Voltaren® (diclofenac sodium) belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). It is used to reduce pain, inflammation, swelling, and stiffness caused by several types of arthritis.
Voltaren (diclofenac) is a prescription nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve mild or moderate pain and inflammation. Voltaren is available as a topical gel and opthalmic solution. The main ingredient, diclofenac, is available in tablet form as a generic drug.
The gel form (Voltaren Gel) is used to reduce arthritis pain in the knees and hands. The opthalmic solution is used before and after eye cataract surgery to reduce inflammation and pain. It is also used prior to corneal refractive surgery to help relieve pain and photophobia.
To read more about this product in gel form (Voltaren Gel), click here.
Voltaren works by reducing inflammation, swelling, stiffness, and joint pain.
It will not cure any of these conditions, and it only works as long it is taken.
The drug is available in liquid solutions, capsules, liquid-filled capsules, tablets, enteric-coated tablets, extended-release tablets, and a topical cream.
Voltaren® (diclofenac sodium enteric-coated tablets) is a benzene-acetic acid derivative. Voltaren (diclofenac sodium) is available as delayed-release (enteric-coated) tablets of 75 mg (light pink) for oral administration. The chemical name is 2-[(2,6-dichlorophenyl)amino] benzeneacetic acid, monosodium salt. The molecular weight is 318.14. Its molecular formula is C14H10Cl2NNaO2.
Diclofenac sodium, originally marketed as Voltaren in the United States, is a nonsteroidal anti-inflammatory drug, or NSAID, which is used to reduce the swelling, pain, redness and warmth that accompany inflammatory conditions, such as arthritis. The U.S. Food and Drug Administration first approved a tablet form of diclofenac in July 1988. A topical preparation, designed to alleviate arthritis symptoms in your extremities, received FDA approval in October 2007.
Typical uses for Voltaren include the relief of pain and inflammation that accompanies osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Off-label uses of the drug include treating symptoms of gout, fibromyalgia, and systemic lupus erythematosus. It is important to note that while Voltaren can provide relief from the symptoms of these conditions, it does not cure them or slow down their progression.
Voltaren uses include the relief of:
Osteoarthritis symptoms, such as pain, stiffness, and swelling
Symptoms of rheumatoid arthritis
Short-term and long-term symptoms of ankylosing spondylitis.
Voltaren belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). Like other NSAIDs, it works by blocking a specific enzyme known as cyclooxygenase (COX), blocking the production of various inflammatory substances in the body.
On occasion, your healthcare provider may recommend Voltaren for something other than the conditions discussed in this article. This is called an “off-label” use. Examples of off-label Voltaren uses include the relief of:
Symptoms of juvenile rheumatoid arthritis
Fibromyalgia symptoms
Symptoms of systemic lupus erythematosus (SLE for short or lupus)
Gout symptoms
Cancer pain
Pain or inflammation caused by other conditions.
By blocking the production of prostaglandins, Voltaren is useful at reducing pain, inflammation, and joint swelling associated with different forms of arthritis and other diseases.
Orally for symptomatic treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.
Orally in fixed combination with misoprostol for the symptomatic treatment of osteoarthritis and rheumatoid arthritis in patients at high risk for developing NSAIA-induced gastric or duodenal ulcers and in patients at high risk for developing complications from these ulcers.
Topically (as gel) for the symptomatic treatment of osteoarthritis-related joint pain. Used for joints amenable to topical therapy (e.g., hands, knees); has not been evaluated on joints of the spine, hip, or shoulder.
Orally for management of juvenile rheumatoid arthritis.
Orally for symptomatic relief of acute gouty arthritis.
Orally or topically for symptomatic treatment of infusion-related superficial thrombophlebitis.
Orally for relief of pain, including postoperative (e.g., orthopedic, gynecologic, oral) pain, in adults.
Transdermally for relief of acute pain due to minor strains, sprains, and contusions.
Orally for symptomatic management of primary dysmenorrhea.
Like other NSAIDs, diclofenac exerts its anti-inflammatory effects by interfering with the activity of cyclooxygenase, or COX, enzymes in your cells. COX enzymes convert fatty acids to prostaglandins, which dilate blood vessels, sensitize nerve endings to pain and stimulate immune cells to produce inflammatory chemicals called cytokines. Blockade of COX enzymes reduces the synthesis of prostaglandins and, thus, the symptoms of inflammation. According to a 2007 review in “Prostaglandins and Other Lipid Mediators,” diclofenac preferentially blocks a specific enzyme called COX-2, which helps to preserve a prostaglandin that protects the lining of your stomach.
According to “Physicians' Desk Reference,” diclofenac sodium is indicated “for relief of signs and symptoms of osteoarthritis and rheumatoid arthritis.” It is also recommended for treating people with ankylosing spondylitis, a form of arthritis that causes fusion of the spine. Osteoarthritis primarily affects weight-bearing joints, such as the knees, hips and spinal column, with the hands involved to a lesser extent. Rheumatoid arthritis is typically more inflammatory than osteoarthritis and causes pain, swelling and deformity in the hands and wrists, feet, elbows, and ankles, although any joint can be involved.
Rheumatoid arthritis is an inflammatory disease that causes stiffness, pain, swelling and loss of function in the joints. It generally occurs in a symmetrical pattern, and often affects the wrist joints and finger joints closest to the hand.
People using diclofenac sodium to treat rheumatoid arthritis usually take 50mg three to four times a day, 75mg twice a day or 100mg once or twice a day, depending upon the specific brand name of the medication they are using, according to a big website. However, people should always follow the specific dosing instructions of a doctor when taking this medication.
Osteoarthritis is the most common form of arthritis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. This condition causes swelling, pain and reduced motion in the joints and usually affects the hands, knees, spine or hip. Osteoarthritis mostly affects cartilage and does not affect skin tissue, the eyes, the lungs or blood vessels, as do other forms of arthritis.
People using diclofenac sodium to treat osteoarthritis generally take 50mg two or three times a day or 75mg twice a day or 100mg once a day, depending upon the specific brand name of the medication they are using, according to a big website. However, people should always follow the specific dosing instructions of a doctor when taking this medication.
Ankylosing spondylitis is a type of arthritis that affects the joints between the spinal bones and the joints between the spine and pelvis. According to MedlinePlus, common symptoms include pain and stiffness that are worse at night or during periods of inactivity, pain that gets better with activity or exercise, and back pain that begins in the joints between the pelvis and spine and over time involves all or part of the spine. Some people with this condition lose motion or mobility of the lower spine or lose the ability to expand their chest.
The usual dose of diclofenac sodium for ankylosing spondylitis is 25mg four times a day, with another 25mg at bedtime when necessary. However, people should always follow the specific dosing instructions of a doctor when taking this medication.
Diclofenac sodium also may be used to treat menstrual cramps and acute migraine attacks, according to MayoClinic.com. Doctors also may prescribe the medication for “off label” use, treating conditions not mentioned in the FDA-approved labeling.
As with any medicine, side effects are possible with Voltaren® (diclofenac sodium); but not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in many cases, they are minor, meaning they require no treatment or are easily treated by you or your healthcare provider.
Voltaren has been studied extensively in clinical trials, with thousands of people worldwide having been evaluated. In these studies, side effects are always documented and compared to side effects that occurred in a similar group of people taking a placebo (a “sugar pill” with no active ingredients). This way, it is possible to see what side effects occur, how often they appear, and how they compare to the group not taking the placebo.
Based on these studies, the most common Voltaren side effects include:
Stomach pain
Constipation
Diarrhea
Heartburn or indigestion (dyspepsia)
Gas
Unexplained bleeding
Ulcer in the stomach or intestines (peptic ulcer)
Nausea
Vomiting
Anemia
Dizziness
Swelling
Increase in liver enzymes
Headache
Itching
Unexplained rash
Ringing in the ears (tinnitus).
As with any drug, there is the potential for serious side effects with Voltaren. The U.S. Food and Drug Administration (FDA) warns that people using nonsteroidal anti-inflammatory drugs (NSAIDs), including Voltaren, may be at higher risk for heart attack or stroke than those who do not take NSAIDs. This warning, however, does not apply to those who take aspirin. This risk may be higher in people who have been taking NSAIDs for a long time. These events can occur without warning and can lead to loss of life. Call 911 if you experience any of the following symptoms:
Chest pain
Shortness of breath
Weakness on one part of your body
Slurred speech.
Other possibly serious Voltaren side effects include but are not limited to:
Allergic reactions, such as:
Swelling of the face or body
Blisters
Unexplained skin rash
Wheezing
Difficulty breathing
Stomach or intestinal problems, including:
Bleeding
Ulcers
A hole (known as a perforation)
Liver damage, which can cause:
Nausea
Fatigue
Yellowing of the skin or whites of the eyes (jaundice)
Excessive tiredness
Increased liver enzymes (found using a standard blood test)
Kidney problems, including kidney failure
High blood pressure
Signs of heart failure, such as rapid weight gain, water retention, or unusual swelling of the arms, legs, hands, or feet.
Because Voltaren can increase the risk of major or life-threatening bleeding, contact your healthcare provider immediately if you notice any unusual bleeding or have any of the following symptoms:
Bloody nose
Black, tarry stools
Blood in the urine or stools
Vomiting blood
Red or purple spots on the skin.
During clinical studies, rare side effects occurred in less than 1 percent of people taking the drug. Because they are so uncommon, it is difficult to tell whether these side effects are because of the medication or something else. These rare side effects include but are not limited to:
Fainting
Dry mouth
Asthma
Weight changes
Hair loss (alopecia)
Blurred vision
Anxiety
Depression
Spinning sensation (vertigo).
Voltaren may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term. Do not use Voltaren just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.
Voltaren may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking Voltaren, especially in older adults.
Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.
Ask a doctor or pharmacist before using any cold, allergy, or other pain medicine. Medicines similar to diclofenac are contained in many combination medicines. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen. Avoid drinking alcohol. It may increase your risk of stomach bleeding.
While there appears to be a link between weight gain and Voltaren use, it occurs in less than 1 percent of people taking the drug. Gradual weight gain can often be managed through lifestyle choices, like limiting alcohol use and eating a heart-healthy diet. However, if weight gain occurs rapidly while taking Voltaren, this could indicate congestive heart failure and should be reported to your healthcare provider.
Problems have been reported in people taking Voltaren® (diclofenac sodium). Gradual weight gain is rarely reported, however. In clinical studies, weight gain occurred in less than 1 percent of people taking Voltaren. It is not possible to say whether the medication, other factors, or a combination of both played a role in this gradual weight gain.
Before medicines are approved, they must go through several clinical studies, where thousands of people are given a particular medicine and then compared to a group of people not given the medicine. In these studies, side effects are always documented. This way, it is possible to see what side effects occur, how often they occur, and how they compare to the group not taking the medicine. Side effects are then usually separated into those that occurred in more than 1 percent of people (common side effects) and those that occurred in less than 1 percent of people (rare side effects).
One important point to keep in mind related to Voltaren and weight gain is that all NSAIDs (nonsteroidal anti-inflammatory drugs), including Voltaren, may cause congestive heart failure. One of the main symptoms of congestive heart failure is unexplained weight gain. In fact, people with congestive heart failure can often have rapid weight gain occur over a couple of days. This weight gain is often combined with other symptoms, such as a cough and swelling in the ankles, feet, and legs. Make sure to contact your healthcare provider if you are taking Voltaren and notice rapid, unexplained weight gain or swelling.
If you are noticing a gradual, less serious gain while taking Voltaren, however, there are some things that you can do. Suggestions include:
Eat a heart-healthy diet. This diet should include:
Lots of fruits, vegetables, grains, and fat-free or low-fat milk and milk products
Lean meats, poultry, fish, beans, eggs, and nuts
Few foods with saturated fats, trans fats, cholesterol, sodium (salt), and added sugars.
Get regular physical activity for at least 30 minutes a day on most days of the week.
Limit your intake of alcohol.
If the weight gain continues, talk to your healthcare provider. He or she can recommend other lifestyle choices or may switch you to another pain-relief medication.
Ask your doctor before using an antidepressant such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.
Tell your doctor about all other medications you use, especially:
a blood thinner such as warfarin (Coumadin, Jantoven);
cyclosporine (Gengraf, Neoral, Sandimmune);
isoniazid (for treating tuberculosis);
lithium (Eskalith, Lithobid);
methotrexate (Rheumatrex, Trexall);
pronbenecid (Benemid);
rifampin (Rifadin, Rifater, Rifamate);
secobarbital (Seconal);
sertraline (Zoloft);
sulfamethoxazole (Bactrim, Septra, Sulfatrim, SMX-TMP, and others);
teniposide (Vumon);
zafirlukast (Accolate);
a diuretic (water pill) such as furosemide (Lasix).
steroids (prednisone and others);
antifungal medication such as fluconazole (Diflucan) or voriconazole (Vfend);
aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), indomethacin (Indocin), meloxicam (Mobic), and others;
cholesterol-lowering medicine such as fenofibrate (Antara, Fenoglide, Lipofen, Lofibra, TriCor, Triglide), fluvastatin (Lescol), or lovastatin (Mevacor, Altoprev, Advicor); or
heart or blood pressure medication such as amiodarone (Cordarone, Pacerone), benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others.
This list is not complete and other drugs may interact with Voltaren. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Comment from: deeder523, 35-44 on Treatment for less than 1 month (Patient), Published: November 15
Within 2 days of full doses of this medication, I felt like a new person. My pain was gone and continues to be very manageable with this medication. I feel like a new, different and happy person again.
Comment from: ... ..., 75 or over on Treatment for 1-6 months (Patient), Published: December 14
As a ... instructor with a degenerative hip, Voltaren gave me .... I could arise in the morning free of pain, go up stairs, put on my socks and teach a Senior class every day... I could again go shopping...
Comment from: yrp78, 55-64 on Treatment for 10+ years (Patient), Published: July 04
I was barely able to walk for the pain in my ankles. Went to the doctor, he looked at my swollen ankles and said “looks like bursitis” and prescribed Voltaren. The next day was much better and by the third day I was pain free. I had considered taking medical disability retirement the pain was so dibilitating. That was 13 years ago and I can still function thanks to this medicine. ...
Comment from: skeetro_lee_14@hotmail.com, 45-54 on Treatment for 1-6 months (Patient), Published: November 04
I took celebrex for approx. 8 years. It just seemed not to work as well as it did. Also the price was very expesive. ... My ortho. MD put me on voltaren, I noted a change in my knee pain in the 1st week. ...
Comment from: mamabear1, 65-74 on Treatment for less than 1 month (Patient), Published: September 25
The severe side effects are not worth taking this drug! Only took 2 days; eyelids severely swollen, severe stomach pain along with abdominal cramping & diarrhea for 12 hrs. Won't recommend to anyone.
Comment from: brokenwing, 45-54 on Treatment for less than 1 month (Patient), Published: January 19
I have very bad knees and have been advised to have knee replacements. The pain I have been suffering every day has been horrible. This is the only medication out of several tried that has given me any measurable relief - and no side effects as yet.
Comment from: 55-64 on Treatment for less than 1 month (Patient), Published: May 22
I got so much relief with this drug! My pain doesn't completely go away;however,it works so much better than Celebrex did.
Comment from: nangayle1, 65-74 on Treatment for less than 1 month (Patient), Published: September 21
My doctor gave me Voltaren for arthritis in my elbows. I could hardly lift my arms... After only 4 days of taking this medication....I have no pain in my elbows. AND....I also have carple tunnel syndrome really bad in my hands. Now my hands are 90% pain free. I just cannot believe it!! Have not had any side effects thus far. Very satisfied!!
Comment from: Carol, 65-74 on Treatment for 5-10 years (Patient), Published: April 24
Have taken this Rx for several years and now my kidney function is bad - especially the BUN. I have been taken off and hopefully the kidney problem will improve. In retrospect I probably should not have been taking it for so long.
Comment from: Jan, 55-64 on Treatment for 6 months - 1 year (Patient), Published: July 21
I've been taking this for arthritis and it works great. I very seldom have bad effects from any med. I get tremendous relief from this. Very satisfied with it.
Comment from: 35-44 Female on Treatment for 2-5 years (Patient), Published: September 18
The worst heartburn I've ever had - and I have always had a bit of GERD. I had lower back surgery (herniated disc) a few years ago and Dr. put me on this to help control the associated swelling and general issues I seem to always have with my back. Works pretty good and better than narcotics.
Comment from: Weezie6452, 45-54 on Treatment for 1-2 years (Patient), Published: May 19
I take 75mg twice a day for arthritis of the neck and lower back, worse in the neck. It is very effective and allows me to get on with my life, staying active and exercising. It has also been helpful with managing migraines.
Comment from: 35-44 Female on Treatment for 6 months - 1 year (Patient), Published: October 15
I am a 42 year old male and have been taking Voltaren for about 8 months now. I have severe osteo arthritis of the hips. This drug has worked excellent for me with no side effects! This drug takes full effect within about 6 hours for me with full pain relief. I do not limp when this drug is in full effect. I take this medication about every 2-3 days for pain relief. I find that 1 pill will provide relief for about 1-1/2 days, and then the pain returns. I highly recommend this drug!