What distinguishes diclofenac from the group of non-prescription painkillers is its speed of action. The active substance - diclofenac potassium is absorbed from the gastrointestinal tract within 15-30 minutes. In addition, there is a strong anti-inflammatory and analgesic effect blocking the production of proinflammatory prostaglandins. (It also has a strong antipyretic effect). Thanks to this, the drug quickly combats various pains, and its effect lasts from 4-6 hours.
General indications for the use of diclofenac:
Short-term treatment of pain and discomfort associated with muscle strain, post-traumatic and joint pain (including rheumatoid arthritis and osteoarthritis), extra-articular rheumatic diseases; painful menstruation and the treatment of migraine attacks with or without aura. Helpful for severe ear, nose and throat infections.
The safety of diclofenac
The drug used in accordance with the indications is safe especially because in the over-the-counter preparation the amount of active substance is several times smaller than in prescription medicines. However, as with other non-steroidal anti-inflammatory drugs, the contraindications from the medicine leaflet should be strictly adhered to. Note - taking the drug during or after a meal prolongs its duration in the digestive tract, therefore it is recommended to take the drug before or between meals.
Do not take Diclofenac, even in small doses if:
- peptic ulcer of the stomach and duodenum
- there is blood in the stool or black stool
- you have or have had an allergic reaction or an attack of asthma after using diclofenac or another analgesic and antipyretic medication such as acetylsalicylic acid, ibuprofen
- you are allergic to any of the auxiliary components of the medicine (see section "Drug composition")
Note: You should inform the physician or pharmacist of the above-mentioned diseases
Special care should be taken when using diclofenac if:
- in the past, after the use of analgesics, anti-inflammatory, there were: stomach and intestinal diseases, abdominal pain, heartburn
- asthma, abnormal heart, liver or kidney function
- you have elevated blood pressure
- blood coagulation disorders or other blood disorders such as hepatic porphyria
Before using the medication should be informed about the occurrence of the above-mentioned diseases of the doctor or pharmacist.
Undesirable effects of chronic use of the drug on the gastrointestinal tract
- the risk of gastric or duodenal ulcer disease activation and consequent gastrointestinal bleeding (tarry stools, anemia),
- indigestion, belching,
- epigastric pain,
- bloating, winds, sometimes diarrhea or constipation,
- nausea, lack of appetite
Contraindications to the use of diclofenac:
Hypersensitivity to the preparation or other similar non-steroidal anti-inflammatory drugs (NSAIDs), peptic ulcer of the stomach or duodenum, ulcerative colitis, aspirin-induced asthma. Caution is given to analgesics in people with impaired liver function, kidney failure, porphyria, haemostatic disorders and elderly patients. In people receiving NSAIDs, serious gastrointestinal side effects (bleeding, ulceration, and gastrointestinal perforation) may occur at any time during treatment and may not be preceded by any symptoms; the risk of bleeding increases with increasing the duration of treatment.
Pregnancy and breast-feeding and the use of diclofenac
During pregnancy and breastfeeding - before taking diclofenac - in small non-prescription doses - you should consult your doctor or pharmacist. It is especially important not to use the medicine during the last three months of pregnancy! Also, it is not recommended for breastfeeding.
Diclefenac poses a risk of drug-related interactions - so if you buy a prescription medication, tell your doctor or pharmacist if you are taking or have recently taken any other medicines:
- anticoagulants (blood thinners, e.g. acenocoumarol, warfarin)
- preparations containing lithium (a medicine used in psychiatry)
- digoxin (a medicine used to treat heart disease)
- methotrexate (a medicine used to treat certain types of cancer)
- cyclosporin (a medicine used in transplant patients)
- oral antidiabetic medicines
- diuretics (medicines increasing the amount of urine)
- certain anti-infectives (quinolones)
- other analgesics (acetylsalicylic acid, ibuprofen)
The risk of cardiovascular events
In the case of diclofenac, like other similar non-steroidal anti-inflammatory drugs, some experts say that they may increase the risk of heart attack or stroke, especially during long-term use and in people with cardiovascular disease. However, they recognize that short-term use in the treatment of acute pain probably does not increase the risk of these cardiovascular adverse events, especially if the drug is used at a low dose.
Support for pain management
To support painkillers, in addition:
- sedatives,
- betamimetics, direct sprays and calcium channel blockers.
- less frequently used alternative treatments for headaches and other types of pain include acupuncture, acupressure, hypnosis and psychotherapy.
ed. Edward Ozga Michalski, MA
internal medicine consultation med. Ewa Pakuła internist
neurological consultation med. Tomasz Rosochowicz
Literature
1. "Menstrual pain and ways to fight it"; Dr Marek Marcyniak, gynecologist-obstetrician; II Chair and Clinic of Gynecology and Obstetrics at the Medical Academy in Warsaw, publ. Internet http://www.mediweb.pl/womens.
2. 30 years after the discovery of John Vane: what we know about the mechanisms of action of non-steroidal anti-inflammatory drugs
3. Drugs used in rheumatology and cardiovascular system - PhD. Biol., Lek. med. Ryszard Międzybrodzki1, med. Jerzy Świerkot, prof. dr hab. ed. Jacek Szechiński - Institute of Immunology and Experimental Therapy of the Polish Academy of Sciences in Wrocław; REUMATOLOGY - Trapia - MARCH 2005
4. "Oncology" - a textbook for students and physicians edited by Radzisław Kordek, Jacek Jassema, Maciej Krzakowski and Arkadiusz Jeziorski, Medical Press, Gdańsk, 2003
5. Encyclopedia of Practical Medicine ONLINE, PHARMINDEX
