Diclofenac gel (Voltaren)

Diclofenac is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Diclofenac works by reducing hormones that cause inflammation and pain in the body.

Therapeutic actions:
The exact mechanism of action is not entirely known, but it is thought that the primary mechanism responsible for its anti-inflammatory / antipyretic / analgesic action is inhibition of prostaglandin synthesis by inhibition of cyclooxygenase (COX). Inhibition of COX also decreases prostaglandins in the epithelium of the stomach, making it more sensitive to corrosion by gastric acid. This is also the main side effect of diclofenac. Diclofenac has a low to moderate preference to block the COX2-isoenzyme (approximately 10-fold) and is said to have therefore a somewhat lower incidence of gastrointestinal complaints than noted with indomethacin and aspirin.
Diclofenac may also be a unique member of the NSAIDs. There is some evidence that diclofenac inhibits the lipoxygenase pathways, thus reducing formation of the leukotrienes (also pro-inflammatory autacoids). There is also speculation that diclofenac may inhibit phospholipase A2 as part of its mechanism of action. These additional actions may explain the high potency of diclofenac - it is the most potent NSAID on a broad basis.

What is it used for?:
- For relief of the signs and symptoms of osteoarthritis;
- For relief of the signs and symptoms of rheumatoid arthritis;
- For acute or long-term use in the relief of the signs and symptoms of ankylosing spondylitis;

Contraindications and cautions:
- allergy to any ingredient in Voltaren Drops;
- known severe allergic reaction (eg, severe rash, hives, breathing difficulties, dizziness) to another NSAID (eg, ibuprofen, naproxen, celecoxib) or aspirin.

Side effects:
Serious side effects: severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred or distorted vision; eye infection; eyelid swelling or redness; sensitivity to glare or light; severe or persistent eye irritation.
Less serious side effects: burning or stinging; discharge; eye redness, irritation, or itching.

Interactions:
The eye may not be able to heal well if using Voltaren together with topical corticosteroids for the eye (eg, dexamethasone).