Diclofenac

"Diclo" redirects here. For the organic solvent sometimes called Di-clo, see Dichloromethane.
"Dichronic" redirects here. For common misspellings, see Diachronic (disambiguation).

Diclofenac
Structure of diclofenac with ball and stick model
Clinical data
Pronunciation/daɪˈkloʊfənæk/[1] or /dɪklɒˈfɛnæk/[2]
Trade namesVoltaren, others[1]
AHFS/Drugs.comMonograph
MedlinePlusa689002
License data
Pregnancy
category
Routes of
administration		Orally, rectal, intramuscular, intravenous, topical, ophthalmic
Drug classNonsteroidal anti-inflammatory agents
ATC code
Legal status
Legal status
Pharmacokinetic data
Protein bindingMore than 99%
MetabolismLiver, oxidative, primarily by CYP2C9, also by CYP2C8, CYP3A4, as well as conjugative by glucuronidation (UGT2B7) and sulfation;[11] no active metabolites exist
Onset of actionWithin 4 hours (gel), 30 min (non-gel)[9]
Elimination half-life1.2–2 h (35% of the drug enters enterohepatic recirculation)
Excretion35% bile, 65% urine[10]
Identifiers
  • [2-(2,6-Dichloroanilino)phenyl]acetic acid
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard100.035.755 Edit this at Wikidata
Chemical and physical data
FormulaC14H11Cl2NO2
Molar mass296.15 g·mol−1
3D model (JSmol)
  • O=C(O)Cc1ccccc1Nc2c(Cl)cccc2Cl
  • InChI=1S/C14H11Cl2NO2/c15-10-5-3-6-11(16)14(10)17-12-7-2-1-4-9(12)8-13(18)19/h1-7,17H,8H2,(H,18,19) checkY
  • Key:DCOPUUMXTXDBNB-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Diclofenac, sold under the brand name Voltaren among others, is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammatory diseases such as gout.[6][9] It can be taken orally (swallowed by mouth), inserted rectally as a suppository, injected intramuscularly, injected intravenously, applied to the skin topically, or through eye drops.[9][12][13] Improvements in pain last up to eight hours.[9] It is also available as the fixed-dose combination diclofenac/misoprostol (Arthrotec) to help protect the stomach.[14][15]

Common side effects include abdominal pain, gastrointestinal bleeding, nausea, dizziness, headache, and swelling.[9] Serious side effects may include heart disease, stroke, kidney problems, and stomach ulceration.[15][9] Use is not recommended in the third trimester of pregnancy.[9] It is likely safe during breastfeeding.[15] Diclofenac is believed to work by decreasing the production of prostaglandins, like other drugs in this class.[16]

In 2022, it was the 51st most commonly prescribed medication in the United States, with more than 12 million prescriptions.[17][18] It is available as its acid or in two salts, as either diclofenac sodium or potassium.[15]

  1. ^ a b Cite error: The named reference tn was invoked but never defined (see the help page).
  2. ^ O'Toole MT, ed. (2017). Mosby's Dictionary of Medicine, Nursing & Health Professions (10th ed.). Elsevier. p. 536. ISBN 978-0-323-22205-1.
  3. ^ "Diclofenac Use During Pregnancy". Drugs.com. 16 January 2000. Retrieved 18 February 2024.
  4. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
  5. ^ "Product monograph brand safety updates". Health Canada. 6 June 2024. Retrieved 8 June 2024.
  6. ^ a b "Voltaren Arthritis Pain- diclofenac sodium gel; Voltaren Arthritis Pain- diclofenac sodium kit". DailyMed. 13 March 2024. Retrieved 13 October 2024.
  7. ^ "Cambia- diclofenac potassium powder, for solution". DailyMed. 25 April 2024. Retrieved 13 October 2024.
  8. ^ "FDA Approves Three Drugs for Nonprescription Use Through Rx-to-OTC Switch Process". U.S. Food and Drug Administration (FDA). 14 February 2020. Retrieved 18 February 2024. Public Domain This article incorporates text from this source, which is in the public domain.
  9. ^ a b c d e f g "Diclofenac epolamine Monograph for Professionals". Drugs.com. Retrieved 18 February 2024.
  10. ^ Williams BS, Buvanendran A (1 January 2011). "Nonopioid analgesics: NSAIDs, COX-2 inhibitors, and acetaminophen". In Benzon HT, Raja SN, Liu SS, Fishman SM (eds.). Essentials of Pain Medicine (3 ed.). W.B. Saunders. pp. 130–139. doi:10.1016/b978-1-4377-2242-0.00026-2. ISBN 978-1-4377-2242-0. Archived from the original on 10 January 2023. Retrieved 10 January 2023.
  11. ^ Sayyad M (23 August 2018). "Diclofenac Oral Uses, Dosage, Side Effects And Composition". Medicine Reviews Agency. Archived from the original on 24 August 2018. Retrieved 18 February 2024.
  12. ^ Chung CH (2017). "The use of Injectable Nonsteroidal Anti-Inflammatory Drugs in Local Accident & Emergency Practice". Hong Kong Journal of Emergency Medicine. 9 (2): 65–71. doi:10.1177/102490790200900201. S2CID 74032271.
  13. ^ "Diclofenac Ophthalmic". medlineplus.gov. 15 July 2016. Retrieved 8 October 2024.
  14. ^ "Arthrotec- diclofenac sodium and misoprostol tablet, film coated". DailyMed. 16 August 2023. Retrieved 13 October 2024.
  15. ^ a b c d British national formulary : BNF 74 (74 ed.). British Medical Association. 2017. pp. 1033–1035. ISBN 978-0-85711-298-9.
  16. ^ Mosby's Drug Reference for Health Professions. Elsevier Health Sciences. 2017. p. 398. ISBN 978-0-323-56682-7.
  17. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  18. ^ "Diclofenac Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.