Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to alleviate pain and reduce inflammation. It is prescribed for conditions like osteoarthritis, rheumatoid arthritis, acute pain, and menstrual cramps. This medication works by blocking prostaglandins, substances in the body responsible for pain and inflammation.
Recommended Daily Dosage
For adults, the maximum daily oral dosage of diclofenac varies by formulation and condition. Immediate-release tablets for pain or dysmenorrhea are often 50 mg three times daily, up to 150 mg per day. Enteric-coated tablets for osteoarthritis or rheumatoid arthritis may be 50 mg two or three times daily, or 75 mg twice daily, with a maximum of 150 mg per day. Extended-release tablets typically have a maximum of 100 mg once daily. It is important to always adhere to a doctor’s instructions or the information provided on the medication’s package leaflet, as individual needs and responses to the drug differ.
Dosage by Form and Condition
Diclofenac dosage varies by formulation and condition. Oral tablets come in immediate-release, delayed-release, and extended-release forms, each with distinct dosing schedules and maximums. For osteoarthritis, delayed-release tablets typically range from 100 mg to 150 mg per day, divided into doses. For rheumatoid arthritis, these tablets might be prescribed at 150 mg to 200 mg per day.
Topical applications like gels, patches, and solutions have different systemic absorption rates compared to oral doses. A 1% diclofenac topical gel for knee osteoarthritis typically involves applying 4 grams four times daily, totaling 16 grams daily to the affected area. For hands, elbows, or wrists, 2 grams applied four times daily is common, with a total daily dose not exceeding 32 grams across all affected joints. Patches are generally applied twice daily to the painful area for acute pain. Do not combine different forms of diclofenac without consulting a healthcare professional due to potential cumulative systemic exposure.
Risks of Overdose and What to Do
Exceeding the recommended daily dosage of diclofenac carries risks. Common overdose signs include nausea, vomiting, stomach pain, and drowsiness. More severe symptoms can include gastrointestinal bleeding, which may appear as bloody vomit or black, tarry stools, which can be fatal. Other serious effects are kidney problems, with little or no urine output, or liver damage, indicated by yellowing of the skin or eyes.
In severe cases, an overdose can lead to agitation, confusion, seizures, or coma. If an overdose is suspected, seek immediate action. Contact a poison control center (e.g., 1-800-222-1222 in the United States) or call 911 for emergency medical attention. Treatment may involve supportive therapy, such as intravenous fluids, activated charcoal to reduce absorption, or medications to manage specific symptoms.
When to Consult a Healthcare Professional
Consult a doctor or pharmacist about diclofenac use in several situations for safety and effectiveness. Seek medical advice promptly if side effects occur, such as severe stomach pain, unusual bleeding, or signs of an allergic reaction like hives or difficulty breathing. Also consult a healthcare provider if the treated condition does not improve or worsens.
Individuals with pre-existing conditions like heart disease, high blood pressure, kidney disease, or liver problems should discuss diclofenac use with their doctor, as these conditions can increase the risk of adverse effects. Inform a healthcare professional about all other medications, as diclofenac can interact with drugs like blood thinners and other NSAIDs. Pregnant or breastfeeding individuals should also seek medical advice, as diclofenac may pose risks to the fetus, especially in later pregnancy, and its safety during breastfeeding is not fully established.