Nonsteroidal anti-inflammatory drug
"Diclo" redirects here. For the organic solvent sometimes called Di-clo, see
Dichloromethane .
Diclofenac Trade names Cataflam, Voltaren, Zipsor, others [ 1] AHFS /Drugs.com Monograph MedlinePlus a689002 License data
Pregnancy category Routes of administration By mouth , rectal , intramuscular , intravenous , topical ATC code Legal status
AU : S4 (Prescription only) / S3 / S2
CA : ℞-only [ 4]
UK : POM (Prescription only) / P / GSL
US : WARNING [ 3] Rx-only / OTC[ 5]
In general: ℞ (Prescription only)
Protein binding More than 99% Metabolism Liver, oxidative, primarily by CYP2C9 , also by CYP2C8 , CYP3A4 , as well as conjugative by glucuronidation (UGT2B7 ) and sulfation ;[ 9] no active metabolites exist Onset of action Within 4 hours (gel),[ 6] 30 min (non-gel)[ 7] Elimination half-life 1.2–2 h (35% of the drug enters enterohepatic recirculation) Excretion 35% bile , 65% urine [ 8]
[2-(2,6-Dichloroanilino)phenyl]acetic acid
CAS Number PubChem CID IUPHAR/BPS DrugBank ChemSpider UNII KEGG ChEBI ChEMBL PDB ligand CompTox Dashboard (EPA ) ECHA InfoCard 100.035.755 Formula C 14 H 11 Cl 2 N O 2 Molar mass 296.15 g·mol−1 3D model (JSmol )
O=C(O)Cc1ccccc1Nc2c(Cl)cccc2Cl
InChI=1S/C14H11Cl2NO2/c15-10-5-3-6-11(16)14(10)17-12-7-2-1-4-9(12)8-13(18)19/h1-7,17H,8H2,(H,18,19)
Y Key:DCOPUUMXTXDBNB-UHFFFAOYSA-N
Y
N Y (what is this?) (verify)
Diclofenac (pronounced [ 1] or [ 10] ), sold under the brand name Voltaren , among others, is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammatory diseases such as gout .[ 7] It is taken by mouth or rectally in a suppository, used by injection, or applied to the skin.[ 7] [ 11] Improvements in pain last for as much as eight hours.[ 7] It is also available in combination with misoprostol in an effort to decrease stomach problems.[ 12]
Common side effects include abdominal pain , gastrointestinal bleeding , nausea, dizziness, headache, and swelling.[ 7] Serious side effects may include heart disease , stroke , kidney problems , and stomach ulceration .[ 12] [ 7] Use is not recommended in the third trimester of pregnancy .[ 7] It is likely safe during breastfeeding .[ 12] Diclofenac is believed to work by decreasing the production of prostaglandins , like other drugs in this class.[ 13]
In 2021, diclofenac was the 61st most commonly prescribed medication in the United States, with more than 11 million prescriptions.[ 14] [ 15] It is available as its acid or in two salts, as either diclofenac sodium or potassium.[ 12]
It is also widely used for livestock; such use was responsible for the Indian vulture crisis , during which in a few years 95% of the country's vulture population was killed, and in many countries agricultural use is now forbidden.[ 16] [ 17] [ 18] [ 19]
^ a b Cite error: The named reference tn
was invoked but never defined (see the help page ).
^ "Diclofenac Use During Pregnancy" . Drugs.com . 16 January 2000. Retrieved 18 February 2024 .
^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)" . nctr-crs.fda.gov . FDA . Retrieved 22 October 2023 .
^ "Product monograph brand safety updates" . Health Canada . 6 June 2024. Retrieved 8 June 2024 .
^ "FDA Approves Three Drugs for Nonprescription Use Through Rx-to-OTC Switch Process" . Food and Drug Administration . 14 February 2020. Retrieved 18 February 2024 . This article incorporates text from this source, which is in the public domain .
^ "How Long Does It Take for Voltaren Gel to Work?" . YouDrugstore . Retrieved 18 February 2024 .
^ a b c d e f g "Diclofenac epolamine Monograph for Professionals" . Drugs.com . Retrieved 18 February 2024 .
^ Williams BS, Buvanendran A (1 January 2011). "Nonopioid analgesics: NSAIDs, COX-2 inhibitors, and acetaminophen" . In Benzon HT, Raja SN, Liu SS, Fishman SM (eds.). Essentials of Pain Medicine (3 ed.). W.B. Saunders. pp. 130–139. doi :10.1016/b978-1-4377-2242-0.00026-2 . ISBN 978-1-4377-2242-0 . Archived from the original on 10 January 2023. Retrieved 10 January 2023 .
^ Sayyad M (23 August 2018). "Diclofenac Oral Uses, Dosage, Side Effects And Composition" . Medicine Reviews Agency. Archived from the original on 24 August 2018. Retrieved 18 February 2024 .
^ O'Toole MT, ed. (2017). Mosby's Dictionary of Medicine, Nursing & Health Professions (10th ed.). Elsevier. p. 536. ISBN 978-0-323-22205-1 .
^ Chung CH (2017). "The use of Injectable Nonsteroidal Anti-Inflammatory Drugs in Local Accident & Emergency Practice". Hong Kong Journal of Emergency Medicine . 9 (2): 65–71. doi :10.1177/102490790200900201 . S2CID 74032271 .
^ a b c d British national formulary : BNF 74 (74 ed.). British Medical Association. 2017. pp. 1033–1035. ISBN 978-0-85711-298-9 .
^ Mosby's Drug Reference for Health Professions . Elsevier Health Sciences. 2017. p. 398. ISBN 978-0-323-56682-7 .
^ "The Top 300 of 2021" . ClinCalc . Archived from the original on 15 January 2024. Retrieved 14 January 2024 .
^ "Diclofenac – Drug Usage Statistics" . ClinCalc . Retrieved 18 February 2024 .
^ Cuthbert RJ, Taggart MA, Prakash V, Chakraborty SS, Deori P, Galligan T, et al. (2014). "Avian scavengers and the threat from veterinary pharmaceuticals" . Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences . 369 (1656): 20130574. doi :10.1098/rstb.2013.0574 . PMC 4213586 . PMID 25405963 .
^ Cite error: The named reference Moreno2021
was invoked but never defined (see the help page ).
^ European Medicines Agency, Committee for Medicinal Products for Veterinary Use, Opinion of the Committee pursuant to Article 30(3) of Regulation (EC) No 726/2004 on the risk to vultures and other necrophagous bird populations in the European Union in connection with the use of veterinary medicinal products containing the substance diclofenac (PDF) , EMA/CVMP/761582/2014, archived (PDF) from the original on 7 July 2022, retrieved 16 April 2022
^ McKie R (11 April 2021). "Rare European vultures being poisoned by livestock drug" . The Guardian . Archived from the original on 16 April 2022. Retrieved 16 April 2022 . ...diclofenac has already been banned in India, Pakistan, Nepal and Bangladesh