Also known as: Voltarol, Voltaren, Diclomax, Dicloflex, Econac, Motifene, diclofenac sodium, diclofenac gel
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) that eases pain and swelling in problems affecting joints, muscles and bones. It comes as tablets, capsules, suppositories, gels, plasters and patches. Like other NSAIDs it can irritate the stomach, and long-term or high-amount use carries small risks to the heart, circulation and kidneys, so it is not suitable for everyone.
Voltarol, Voltaren, Diclomax, Dicloflex, Econac, Motifene, diclofenac sodium, diclofenac gel
Usual preparations
Tablets, capsules, suppositories, gels, plasters and patches; injection (ampoules) also exists. The NHS says tablets and capsules are prescription only, while gel, patches and plasters for joint pain can be bought from pharmacies. (summary of the cited reference, not a prescription)
Onset and duration
Tablets and capsules take 20 to 30 minutes to work, while gels, plasters and patches usually take 1 to 2 days.
Monitoring
The prescriber reviews whether diclofenac is still needed, because the NHS advises the lowest amount that works for the shortest possible time and notes stomach, heart and kidney risks with long use.
Legal status differs between countries and can change; each row cites the document it was taken from and applies only to the country named.
What it is used for
Aches and pains, and problems with joints, muscles and bones, including arthritis, sprains and back pain
Migraines and pain after dental surgery
Gel, patches and plasters for joint pain, used on the area of the body that hurts
Children may be prescribed diclofenac for joint problems, with the type depending on their age
How it works in the body
Diclofenac is an NSAID and works by reducing hormones that cause inflammation and pain in the body. A gel, plaster or patch only works on the area of the body where it is put on.
Common side effects
Feeling sick and stomach ache are common; the NHS advises taking tablets with a meal or snack, or just after eating
With gels, skin reactions where the gel is applied are the most common side effect
Serious: seek help
Black poo, or yellowing of the skin or eyes, are warning signs the NHS lists, and prompt advice from a GP or NHS 111 is the route to take
Breathlessness with swollen legs can be a sign of heart failure and needs prompt advice from a GP or NHS 111
Chest pain or symptoms of a stroke need an emergency call to 999
Swelling of the lips, mouth, tongue or throat can be a serious allergic reaction and needs an immediate call to 999
Tablets and capsules can cause an ulcer in the stomach or gut after long use or in big amounts
There is a small risk of heart failure or kidney failure with the maximum amount taken for a long time
Cautions and interactions
Not suitable for people who have had an allergic reaction to diclofenac, aspirin or other NSAIDs
The NHS also lists asthma, a history of stomach ulcers or bleeding, high blood pressure, heart failure, severe liver or kidney disease, Crohn's disease or ulcerative colitis, lupus and blood clotting disorders as reasons it may not be suitable
NSAIDs other than aspirin may carry a higher risk of heart attack or stroke than not using them, and the risk of artery-clotting events may rise with higher amounts and longer use
UK product information for diclofenac lists established heart failure, ischaemic heart disease, peripheral arterial disease and cerebrovascular disease as contraindications
The NHS says diclofenac is not usually recommended in pregnancy, and a doctor may advise it only if the benefits outweigh the risks
The NHS says diclofenac can be used while breastfeeding, because only tiny amounts reach breast milk
Other medicines needing care include some antibiotics, anticoagulants such as warfarin, digoxin and blood pressure medicines
The NHS says diclofenac can be taken with paracetamol or codeine, but aspirin, ibuprofen or naproxen should not be combined with it without talking to a doctor
The NHS says herbal remedies and supplements lack enough information to show they are compatible with diclofenac
Drinking too much alcohol may irritate the stomach and raises the risk of a stomach ulcer
Interactions
Check interactions
Taking Diclofenac with other medicines? Add them to the checker to see what the official sources say about each pair: the mechanism, general management and monitoring, never a bare "safe".
Interactions documented in the official sources cited on each card. The list covers the medicines represented on this site and is not exhaustive; how the interaction data is compiled.
No pair records for this medicine are in the sources currently represented by Anatomy Nexus. Absence from this list does not mean no interaction exists.
As a member of NSAIDs
Records written for the whole nsaids class apply to Diclofenac.
Contraindicated or avoidOfficial guidance: avoid the combinationtherapeutic duplication
Taking ibuprofen with another NSAID (naproxen, diclofenac, celecoxib, high-dose aspirin) adds stomach, kidney and heart harm without extra pain relief.
Why it can occur
additive bleeding risk
What official information says
UK information advises not taking ibuprofen with similar painkillers such as aspirin or naproxen without talking to a pharmacist or doctor.
What to discuss with a clinician
Official UK information: one NSAID at a time.
Basis of the status
NHS: Taking ibuprofen with other medicines (do not take with similar painkillers)
Any NSAID (ibuprofen, naproxen, diclofenac, celecoxib, high-dose aspirin) with losartan can reduce its effect and cause acute kidney injury and hyperkalaemia.
Why it can occur
nephrotoxicity
What official information says
UK information advises telling a doctor before taking anti-inflammatory painkillers with losartan; the BNF advises monitoring renal function.
What to discuss with a clinician
Avoid regular use where possible; monitor kidney function and potassium if combined.
Therapeutic duplication. Two NSAIDs together (including aspirin at pain-relief doses, or an oral NSAID with a prescription NSAID such as naproxen) add gastrointestinal, kidney and cardiovascular harm without extra pain relief; UK information advises not taking ibuprofen with similar painkillers without advice. UK
Medicines that share the class of Diclofenac. They are separate medicines with their own licences, doses and interactions, not alternative names for Diclofenac.
Medicines often discussed alongside Diclofenac: used together, compared with it, or acting on the same problem by a different route.
Key facts
Fact
Detail
Type of medicine
A non-steroidal anti-inflammatory drug (NSAID) that reduces pain and swelling
Forms
Tablets, capsules, suppositories, gels, plasters and patches
UK brand names
Voltarol, Dicloflex, Diclomax, Econac and Motifene (as listed by the NHS)
Speed
Tablets and capsules 20 to 30 minutes; gels, plasters and patches 1 to 2 days
Main cautions
Stomach ulcers and bleeding, and heart, circulation and kidney risks, especially with long use
Emergency signs
Chest pain, stroke symptoms or swelling of the lips, tongue or throat need a 999 call
What is diclofenac used for?
Diclofenac is a non-steroidal anti-inflammatory drug, or NSAID, which means it reduces swelling and pain. The NHS describes it as a treatment for aches and pains, and for problems with joints, muscles and bones. These include arthritis, sprains, back pain, migraines and pain after dental surgery. Diclofenac comes as tablets, capsules, suppositories, gels, plasters and patches. The NHS says gels, patches and plasters are used for joint pain in a particular area of the body. Children may be prescribed diclofenac for joint problems, with the type depending on their age.
How does diclofenac work, and how quickly?
Diclofenac works by reducing hormones that cause inflammation and pain in the body. Tablets and capsules take about 20 to 30 minutes to start working. Gels, plasters and patches usually take 1 to 2 days. A gel, plaster or patch only works on the area where it is put on, and the NHS describes gels as treatment for pain in one area. For tablets and capsules the NHS advice is the lowest amount that works for the shortest possible time.
What are the side effects of diclofenac?
Feeling sick and stomach ache are common, and the NHS advises taking tablets with a meal or snack, or just after eating. With gels, skin reactions where the gel is applied are the most common problem. The NHS describes options for irritated skin that include using the gel less often or leaving it off until the irritation settles, and says to speak to a doctor if it does not go away. Black poo, or yellowing of the skin or eyes, are warning signs, and prompt advice from a GP or NHS 111 is the route to take. Breathlessness with swollen legs can be a sign of heart failure and also needs prompt advice from a GP or NHS 111. Chest pain or symptoms of a stroke need an emergency call to 999. Swelling of the lips, mouth, tongue or throat can be a serious allergic reaction, and this also needs an immediate 999 call.
Heart, circulation and stomach cautions
MedlinePlus says NSAIDs other than aspirin may have a higher risk of heart attack or stroke than not using them. UK product information says the risk of artery-clotting events such as heart attack or stroke may rise with higher amounts and longer use. The NHS lists high blood pressure and heart failure among reasons diclofenac may not be suitable. UK product information for diclofenac also lists established heart failure, ischaemic heart disease, peripheral arterial disease and cerebrovascular disease as contraindications. The NHS says tablets and capsules can cause an ulcer in the stomach or gut after long use or in big amounts, and MedlinePlus says NSAIDs may cause ulcers, bleeding or holes in the stomach or intestine. There is also a small risk of heart failure or kidney failure with the maximum amount taken for a long time.
Pregnancy, other medicines and alcohol
The NHS says diclofenac is not usually recommended in pregnancy, and a doctor may advise it only if the benefits outweigh the risks. The NHS says it can be used while breastfeeding, because only tiny amounts reach breast milk. The NHS says some antibiotics, anticoagulants such as warfarin, digoxin and blood pressure medicines need caution with diclofenac. It says diclofenac can be taken with paracetamol or codeine, but aspirin, ibuprofen or naproxen should not be combined with it without talking to a doctor. There is not enough information to show that herbal remedies and supplements are compatible with it. The NHS says drinking alcohol within the national guidelines is possible, but too much may irritate the stomach and raises the risk of an ulcer.
Frequently asked questions
Does diclofenac gel work as fast as tablets?
The NHS says tablets and capsules take 20 to 30 minutes to work, while gels, plasters and patches usually take 1 to 2 days. A gel, plaster or patch only works on the area where it is put on.
Can I drink alcohol while taking diclofenac?
The NHS says alcohol within the national guidelines is possible, but drinking too much may irritate the stomach. This raises the risk of a stomach ulcer, so a pharmacist or GP can advise if there are doubts.
Can diclofenac be taken with other painkillers?
The NHS says it can be taken with paracetamol or codeine. Aspirin, ibuprofen or naproxen should not be combined with it without talking to a doctor first.
Is long-term diclofenac a concern for the heart?
The NHS says there is a small risk of heart failure or kidney failure with the maximum amount taken for a long time. Anyone with chest pain or stroke symptoms needs an emergency call to 999.
Can diclofenac be used in pregnancy or while breastfeeding?
The NHS says diclofenac is not usually recommended in pregnancy, and a doctor may advise it only if the benefits outweigh the risks. The NHS says it can be used while breastfeeding, because only tiny amounts reach breast milk.
Connected pages in detail
What each linked page on Anatomy Nexus covers, in a line, for Diclofenac.
Conditions
OsteoarthritisThe commonest joint disease: progressive loss of articular cartilage with changes in the underlying bone, causing pain and stiffness.
Rheumatoid arthritisA chronic autoimmune disease in which the immune system attacks the synovial lining of joints.
MigraineA recurrent headache disorder with attacks of moderate to severe throbbing pain, typically one-sided, lasting 4 to 72 hours.
Peptic ulcerA break in the lining of the stomach or duodenum that extends through the mucosa, caused by acid acting on a weakened defence.
Heart failureA syndrome in which the heart cannot pump enough blood to meet the body's needs, or can do so only at raised filling pressures.
High blood pressure (hypertension)Persistently raised arterial pressure, usually defined as 140/90 mmHg or more in the clinic (135/85 on home readings).
Chronic kidney diseasePersistent reduction in kidney function (a filtration rate below 60 ml/min) or evidence of kidney damage such as protein in the urine.
IbuprofenA non-steroidal anti-inflammatory (NSAID) that eases pain, inflammation and fever by blocking prostaglandin production.
AspirinA low-dose antiplatelet that stops platelets clumping into clots, used long term after heart attacks and strokes.
ParacetamolThe first-line painkiller and fever reducer for most people (acetaminophen in North America).
OmeprazoleA proton pump inhibitor that switches off acid production in the stomach.
Drug classes
NSAIDsPainkillers that also reduce inflammation and fever: ibuprofen, naproxen, diclofenac and the COX-2 selective coxibs.
Educational content. Anatomy Nexus provides medical education and does not replace professional medical advice, diagnosis, treatment, prescribing or pharmacist review. Doses, choices and monitoring are decided by a prescriber for an individual; never start, stop or change a medicine on the basis of this page.
