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NSAID — Gynaecological Pain

Diclofenac (Dysmenorrhoea / Post-gynaecological Procedure)

Brand names: Voltarol

This monograph covers diclofenac, a non-steroidal anti-inflammatory drug, used in gynaecology for dysmenorrhoea and pain after gynaecological procedures.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It inhibits cyclo-oxygenase enzymes, reducing prostaglandin synthesis; in dysmenorrhoea this lowers uterine prostaglandin-driven contractions and pain.

Prescribing in practice

  • Avoid NSAIDs from the third trimester of pregnancy because of the risk of premature closure of the ductus arteriosus, fetal renal impairment and oligohydramnios; recent regulatory advice also cautions against routine use from around the midpoint of pregnancy.
  • Use the lowest effective dose for the shortest time, with gastrointestinal, cardiovascular and renal risks in mind, and consider gastroprotection where indicated.
  • Avoid in active peptic ulceration, significant renal impairment and severe heart failure.

Monitoring

For short courses routine monitoring is not required, but consider renal function and gastrointestinal tolerance with risk factors or longer use.

Counselling the patient

  • Take with or after food to reduce stomach irritation.
  • Do not use in later pregnancy unless a clinician specifically advises.
  • Report black stools, severe indigestion or breathlessness.

Evidence & guidelines

NSAIDs are well established as effective for primary dysmenorrhoea, and the MHRA advises avoiding their use in the later stages of pregnancy because of fetal cardiovascular and renal risks.

Reference: RCOG Green-top (Hysteroscopy); NICE NG73 (Endometriosis); MHRA 2013; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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