Diclofenac Potassium Risks, Warnings, and Complications

CARDIOVASCULAR EVENTS: Taking NSAIDs, including diclofenac potassium, carries an increased risk of serious cardiovascular events such as heart attack and stroke, which may be fatal. This risk begins as early as the first few weeks of treatment with diclofenac potassium and other NSAIDs. People with pre-existing cardiovascular disease and those taking high doses or prolonged treatment with diclofenac potassium are at a higher risk of developing these serious side effects. Your doctor will prescribe the lowest dose for the shortest duration to treat your condition. Before starting diclofenac potassium, tell your healthcare provider if you have heart disease or a recent heart attack. You should not take this medicine around the time of a coronary artery bypass graft (heart bypass surgery). Call 911 or seek emergency medical help if you develop chest pain, chest tightness, difficulty breathing, trouble speaking or walking, or weakness on one side of your body at any time during treatment.

GASTROINTESTINAL COMPLICATIONS: Taking NSAIDs, including diclofenac potassium, is associated with an increased risk of GI toxicity (bleeding, ulceration, and perforation in the gastrointestinal tract). The risk is higher with long-term treatment but can also occur after short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). People with a prior history of peptic ulcer disease (stomach ulcers) are at a 10 times higher risk of developing stomach bleeding on NSAIDs. Taking medications such as aspirin, corticosteroids, antidepressants (SSRIs), or a blood thinner can increase the risk of stomach bleeding. Other risk factors include smoking, alcohol use, older age, and poor health status. Give your doctor a complete medical history before starting diclofenac potassium. Take the smallest dose for the shortest time to minimize these risks. Avoid taking diclofenac potassium with other NSAIDs. Stop taking diclofenac potassium and call your doctor right away if you notice signs of gastrointestinal bleeding, such as blood or coffee grounds in your vomit, black or tarry stools, persistent stomach pain, or any unusual bleeding or bruising.

LIVER DAMAGE: A drug reaction in patients receiving diclofenac can lead to liver damage. This complication can occur as early as the first 1-2 months of treatment. Risk factors include pre-existing liver disease, taking other drugs that can cause liver damage, such as acetaminophen (Tylenol), or drinking alcohol. The damage to the liver may not cause obvious symptoms. Doctors typically monitor patients taking diclofenac potassium for a prolonged duration with periodic lab tests to keep an eye on liver function. Tell your doctor if you have a history of hepatic disease. Stop taking diclofenac potassium and call your doctor right away if you develop warning symptoms of liver injury such as systemic symptoms (fever, tiredness, low energy), loss of appetite, flu-like symptoms, swollen glands, abdominal pain, nausea, vomiting, yellowing of the skin or eyes, light-colored stools, or dark urine.

HYPERTENSION: Taking diclofenac potassium and other NSAIDs is associated with a greater risk of new-onset hypertension (high blood pressure) or worsening control of hypertension in people with this condition. In addition, NSAIDs can reduce the response to blood pressure medications such as ACE inhibitors and diuretic therapy. Keep a log of your blood pressure readings at home and tell your doctor if they are higher than normal.

FLUID RETENTION: Patients taking NSAIDs, including diclofenac potassium, can develop fluid retention. This can lead to new or worsening swelling in the arms and legs, high blood pressure, and congestive heart failure. In addition, diclofenac can make certain medications prescribed for these conditions (such as water pills, ACE inhibitors, and ARBs) less effective. Diclofenac may not be right for you if you have severe heart failure. Call your doctor right away or seek emergency medical attention if you develop trouble breathing, fatigue, swelling, or sudden weight gain.

KIDNEY DAMAGE: Taking diclofenac potassium can decrease renal blood flow and cause kidney injury and acute renal failure. Elderly patients are at a greater risk of kidney damage. Other risk factors for renal toxicity include renal impairment (reduced renal function), heart failure, dehydration, hypovolemia, liver dysfunction, and the use of certain other medications such as diuretics (water pills), ACE inhibitors, and ARBs. Tell your doctor if you experience vomiting, diarrhea, or bleeding resulting in loss of body fluids while on diclofenac potassium. This medication may not be safe for people with pre-existing kidney problems. Call your doctor immediately if you develop difficulty urinating, pain with urination, cloudy, discolored, or bloody urine, or back pain.

SERIOUS SKIN REACTIONS: Rarely, taking diclofenac potassium can cause a severe allergic reaction called anaphylaxis (throat tightening and difficulty breathing), severe asthma attacks, or severe skin reactions, which can be fatal. Tell your doctor if you have ever had an allergic reaction to NSAIDs, including aspirin. People who have aspirin-sensitive asthma, frequent stuffy or runny nose, or nasal polyps are at an increased risk. Stop taking diclofenac potassium and get immediate medical help if you develop difficulty breathing, swelling, skin rash, hives, itching, blistering, or peeling.

RISK DURING PREGNANCY: Taking diclofenac potassium during pregnancy can cause harm to the unborn baby. Before starting treatment with diclofenac potassium, tell your healthcare provider if you are pregnant, could be pregnant, or are planning a pregnancy soon.