred for pain and inflammation, but coordinate timing if you take low-dose aspirin so the antiplatelet effect isn’t reduced.
Etodolac is relatively COX-2 selective and may have a gentler GI profile for chronic therapy. Efficacy for arthritis is comparable; the choice often depends on individual tolerance, dosing convenience, and comorbidities.
Piroxicam has a very long half-life (once daily) but carries higher GI toxicity and risk of serious skin reactions. Diclofenac generally offers a better safety balance for most patients.
Nabumetone is a prodrug, usually given once daily, and may be easier on the stomach than some traditional NSAIDs. Diclofenac may act faster and provide stronger anti-inflammatory effects in some cases; both carry class risks.
Both are traditional NSAIDs; ketoprofen may cause more photosensitivity and is less commonly used in some regions. Diclofenac has robust topical options (gel/patch) with lower systemic exposure.
Aceclofenac is closely related and metabolized to diclofenac; some studies suggest similar efficacy with potentially improved GI tolerability. Availability varies by country.
Etoricoxib is a COX-2 selective NSAID with lower GI ulcer risk but a higher cardiovascular risk signal. Diclofenac is less selective and may pose intermediate GI and CV risks; patient risk profile guides the choice.
Oral forms treat widespread or deep-seated inflammation but carry more systemic risks. Topical gel targets localized joints with fewer systemic side effects, making it a safer first-line option for hand and knee osteoarthritis.
