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diclofenac

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Brand names: Voltaren, Cataflam

Nonsteroidal Anti-Inflammatory Drug (NSAID) OTC

Diclofenac is a gel that helps with arthritis pain in your hands, wrists, elbows, feet, ankles, or knees. It belongs to a class of drugs called NSAIDs.

Drug Pricing (NADAC)

Generic Price

$1.44/unit

Generic Available

Yes (55 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

This medicine temporarily relieves arthritis pain.

Common side effects

Pain, Headache

Key warnings

There are no boxed warnings in the provided data.

How It Works

Diclofenac is an NSAID. It reduces pain and swelling by blocking substances in the body that cause inflammation.

How to Take It

Use this medicine up to 21 days, unless your doctor tells you otherwise. Do not use it for strains, sprains, bruises, or sports injuries. Apply the gel 4 times a day, every day. Use the dosing card to measure the correct amount. For upper body areas (hand, wrist, elbow) use 2.25 inches (2 grams). For lower body areas (foot, ankle, knee) use 4.5 inches (4 grams). Apply to clean, dry skin without cuts, wounds, infections, or rashes. Do not use with heat or bandages.

Pregnancy & Breastfeeding

There is no information about pregnancy or breastfeeding in the provided data.

Missed Dose

Apply the gel as soon as you remember. Do not apply extra gel to make up for the missed dose.

Storage

Store at room temperature (68-77°F). Do not freeze.

Side Effects (from patient reports)

Based on 96,761 FDA adverse event reports.

Medicine not working
13,689
Pain
12,281
Tiredness
11,317
Rheumatoid arthritis
9,240
Rash
8,747
Joint pain
8,640
Using the medicine for something it's not approved for
8,614
Stomach upset
8,482
Hair loss
8,041
Systemic lupus erythematosus
7,710

FDA Adverse Event Report Analysis

Detailed analysis of 82,165 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2001–2025.

Total Reports

82,165

Death-Related Reports

10,052

Hospitalization Reports

30,047

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 49,189 (68%)
Male 23,059 (32%)

Age Distribution

0–17 1,369
18–44 14,899
45–64 19,381
65–74 9,509
75+ 7,768

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DRUG INEFFECTIVE 13,688
2 PAIN 12,281
3 FATIGUE 11,317
4 RHEUMATOID ARTHRITIS 9,241
5 RASH 8,747
6 ARTHRALGIA 8,640
7 OFF LABEL USE 8,614
8 ABDOMINAL DISCOMFORT 8,483
9 ALOPECIA 8,041
10 SYSTEMIC LUPUS ERYTHEMATOSUS 7,710
11 JOINT SWELLING 7,709
12 PEMPHIGUS 7,542
13 GLOSSODYNIA 7,315
14 SWELLING 7,266
15 ARTHROPATHY 7,065

Reactions in Death Reports

OFF LABEL USE 2,418
GENERAL PHYSICAL HEALTH DETERIORATION 2,274
RHEUMATOID ARTHRITIS 2,257
SYSTEMIC LUPUS ERYTHEMATOSUS 2,257
FATIGUE 2,248
GLOSSODYNIA 2,230
RASH 2,226
HYPERTENSION 2,224
JOINT SWELLING 2,208
INFUSION RELATED REACTION 2,194

Reactions in Hospitalization Reports

FATIGUE 4,087
PAIN 3,989
VOMITING 3,727
ARTHRALGIA 3,709
OFF LABEL USE 3,619
DRUG INEFFECTIVE 3,361
NAUSEA 3,349
DYSPNOEA 3,338
ABDOMINAL DISCOMFORT 3,311
RASH 3,263

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

There are no boxed warnings in the provided data.

Known Drug Interactions

moderate misoprostol

7 DRUG INTERACTIONS See Table 1 for clinically significant drug interactions with diclofenac and misoprostol. Table 1: Clinically Significant Drug Interactions with Diclofenac and Misoprostol Drugs That Interfere with Hemostasis Clinical Impact: Diclofenac and anticoagulants such as warfarin have a synergistic effect on bleeding. The concomitant use of diclofenac and anticoagulants have an increased risk of serious bleeding compared to the use of either drug alone.

Mechanism: Diclofenac can increase the risk of serious bleeding in the stomach. Misoprostol is used with it to help protect the lining of the stomach and reduce this risk.

What to do: Take this combination exactly as your doctor tells you to help prevent stomach ulcers and bleeding.

moderate warfarin

Table 3: Drugs that Can Increase the Risk of Bleeding Drug Class Specific Drugs Anticoagulants argatroban, dabigatran, bivalirudin, desirudin, heparin, lepirudin Antiplatelet Agents aspirin, cilostazol, clopidogrel, dipyridamole, prasugrel, ticlopidine Non-steroidal Anti-Inflammatory Agents celecoxib, diclofenac, diflunisal, fenoprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, naproxen, oxaprozin, piroxicam, sulindac Serotonin Reuptake Inhibitors citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, paroxetine, sertraline, venlafa...

Mechanism: Diclofenac is an anti-inflammatory medicine that can increase the risk of bleeding when used with warfarin. This combination makes it harder for your blood to clot properly.

What to do: Avoid using these medications together unless your doctor specifically tells you to. If you must take both, watch closely for any signs of bleeding or bruising.

NSAIDs with short elimination half-lives (e.g., diclofenac, indomethacin) should be avoided for a period of two days before, the day of, and two days following administration of pemetrexed.

Mechanism: Taking two different NSAID pain relievers at the same time increases the chance of serious side effects like stomach ulcers or kidney issues.

What to do: You should generally avoid using these two medications at the same time.

minor digoxin

Conivaptan 33% 43% Diltiazem 20% NA Indomethacin 40% NA Mirabegron 29% 27% Nefazodone 27% 15% Nifedipine 45% NA Propantheline 24% 24% Quinine NA 33% Rabeprazole 29% 19% Saquinavir 27% 49% Spironolactone 25% NA Telmisartan 20 to 49% NA Tricagrelor 31% 28% Tolvaptan 30% 20% Trimethoprim 22 to 28% NA Digoxin concentrations increased, but magnitude is unclear Alprazolam, azithromycin, cyclosporine, diclofenac, diphenoxylate, epoprostenol, esomeprazole, ibuprofen, ketoconazole, lansoprazole, metformin, omeprazole Measure serum digoxin concentrations before initiating concomitant drugs.

Mechanism: Diclofenac may cause the amount of digoxin in your body to increase. It is not clear exactly how much the levels will change when these drugs are used together.

What to do: Your doctor should measure your digoxin blood levels before you start taking diclofenac.

Although not specifically studied, fluconazole has the potential to increase the systemic exposure of other non-steroidal anti-inflammatory drugs (NSAIDs) that are metabolized by CYP2C9 (e.g., naproxen, lornoxicam, meloxicam, diclofenac).

Mechanism: Fluconazole blocks the liver protein that normally clears diclofenac, causing the pain medicine to build up in your system.

What to do: Your doctor may need to lower your dose of diclofenac to prevent side effects.

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Common Questions

How long should I use this medicine?
Use it for up to 21 days, unless your doctor tells you otherwise.
Can I use it for a sports injury?
No, this medicine is not for strains, sprains, bruises, or sports injuries.
How often should I apply the gel?
Apply it 4 times a day, every day.
How much gel should I use?
For upper body areas (hand, wrist, elbow) use 2.25 inches (2 grams). For lower body areas (foot, ankle, knee) use 4.5 inches (4 grams).
Where should I apply the gel?
Apply it to clean, dry skin without cuts, wounds, infections, or rashes.
Can I use a heating pad with this gel?
No, do not use external heat such as a heating pad.
Can I cover the treated area with a bandage?
No, do not apply a bandage over the treated area.
What should I do if it doesn't work after 7 days?
Stop using it if you don't get pain relief after 7 days.
How should I store the dosing card?
Store the dosing card with your diclofenac gel.
Can I use this on more than two areas at once?
No, do not use on more than 2 body areas at the same time
What are the common side effects of diclofenac?
The most commonly reported side effects of diclofenac include Pain, Headache. Based on 96,761 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does diclofenac interact with other medications?
Yes, diclofenac has 11 known drug interactions. Notable interactions include misoprostol, warfarin, celecoxib. Always inform your doctor about all medications you are taking.
What drug class is diclofenac?
diclofenac belongs to the Nonsteroidal Anti-Inflammatory Drug (NSAID) drug class. It is available over the counter (OTC). This medicine temporarily relieves arthritis pain.
Is diclofenac safe during pregnancy?
There is no information about pregnancy or breastfeeding in the provided data.. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has diclofenac been recalled?
There is 1 recall associated with diclofenac products. Failed PH Specifications. Check the recalls section below for full details and affected products.

Active Recalls

Class III December 22, 2025

Failed PH Specifications

Cipla USA, Inc.

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Medication Guides

Related Health & Safety Data

What the FDA Data Shows for diclofenac

The FDA label for diclofenac (sold under brand names such as Voltaren, Cataflam) classifies it as an over-the-counter product in the Nonsteroidal Anti-Inflammatory Drug (NSAID) class. This medicine temporarily relieves arthritis pain. Official labeling lists 2 commonly reported side effects, including Pain, Headache.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 96,761 voluntary reports. The database also lists 11 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $1.44.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 1 recall record on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: July 29, 2024

All federal data sources used on this page