Top 300 Pharmacy Drug Cards

DICLOFENAC: Voltaren, Various

Class: NSAID

Dosage Forms. Tablet: 50 mg; Tablet, Extended Release: 25 mg, 50 mg, 75 mg, 100 mg; Capsule: 25 mg; Powder for Solution: 50 mg/packet

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Common FDA Label Indication, Dosing, and Titration.

1. Osteoarthritis: 100 mg extended release po daily or bid

2. Rheumatoid arthritis: 100 mg extended release daily or bid

Off-Label Uses.

1. Pain: 100 mg extended release po daily

MOA. Nonselective inhibitor of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2), and reversibly alters platelet function and prolongs bleeding time.

Drug Characteristics: Diclofenac

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Medication Safety Issues: Diclofenac

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Drug Interactions: Diclofenac

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Adverse Reactions: Diclofenac

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Efficacy Monitoring Parameters. Decreased pain and improved range of motion.

Toxicity Monitoring Parameters. Monitor CBC, LFTs, SCr, fecal occult blood tests, severe skin rash, black tarry stools, chest pains, yellowing of eyes or skin, and change in urination.

Key Patient Counseling Points. Take with food or milk to decrease GI upset.

Clinical Pearls. Elderly patients are at increased risk of GI ulceration. Patients with underlying cardiac dysfunction are at increased risk of cardiovascular effects. Use lowest dose for shortest period of time to minimize toxicity. Available in both sodium and potassium salts, in combination with misoprostol, and in ophthalmic and topical products. Medication guide required at dispensing.