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|Trade names||Cataflam, Voltaren, others |
|Pregnancy category||AU: C US: C (Risk not ruled out) in 1st and 2nd trimester, D in 3rd trimester|
|Routes of administration||By mouth, rectal, intramuscular, intravenous (renal- and gallstones), topical|
|ATC code||D11AX18 ( WHO ) M01AB05 ( WHO ), M02AA15 ( WHO ), S01BC03 ( WHO )|
|Legal status||AU: S2 (Pharmacy only) – S4, UK: POM (Prescription only) (P for topical formulation), ℞-only in most preparations/countries, limited OTC in some countries, manufacture and veterinary use is banned in India, Nepal, and Pakistan due to imminent extinction of local vultures|
|Protein binding||More than 99%|
|Metabolism||Liver, oxidative, primarily by CYP2C9, also by CYP2C8, CYP3A4, as well as conjugative by glucuronidation (UGT2B7) and sulfation;  no active metabolites exist|
|Elimination half-life||1.2–2 hr (35% of the drug enters enterohepatic recirculation)|
|Excretion||40% biliary 60% urine|
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As given samples for my severe tennis elbow, didn t feel ANY type of relief; even a tiny bit would have helped.The concomitant use of diclofenac with other NSAIDs or salicylates is not recommended.
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Additionally, fluid retention and edema have been observed in some patients treated with NSAIDs. Use of diclofenac may blunt the CV effects of several therapeutic agents used to treat these medical conditions e.Of the 211 patients treated with diclofenac sodium gel.
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Inform patient to wash his/her hands after use, unless the hands are the treated joint. If diclofenac sodium topical gel is applied to the han s for treatment; inform patient not to formulation of diclofenac the treated han s for at least 1 hour after the application.Hepatic Impairment: Hepatic metabolism accounts for almost 100% of VOLTAREN formulation of diclofenac, so patients with hepatic disease may require reduced formulations of diclofenac of VOLTAREN compared to patients with normal hepatic function.
Voriconazole: When co-administered with voriconazole inhibitor of CYP2C9, 2C19 and 3A4 enzyme the Cmax and AUC of diclofenac increased by 114% and 78% respectively see DRUG INTERACTIONS Aspirin: When NSAIDs were administered with aspirin, the protein binding of NSAIDs were reduced, although the clearance of free NSAID was not altered.
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