Formulary
Diclofenac potassium: Indications, Dosing, Side Effects and Interactions
Diclofenac potassium clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 4 min read
Diclofenac potassium: Indications, Dosing, Side Effects and Interactions
Diclofenac potassium clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Pain and inflammation in rheumatic disease and other musculoskeletal disorders**
- **Child** (By Mouth): 14-17 years 75-100 mg daily in 2-3 divided doses.
- **Adult** (By Mouth): 75-150 mg daily in 2-3 divided doses.
**Acute gout**
- **Adult** (By Mouth): 75-150 mg daily in 2-3 divided doses.
**Postoperative pain**
- **Child** (By Mouth): 14-17 years 75-100 mg daily in 2-3 divided doses.
- **Adult** (By Mouth): 75-150 mg daily in 2-3 divided doses.
**Migraine**
- **Adult** (By Mouth): 50 mg for 1 dose, to be given at onset of migraine; then 50 mg for 1 dose after 2 hours if required, then 50 mg after 4-6 hours up to a maximum of 200 mg per day.
**Fever in ear, nose, or throat infection**
- **Child** (By Mouth): 9-17 years (body-weight 35 kg and above) Up to 2 mg/kg daily in 3 divided doses; maximum 100 mg per day.
**Pain and inflammation in rheumatic disease and other musculoskeletal disorders for diclofenac potassium**
- **Child 14-17 years** (By mouth): 75-100 mg daily in 2-3 divided doses.
**Postoperative pain for diclofenac potassium**
- **Child 9-13 years (body-weight 35 kg and above)** (By mouth): Up to 2 mg/kg daily in 3 divided doses; maximum 100 mg per day.
- **Child 14-17 years** (By mouth): 75-100 mg daily in 2-3 divided doses.
**Fever in ear, nose, or throat infection for diclofenac potassium**
- **Child 9-17 years (body-weight 35 kg and above)** (By mouth): Up to 2 mg/kg daily in 3 divided doses; maximum 100 mg per day.
Cautions
General cautions: Allergic disorders; cardiac impairment (NSAIDs may impair renal function); coagulation defects; connective-tissue disorders; dehydration (risk of renal impairment); history of cardiac failure; history of gastro-intestinal disorders (e.g. ulcerative colitis, Crohn's disease); hypertension; may mask symptoms of infection; oedema; risk factors for cardiovascular events Specific cautions: With systemic use Elderly (risk of serious side-effects and fatalities) (in adults)
Contraindications
Active gastro-intestinal bleeding; active gastro-intestinal ulceration; cerebrovascular disease; history of gastro-intestinal bleeding related to previous NSAID therapy; history of gastro-intestinal perforation related to previous NSAID therapy; history of recurrent gastro-intestinal haemorrhage (two or more distinct episodes); history of recurrent gastro-intestinal ulceration (two or more distinct episodes); ischaemic heart disease; mild to severe heart failure; peripheral arterial disease
Side effects
Common or very common Appetite decreased; diarrhoea; dizziness; gastrointestinal discomfort; gastrointestinal disorders; headache; nausea; skin reactions; vertigo; vomiting Uncommon Chest pain; heart failure; myocardial infarction; palpitations Rare or very rare Acute kidney injury; agranulocytosis; alopecia; anaemia; angioedema; anxiety; aplastic anaemia; asthma; confusion; constipation; depression; drowsiness; dyspnoea; erectile dysfunction; fatigue; haemolytic anaemia; haemorrhage; hearing impairment; hepatic disorders; hypersensitivity; hypertension; hypotension; inflammatory bowel disease; irritability; leucopenia; memory loss; meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible); nephritis tubulointerstitial; nephrotic syndrome; oedema; oesophageal disorder; oral disorders; pancreatitis; photosensitivity reaction; pneumonitis; proteinuria; psychotic disorder; renal papillary necrosis; seizure; sensation abnormal; severe cutaneous adverse reactions (SCARs); shock; sleep disorders; stroke; taste altered; thrombocytopenia; tinnitus; tremor; vasculitis; vision disorders Frequency not known Hallucination; malaise; optic neuritis Side-effects, further information For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non-steroidal anti-inflammatory drugs
Interactions
**Severe interactions:**
- Cases of serious toxicity have been reported when methotrexate and NSAIDs, including diclofenac are given within 24 hours of each other.
- Potent CYP2C9 inhibitors: Caution is recommended when co-prescribing diclofenac with potent CYP2C9 inhibitors (such as voriconazole), which could result in a significant increase in peak plasma...
**Other interactions (21):**
- Lithium: If used concomitantly, Voltarol may increase plasma concentrations of lithium.
- Monitoring of the serum lithium level is recommended.
- Digoxin: If used concomitantly, Voltarol may raise plasma concentrations of digoxin.
- Monitoring of the serum digoxin level is recommended.
- Diuretics and antihypertensive agents: Like other NSAIDs, concomitant use of Voltarol with diuretics and antihypertensive agents (e.g.
- Patients should be adequately hydrated and consideration should be given to monitoring of renal function after initiation of concomitant therapy periodically thereafter, particularly for diuretics...
Pregnancy
Important safety information For diclofenac potassium MHRA/CHM advice: NSAIDs: potential risks following prolonged use after 20 weeks of pregnancy (June 2023) See Non-steroidal anti-inflammatory drugs .
Breast feeding
Use with caution during breast-feeding. Amount in milk too small to be harmful.
Hepatic impairment
Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
Renal impairment
In general, for NSAIDs the MHRA advises to avoid where possible; if necessary, use with caution (risk of fluid retention and further renal impairment, including renal failure). For diclofenac potassium , avoid in severe impairment. M
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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