medicationPrescription only (US)OTC supplementDiclofenac is FDA-approved as an oral, topical gel, and ophthalmic NSAID; low-dose OTC formulations (e.g., Voltaren Arthritis Pain gel) exist for topical useRectal suppository formulations used in the cited ERCP-prevention trials are not the typical US retail form
DiclofenacBenefits, Dosage & Interactions
Also known as: Voltaren
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used to reduce pain, inflammation, and fever. It is commonly prescribed for conditions such as arthritis, musculoskeletal injuries, and menstrual pain. It is typically taken with a meal. Dose, response, and interaction risk vary by individual, so use should be reviewed with a clinician.
Researched by DoseRoutine R&D TeamReviewed for accuracy by Nicholas Alexander, RSELast updated
Evidence: Strong — 2 human randomized trials and regulatory approval on file.
Evidence strengthStrong · 4/4
PreclinicalStrong human evidence
2 human randomized trials and regulatory approval on file.
Plasma half-life
Not established
Typical timing
with meal
Food rule
with food
Default unit
mg
What published protocols report
Ranges documented in the literature, shown for reference. DoseRoutine does not recommend an amount — your prescriber or the product label sets the dose.
- Reported amounts
- Rectal suppository doses of 100 mg used prophylactically before ERCP, and oral/injectable NSAID regimens studied for acute pancreatitis and chronic low back and musculoskeletal pain[1][2][3][4]
- Route studied
- Oral, rectal (suppository), and topical gel formulations, depending on the indication studied[1][2][3][4]
Reported for Diclofenac in the cited sources. Published ranges are not dosing advice.
References & evidence
Documents the Diclofenac entry is written from. Each number matches an inline marker above.
- [1]Rectal diclofenac versus indomethacin for prevention of post-ERCP pancreatitis (DIPPP): a multicentre, double-blind, randomised, controlled trialKang X, Xia M, Wang J, Wang X, Luo H, Qin W · Gut · 2025 · Peer-reviewed · PMID 40113243
- [2]Buprenorphine Versus Diclofenac for Pain Relief in Acute Pancreatitis: A Double-Blinded Randomized Controlled TrialSaini M, Samanta J, Kumar A, Choudhury A, Dhar J, Jafra A · Clinical Gastroenterology and Hepatology · 2024 · Peer-reviewed · PMID 37924855
- [3]Non-steroidal anti-inflammatory drugs for chronic low back painEnthoven WT, Roelofs PD, Deyo RA, van Tulder MW, Koes BW · The Cochrane Database of Systematic Reviews · 2016 · Peer-reviewed · PMID 26863524
- [4]Topical NSAIDs for chronic musculoskeletal pain in adultsDerry S, Conaghan P, Da Silva JA, Wiffen PJ, Moore RA · The Cochrane Database of Systematic Reviews · 2016 · Peer-reviewed · PMID 27103611
How to track Diclofenac doses
Tracking Diclofenac well takes four fields and a habit. Here is what to record so the log is still useful in three months.
- 1
Add the dose and unit
Log Diclofenac with its dose in mg so totals stay comparable over time — including days when you split the dose or skip it.
- 2
Set the time of day and food rule
Typical timing is with_meal. Take it with food, and record it that way so absorption stays consistent. Reminders fire at that time and can export to your calendar.
- 3
Check it against the rest of the stack
Run Diclofenac through the interaction checker against everything else in the routine — supplements, peptides, hormones and prescriptions — before it becomes a daily habit.
- 4
Log adherence, not intentions
Mark each dose taken, skipped or delayed as it happens. Weeks of honest logs are what make an adherence rate or a trend line meaningful; retrospective guessing is not.
- 5
Review against outcomes
Review Diclofenac alongside your logged metrics and any relevant blood work every few weeks before changing the dose, so the change is a response to data rather than to a good or bad day.
What to log each time
- Dose in mg
- Time of day and whether it was taken with food
- Taken / skipped / delayed
- Any side effects or notable changes
References & Evidence
Sources on this page that document Diclofenac dosing, timing and safety.
- [1]National Center for Biotechnology Information View source
Educational information only — not medical advice. Dose ranges vary by person, indication and prescriber.
What is Diclofenac?Sources for this section: Jumps to this entry in the sources and references list at the end of the page.
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used to reduce pain, inflammation, and fever. It is commonly prescribed for conditions such as arthritis, musculoskeletal injuries, and menstrual pain. Available in several forms, including oral tablets, topical gels, patches, and ophthalmic solutions, its application varies depending on the specific condition being treated. Diclofenac works by inhibiting the production of certain chemicals in the body that cause inflammation and pain. (PubChem)
Diclofenac was first synthesized in 1965 and has been in medical use since the early 1970s. It is a widely used medication globally due to its effectiveness in managing a variety of inflammatory and painful conditions. (DrugBank)
What does the research say about Diclofenac?
Tap a section to expand.
Diclofenac exerts its therapeutic effects primarily by inhibiting the enzyme cyclooxygenase (COX). There are two main isoforms of COX: COX-1 and COX-2. COX-1 is involved in maintaining normal physiological functions, such as protecting the stomach lining and promoting blood clotting. COX-2 is primarily induced during inflammatory processes and is responsible for the production of prostaglandins that mediate pain and inflammation. (NIH ODS)
Diclofenac is considered a non-selective NSAID, meaning it inhibits both COX-1 and COX-2 enzymes. By inhibiting COX-2, it reduces the synthesis of pro-inflammatory prostaglandins, leading to anti-inflammatory, analgesic (pain-relieving), and antipyretic (fever-reducing) effects. The inhibition of COX-1, however, can lead to some of the common side effects associated with NSAIDs, particularly those affecting the gastrointestinal tract and blood clotting. (FDA label)
Source for this section: Sources for How does Diclofenac work?: Jumps to this entry in the sources and references list at the end of the page.
Diclofenac is effective in managing a range of conditions characterized by pain and inflammation. Its primary benefits include:
* **Relief of Osteoarthritis Pain:** It helps reduce pain and stiffness in joints affected by osteoarthritis, improving mobility. (Cochrane)
* **Management of Rheumatoid Arthritis:** Diclofenac can alleviate pain, swelling, and tenderness associated with rheumatoid arthritis, improving joint function. (Cochrane)
* **Acute Pain Relief:** It is effective for short-term management of acute pain, such as sprains, strains, dental pain, and post-operative pain. (MedlinePlus)
* **Reduction of Inflammation:** Due to its anti-inflammatory properties, it can reduce swelling and inflammation in various musculoskeletal conditions. (PubChem)
* **Treatment of Ankylosing Spondylitis:** Diclofenac can significantly improve symptoms like back pain and stiffness in patients with ankylosing spondylitis. (Cochrane)
* **Menstrual Pain (Dysmenorrhea):** It is often used to relieve the discomfort and pain associated with menstrual cramps. (MedlinePlus)
* **Migraine Headaches:** Some formulations are specifically used for the acute treatment of migraine attacks. (FDA label)
* **Actinic Keratosis (Topical forms):** Topical diclofenac gel can be used to treat actinic keratosis, a precancerous skin condition. (NIH ODS)
Numerous clinical studies support the efficacy of diclofenac for its indicated uses. A systematic review and meta-analysis published in the Cochrane Database of Systematic Reviews evaluated diclofenac's effectiveness for osteoarthritis and rheumatoid arthritis, concluding that it provides significant pain relief and improves functional outcomes compared to placebo. Another Cochrane review found diclofenac to be effective for managing acute post-operative pain. The FDA has approved various diclofenac formulations based on rigorous clinical trial data demonstrating its safety and efficacy for specific conditions. The European Medicines Agency (EMA) has also assessed diclofenac, providing prescribing information and safety updates based on ongoing research and post-market surveillance.
Like all medications, diclofenac can cause side effects, though not everyone experiences them. Common side effects often involve the gastrointestinal system, while more serious effects, though less common, can occur:
**Common Side Effects (PubChem, MedlinePlus):**
* Nausea, vomiting, diarrhea, or constipation
* Stomach pain or discomfort
* Indigestion or heartburn
* Headache
* Dizziness
* Rash or itching
* Fluid retention (swelling in ankles, feet)
* Increased liver enzymes (may be detected in blood tests)
**Less Common but Serious Side Effects (FDA label, Mayo Clinic):**
* Gastrointestinal bleeding, ulcers, or perforation (symptoms include severe stomach pain, black, tarry stools, or vomit that looks like coffee grounds)
* Kidney problems or kidney failure (symptoms include decreased urination, swelling, fatigue)
* Cardiovascular events like heart attack or stroke (symptoms include chest pain, shortness of breath, weakness on one side of the body, slurred speech)
* High blood pressure
* Allergic reactions (e.g., hives, difficulty breathing, swelling of face/throat)
* Liver damage (symptoms include yellowing of skin/eyes, dark urine, severe nausea/vomiting)
* Asthma attacks in individuals with aspirin-sensitive asthma
* Skin reactions (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis, characterized by severe rash, blistering, and peeling skin)
This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Patients using diclofenac should be aware of several important warnings to minimize potential risks:
* **Cardiovascular Thrombotic Events:** NSAIDs, including diclofenac, may increase the risk of serious cardiovascular thrombotic events, myocardial infarction (heart attack), and stroke, which can be fatal. This risk may increase with duration of use. Patients with existing cardiovascular disease or risk factors for cardiovascular disease may be at greater risk. (FDA label)
* **Gastrointestinal Risk:** NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events. (FDA label)
* **Renal Effects:** NSAID use may result in new onset or worsening of existing renal impairment and can lead to acute renal failure. Caution is advised in patients with impaired renal function, heart failure, or dehydration. (NIH ODS)
* **Liver Effects:** Diclofenac has been associated with elevated liver enzymes and, in rare cases, severe liver injury, including fulminant hepatitis, liver necrosis, and liver failure. Liver function should be monitored during treatment. (FDA label)
* **Hypertension:** NSAIDs, including diclofenac, can lead to new onset of hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of cardiovascular events. Blood pressure should be monitored closely. (Mayo Clinic)
* **Fluid Retention and Edema:** Fluid retention and edema have been observed in some patients taking NSAIDs. Diclofenac should be used with caution in patients with fluid retention or heart failure. (MedlinePlus)
* **Serious Skin Reactions:** Diclofenac can cause serious skin adverse reactions such as exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. Discontinue diclofenac at the first appearance of skin rash or any other sign of hypersensitivity. (FDA label)
* **Anaphylactoid Reactions:** Patients with aspirin sensitivity (aspirin-induced asthma, urticaria, or other allergic-type reactions) should not take diclofenac due to the risk of cross-hypersensitivity reactions. (EMA SmPC)
* **Pregnancy:** Diclofenac should be avoided during the third trimester of pregnancy due to the risk of premature closure of the fetal ductus arteriosus and potential renal dysfunction in the fetus. (FDA label)
This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Diclofenac should not be used in individuals with the following conditions:
* **Known Hypersensitivity:** Individuals with a known allergy to diclofenac, aspirin, or other NSAIDs (which may manifest as asthma, urticaria, or allergic-type reactions after taking an NSAID). (FDA label)
* **Peri-operative Pain in Coronary Artery Bypass Graft (CABG) Surgery:** For the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery. (FDA label)
* **Severe Renal Impairment:** Patients with severe, uncontrolled kidney disease. (EMA SmPC)
* **Severe Hepatic Impairment:** Patients with severe, uncontrolled liver disease. (EMA SmPC)
* **Active Peptic Ulcer or Gastrointestinal Bleeding:** Patients with a current stomach ulcer, active bleeding from the stomach or intestines, or a history of recurrent peptic ulcers. (PubChem)
* **Inflammatory Bowel Disease:** In certain cases of active inflammatory bowel disease like Crohn's disease or ulcerative colitis, due to risk of exacerbation. (DrugBank)
* **Severe Heart Failure:** Patients with severe, uncontrolled heart failure. (EMA SmPC)
* **Third Trimester of Pregnancy:** Due to the risk of fetal harm. (FDA label)
This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Combining diclofenac with certain other medications can increase the risk of adverse effects or alter the effectiveness of either drug. It's crucial to inform your clinician about all medications and supplements you are taking.
* **Other NSAIDs (e.g., ibuprofen, naproxen, celecoxib):** Concurrent use significantly increases the risk of gastrointestinal bleeding, ulcers, and other adverse events without providing additional therapeutic benefit. (MedlinePlus)
* **Aspirin:** While low-dose aspirin is often used for cardiovascular protection, combining it with diclofenac can increase the risk of serious gastrointestinal events. If co-administration is necessary, careful monitoring is required. (FDA label)
* **Anticoagulants (e.g., Warfarin, Heparin):** Diclofenac can enhance the effects of anticoagulants, leading to an increased risk of bleeding. Close monitoring of coagulation parameters is essential. (NIH ODS)
* **Antiplatelet Agents (e.g., Clopidogrel):** Increased risk of gastrointestinal bleeding when co-administered with diclofenac. (Mayo Clinic)
* **Corticosteroids (e.g., Prednisone):** Concomitant use with diclofenac may increase the risk of gastrointestinal ulceration or bleeding. (FDA label)
* **Diuretics (e.g., Furosemide, Hydrochlorothiazide):** NSAIDs can reduce the natriuretic (salt-excreting) and diuretic effects of loop and thiazide diuretics. They can also increase the risk of renal insufficiency. (NIH ODS)
* **ACE Inhibitors and Angiotensin Receptor Blockers (ARBs):** Co-administration with diclofenac may lead to a deterioration of renal function, especially in elderly or dehydrated patients. This combination can also attenuate the blood pressure-lowering effect of these medications. (FDA label)
* **Beta-Blockers:** Diclofenac may reduce the antihypertensive effect of beta-blockers. (EMA SmPC)
* **Digoxin:** Diclofenac may increase serum concentrations of digoxin. Monitoring of digoxin levels is recommended. (NIH ODS)
* **Lithium:** Diclofenac may increase plasma lithium levels due to decreased renal clearance. Monitoring of lithium levels is advised. (MedlinePlus)
* **Methotrexate:** Diclofenac may increase plasma concentrations of methotrexate, potentially leading to methotrexate toxicity. Use with caution. (FDA label)
* **Cyclosporine and Tacrolimus:** Concurrent use with diclofenac may increase the risk of nephrotoxicity. (EMA SmPC)
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of gastrointestinal bleeding when combined with diclofenac. (Mayo Clinic)
This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.
Diclofenac is typically taken with food or milk to minimize gastrointestinal upset, as it is a non-steroidal anti-inflammatory drug (NSAID) known for potential stomach irritation. (FDA label) The exact timing and frequency (e.g., once daily, multiple times daily) will be user-directed and must be set by a licensed clinician, depending on the specific condition being treated, the formulation (e.g., immediate-release, extended-release), and individual patient factors. For acute pain, it might be taken as needed, while for chronic conditions like arthritis, it might be scheduled regularly. Topical forms are applied directly to the skin, and ophthalmic solutions are applied to the eye, as directed by a clinician. (NIH ODS)
Source for this section: Sources for When should you take Diclofenac?: Jumps to this entry in the sources and references list at the end of the page.
What interacts with Diclofenac?
| Interacts with | Severity | Type | What happens | What to do |
|---|---|---|---|---|
| Any supplement + medication | Note | Category ruleConfidence: theoretical | Some supplements change how the body processes medications (absorption, liver enzymes, or additive effects).Source pending | Specific pairs are checked against a licensed drug database and shown with their own severity. Always confirm with your provider or pharmacist. |
| Any vitamin + medication | Note | Category ruleConfidence: theoretical | Certain vitamins interact with specific medications (e.g., vitamin K with blood thinners).Source pending | Specific pairs are checked against a licensed source; confirm with your provider. |
Frequently asked questions about Diclofenac
Diclofenac is a medication. It is also known as Voltaren. What follows is drawn from peer-reviewed literature indexed on PubMed, FDA label text where a label exists, and NIH reference records.
Diclofenac is commonly discussed in the context of the goals discussed on its profile page. Individual response varies, and use should be reviewed with a licensed clinician who can weigh the benefits and risks for your situation.
For Diclofenac, it is typically taken with a meal and it is usually taken with food. Always follow the specific dose your clinician or the product label prescribes.
Diclofenac carries potential side effects and drug interactions, documented in NIH, Mayo Clinic, and FDA label sources. Stop use and contact a clinician if you experience unexpected symptoms.
Diclofenac is a medication, and interactions are possible with prescriptions, hormones, peptides and other supplements in the same routine. Because Diclofenac is usually taken with a meal, most avoidable conflicts come from what else lands in that same window. Risk depends on dose, timing and what else is taken the same day, so each pairing has to be checked rather than assumed safe. The free checker at https://doseroutine.com/interaction-checker covers Diclofenac with no sign-up.
Combining a medication like Diclofenac with TRT is usually a question of labs rather than a blanket yes or no: the ester, injection interval and any aromatase inhibitor all change the answer. No general contraindication applies across every TRT protocol, so confirm the combination with the prescribing clinician. See the free TRT interaction reference: https://doseroutine.com/trt-supplement-interactions
Each peptide class carries its own profile against Diclofenac: a healing peptide raises different questions than a GLP-1 agonist or a growth-hormone secretagogue. Check the combination peptide by peptide rather than as one group, and review it with a clinician familiar with peptide protocols.
Published frequency for Diclofenac varies by protocol and formulation, so the label or prescription is what sets it. It is typically taken with a meal. Most protocols have it taken with food. Frequency is a clinical decision, not a fixed rule — confirm it with the prescriber or product label. Comparison of apps that keep a schedule like this: https://doseroutine.com/best-dose-tracking-apps
The effect of a missed dose of Diclofenac depends on the protocol and formulation you are on. Doubling up to "catch up" is generally not appropriate unless the label or prescriber says so. Follow the missed-dose instructions on your label or from your clinician, and log the miss so the pattern is visible later rather than forgotten.
For Diclofenac the useful record is the dose, the time it was actually taken, and what else was taken in the same window. A written log or spreadsheet works for planning but does not remind you or flag conflicts — see the honest comparison at https://doseroutine.com/vs/spreadsheet and the wider roundup at https://doseroutine.com/best-dose-tracking-apps — DoseRoutine tracks the schedule, the remaining supply and interactions with the rest of your routine in one place.
Which studies looked at Diclofenac?
Peer-reviewed research indexed in PubMed. Each entry links to the original record.
- 1.Topical Diclofenac for Prevention of Capecitabine-Associated Hand-Foot Syndrome: A Double-Blind Randomized Controlled Trial(opens PubMed in a new tab)J Clin Oncol · 2024 · PMID 38412399 · https://pubmed.ncbi.nlm.nih.gov/38412399/
Sources cited on this page
Specific documents referenced by the numbered markers above. Each number matches the marker in the text.
- PubChem CID 5018304(opens in a new tab)National Center for Biotechnology Information · pubchem.ncbi.nlm.nih.gov/compound/5018304
Verify at
Publisher search links for Diclofenac. These are places to check the information — they are not citations, so they are not numbered.
- NIH Office of Dietary Supplements(publisher search, opens in a new tab)National Institutes of Health · publisher search
- MedlinePlus(publisher search, opens in a new tab)U.S. National Library of Medicine · publisher search
- Mayo Clinic(publisher search, opens in a new tab)Mayo Clinic · publisher search
- FDA-approved labeling (DailyMed)(publisher search, opens in a new tab)U.S. Food and Drug Administration · publisher search
- European Medicines Agency(publisher search, opens in a new tab)European Medicines Agency · publisher search
- Cochrane Library(publisher search, opens in a new tab)Cochrane · publisher search
- DrugBank(publisher search, opens in a new tab)DrugBank Online · publisher search
- PubMed literature search(publisher search, opens in a new tab)National Library of Medicine · publisher search
- Wikipedia entry(publisher search, opens in a new tab)Wikipedia · publisher search
DoseRoutine compiles summaries from publicly available scientific and regulatory references. Always verify important decisions with a licensed clinician. How we source and review this information.
What is the short answer on Diclofenac?
Plain-text summary, safe to quote verbatim:
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) used to reduce pain, inflammation, and fever. It is commonly prescribed for conditions such as arthritis, musculoskeletal injuries, and menstrual pain. It is typically taken with a meal. Dose, response, and interaction risk vary by individual, so use should be reviewed with a clinician.
Source: DoseRoutine — https://doseroutine.com/library/diclofenac
Cite this page
Using this in an article, AI answer, or research note? Please attribute:
DoseRoutine. (2026). Diclofenac — Overview, Benefits & Side Effects. Retrieved from https://doseroutine.com/library/diclofenac
What compounds are similar to Diclofenac?
Others in the medication category or studied for the same goals.