Voltarol (Diclofenac)
💊 Arthrotec is a preparation of diclofenac (NSAID) combined with misoprostol, a prostaglandin analogue, which helps reduce NSAID-induced gastrointestinal side effects such as ulcers and bleeding.
📖 About
- Always check the BNF link here for updated dosing and safety guidance.
- Diclofenac is a widely used NSAID with analgesic, anti-inflammatory, and antipyretic properties.
⚙️ Mode of Action
- 🧪 Inhibits prostaglandin synthesis by reversibly inhibiting cyclo-oxygenase (COX) enzymes.
- COX-1 → protective prostaglandins (gastric mucosa, platelets, renal blood flow).
- COX-2 → inducible, mainly in inflammation (pain, swelling, fever).
- ⚡ Diclofenac is relatively short-acting (short elimination half-life), limiting accumulation.
💊 Dose Range (check BNF/datasheet)
| Name | Starting Dose | Frequency | Route |
|---|
| Voltarol (standard) | 50 mg | TDS | PO |
| Voltarol Slow-Release | 75 mg | OD or BD | PO / PR |
| Voltarol Suppository | 100 mg | Stat | PR |
🔗 Interactions
- 📖 See BNF for complete list.
- ⚠️ Increased risk of GI bleed with corticosteroids, SSRIs, and anticoagulants.
- 💊 Can reduce antihypertensive effect of ACE inhibitors, ARBs, and diuretics.
- ↑ Risk of renal impairment with other nephrotoxic agents (e.g., aminoglycosides).
⚠️ Cautions
- 📅 Avoid long-term use if possible – use the lowest effective dose for the shortest duration.
- ⚡ Monitor renal function, especially in elderly or dehydrated patients.
- 🫁 Use with caution in asthma (risk of bronchospasm).
⛔ Contraindications
- 🚫 Active or history of peptic ulcer disease or GI bleeding.
- 🚫 Severe renal impairment, dehydration.
- 🚫 Cardiovascular disease: IHD, CCF, PVD, haemorrhagic stroke (↑ risk of CV events with diclofenac).
- 🚫 Hypersensitivity to NSAIDs (e.g., asthma, urticaria, anaphylaxis).
😬 Side Effects
- 🤢 GI disturbance: dyspepsia, abdominal pain, nausea, diarrhoea.
- 🩸 Serious risk: peptic ulceration, GI bleed, perforation.
- 💧 Fluid retention, oedema, hypertension.
- 🧪 AKI (especially in dehydration or CKD).
- 🧴 Skin reactions: rashes, photosensitivity, rare Stevens–Johnson syndrome.
📚 References
- BNF: Diclofenac
- NICE guidelines on Osteoarthritis and Chronic Pain management.
📝 Revisions
