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Non-selective NSAID

Diclofenac (Rheumatology)

Brand names: Voltarol, Diclomax, Dyloject

In rheumatology, diclofenac is a non-steroidal anti-inflammatory drug used to relieve pain and inflammation in arthritis and other musculoskeletal conditions, available orally and as a topical preparation.

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 and thereby decreasing pain, swelling and inflammation.

Prescribing in practice

  • Carries a higher cardiovascular thrombotic risk than other non-selective NSAIDs and is contraindicated in established cardiovascular disease — use the lowest effective dose for the shortest time.
  • Also causes gastrointestinal ulceration and renal impairment; consider gastroprotection and avoid in severe heart failure, peptic ulceration or significant renal disease.
  • Topical use limits systemic exposure for localised joint pain; consult the SPC and apply MHRA contraindication advice.

Monitoring

Monitor blood pressure, renal function and for gastrointestinal symptoms, especially in older or higher-risk patients on oral therapy.

Counselling the patient

  • Take oral doses with food and report black stools or indigestion.
  • Use the lowest dose for the shortest period needed.
  • Wash hands after applying the topical gel and avoid broken skin.

Evidence & guidelines

Analgesic and anti-inflammatory efficacy in arthritis is well established, with cardiovascular risk highlighted by MHRA review.

Reference: NICE NG193; CHM/MHRA review 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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