No, diclofenac isn't being completely discontinued, but specific formulations, especially oral tablets and some topical gels, are facing shifts due to cardiovascular risks, with some moving behind-the-counter (OTC) in certain countries like the UK (to prescription only), while others are discontinued or made OTC (like in the US) for better access, leading to confusion and different availability by region and form.
As of August 2024, there will be no approved prescription versions of diclofenac sodium gel, 1% listed in the Orange Book, meaning it will no longer be available as a prescription drug.
This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Capsule. Tablet, Enteric Coated.
Diclofenac sodium, considered as an analgesic and anti-inflammatory otic preparation, is shown to be as ototoxic as gentamicin in chronic use which may lead to loss of hearing especially when used topically in chronic otitis cases with tympanic membrane damage.
12, 2013 study in PLoS Medicine (2013;10:e1001388) indicates that diclofenac use can increase the risk of heart attack or stroke in patients with pre-existing conditions such as diabetes, high cholesterol or other high risk factors for cardiovascular problems.
Some NSAIDs, such as naproxen and ibuprofen, are available OTC and without prescription and can be taken for short periods for mild to moderate pain, inflammation, and fever. Other prescription NSAIDs, such as flurbiprofen and indomethacin, may also be alternatives to diclofenac.
Diclofenac tablets and capsules can cause an ulcer in your stomach if you take them for a long time or in large doses, or if you're older or in poor general health. If you have a stomach ulcer or have ever had one, you may not be able to take diclofenac tablets or capsules. Your doctor will prescribe another medicine.
Diclofenac has an average rating of 7.3 out of 10 from a total of 709 ratings on Drugs.com. 68% of reviewers reported a positive effect, while 21% reported a negative effect. Voltaren Arthritis Pain Gel has an average rating of 7.1 out of 10 from a total of 261 ratings on Drugs.com.
Pain Medications – Anti inflammatory drugs like Aspirin, Ibuprofen and Naproxen – (NSAIDS) can cause tinnitus. The ringing can be worse at higher doses with NSAIDS. 3. Anti-anxiety medications – Xanax, Valium and Klonopin can sometimes cause tinnitus.
Do not take diclofenac with similar painkillers, like aspirin, ibuprofen or naproxen, without talking to a doctor. Diclofenac, aspirin, ibuprofen and naproxen all belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).
It comes as: tablets and capsules, including slow-release tablets and capsules, that are prescription only.
Diclofenac can raise your blood pressure, partially due to fluid buildup, as discussed above. Typically, this increase is small. And your blood pressure should return to normal if you stop taking diclofenac.
Keep using this medicine for the full time of treatment. However, do not use this medicine more often or for a longer time than your doctor ordered. This medicine is not for long-term use.
What will happen if I stop taking diclofenac? When you stop taking diclofenac tablets or capsules, or stop using the suppositories, the effects will wear off after about 15 hours. When you stop using the gel, plasters or patches, the effects will wear off after 1 or 2 days.
Discontinued medicines and available alternatives
The toxic nonsteroidal anti-inflammatory drug (NSAID) diclofenac caused the collapse of vulture populations in South Asia in the 1990s (1, 2). In 2006, India, Nepal, and Pakistan banned veterinary use of diclofenac (1, 2), and later Bangladesh, Iran, Cambodia, and Oman enacted bans as well (3).
Medications for blood pressure, such as beta blockers and ACE inhibitors, can also cause tinnitus. As this category includes various types of medications, it's essential to speak with your healthcare provider regarding alternatives, if you're concerned about the medication causing tinnitus.
Tinnitus can develop slowly over time or happen suddenly. It's not known exactly why it happens but it's often linked to: hearing loss. inner ear damage caused by repeated exposure to loud noises or some medicines.
A series of 252 nationwide studies found that diclofenac increased the adverse event rate by 50%. It may increase a patient's risk of heart attack by 40%. The risk of serious heart problems, such as heart attack, increases in patients with a history of cardiovascular issues, heart disease, or high blood pressure.
Now, you may be asking, “Why can't I use Voltaren gel on my back or shoulder?” This is because it hasn't been well-studied on these body areas. More research is needed to see if Voltaren gel is safe and effective for these uses.
In general, meloxicam is considered a stronger painkiller and requires a prescription from a healthcare provider.
Topical diclofenac has a black box warning for risk of serious cardiovascular and gastrointestinal events. Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.
Dosage and strength
Diclofenac comes as tablets, capsules, suppositories, gel, plasters and patches. Your dose will depend on how you take or use it. If you take tablets or capsules, the usual dose is 75mg to a maximum of 150mg a day.
Clinical-trial and epidemiological data consistently point towards an increased risk of arterial thrombotic events (for example myocardial infarction or stroke) associated with the use of diclofenac, particularly at high dose (150 mg daily) and in long-term treatment.