Diclofenac tablets, capsules and suppositories

Dosage

You'll usually take diclofenac tablets, capsules or suppositories 2 to 3 times a day.

The usual dose is 75mg to 150mg a day, depending on what your doctor prescribes for you. Follow your doctor's advice on how many tablets to take, and how many times a day.

If your doctor prescribes diclofenac for your child, they'll use your child's weight to work out the right dose for them.

If you have pain all the time, your doctor may recommend slow-release diclofenac tablets or capsules. You'll usually take these either once a day in the evening, or twice a day. If you're taking slow-release diclofenac twice a day, leave a gap of 10 to 12 hours between your doses.

How to take tablets and capsules

Swallow diclofenac tablets or capsules with a drink of milk. If you need to take them with water, take them after a meal or snack. Taking them with milk or food means they'll be less likely to upset or irritate your stomach.

Swallow them whole, do not crush, break or chew them.

How to use suppositories

Suppositories are medicine that you push gently into your anus (bottom).

1. Go to the toilet beforehand if you need to.
2. Wash your hands before and after using the medicine. Also clean around your anus with mild soap and water, rinse and pat dry.
3. Unwrap the suppository.
4. Gently push the suppository into your anus with the pointed end first. It needs to go in about 3 centimetres (1 inch).
5. Sit or lie still for about 15 minutes. The suppository will melt inside your anus. This is normal.

Diclofenac gel

Dosage

You'll usually use the gel 2 to 4 times a day, depending on how strong it is. Check the packaging for more information or speak to your pharmacist.

If you're using the gel twice a day, use it once in the morning and once in the evening. If you're using it 3 or 4 times a day, wait at least 4 hours before putting on any more.

The amount of gel you need depends on the size of the area you want to treat. You'll usually use an amount about the size of a 1 penny or 2 pence piece (2 to 4 grams).

How to use the gel

1. Gently squeeze the tube, or press firmly and evenly on the nozzle of the dispenser, to get a small amount of gel.
2. Put the gel on the painful or swollen area and slowly rub it in. It may feel cool on your skin. Wash your hands afterwards.
   

   It's safe to take diclofenac with paracetamol or codeine.

   Do not take diclofenac with similar painkillers, like aspirin, ibuprofen or naproxen, without talking to a doctor.

   Diclofenac, aspirin, ibuprofen and naproxen all belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). Taking diclofenac together with other NSAIDs may increase your chances of getting side effects like a stomach ache.

   NSAIDs are also used in medicines you can buy from pharmacies, such as cough and cold remedies.

   Side effects

   Like all medicines, diclofenac can cause side effects, although not everyone gets them.

   Common side effects

   Common side effects of diclofenac tablets, capsules and suppositories happen in more than 1 in 100 people.

   Talk to your doctor or pharmacist if these side effects bother you or do not go away:

   • feeling sick (nausea)
   • being sick (vomiting) or diarrhoea
   • feeling dizzy or vertigo
   • headaches
   • stomach ache, wind or loss of appetite
   • mild rash

   You're less likely to have side effects with diclofenac gel or plasters. This is because less medicine gets into your body. But you may still get the same side effects, especially if you use a lot on a large area of skin.

   Using diclofenac gel or plasters can affect your skin. It can make your skin:

   • more sensitive to sunlight than normal
   • develop a rash where you applied the gel or plaster
   • dry or irritated (eczema)
   • itchy or inflamed (dermatitis)

   Serious side effects

   These serious side effects are rare and happen in less than 1 in 1,000 people.

   Call your doctor straight away if:

   • you have blood in your vomit or black poo – these could be signs of bleeding in your stomach or gut
   • you have severe indigestion, heartburn or stomach pain, vomiting or diarrhoea – these can be signs of an ulcer or inflammation in your stomach or gut
   • the whites of your eyes or your skin turn yellow, although this may be less obvious on brown or black skin – this can be a sign of liver problems
   • you have a raised, itchy rash, or swollen or puffy skin – these can be signs of hives (urticaria) or oedema(swelling)
   • you have breathlessness, tiredness and swollen legs or ankles – these can be signs of heart failure               
           Contraindications
   • Asthma
     Anaphylaxis
     Edema
     Hypertension
     Gastrointestinal bleeding

     Serious skin reactions

     Thrombosis

     Hematologic toxicity

     Hepatotoxicity

     Renal toxicity

     Avoid concomitant use of nsaids

      

     Preterm birth

     Hyperglycemia

     Laboratory monitoring

     Fever