Diclofenac
Nonsteroidal anti-inflammatory drug / From Wikipedia, the free encyclopedia
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Diclofenac (pronounced /daɪˈkloʊfənæk/[1] or /dɪklɒˈfɛnæk/[9]), sold under the brand name Voltaren, among others, is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammatory diseases such as gout.[7] It is taken by mouth or rectally in a suppository, used by injection, or applied to the skin.[7][10] Improvements in pain last for as much as eight hours.[7] It is also available in combination with misoprostol in an effort to decrease stomach problems.[11]
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Trade names | Cataflam, Voltaren, Zipsor, others[1] |
AHFS/Drugs.com | Monograph |
MedlinePlus | a689002 |
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Routes of administration | By mouth, rectal, intramuscular, intravenous, topical |
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Protein binding | More than 99% |
Metabolism | Liver, oxidative, primarily by CYP2C9, also by CYP2C8, CYP3A4, as well as conjugative by glucuronidation (UGT2B7) and sulfation;[5] no active metabolites exist |
Onset of action | Within 4 hours (gel),[6] 30 min (non-gel)[7] |
Elimination half-life | 1.2–2 h (35% of the drug enters enterohepatic recirculation) |
Excretion | 35% bile, 65% urine[8] |
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ECHA InfoCard | 100.035.755 |
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Formula | C14H11Cl2NO2 |
Molar mass | 296.15 g·mol−1 |
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Common side effects include abdominal pain, gastrointestinal bleeding, nausea, dizziness, headache, and swelling.[7] Serious side effects may include heart disease, stroke, kidney problems, and stomach ulceration.[11][7] Use is not recommended in the third trimester of pregnancy.[7] It is likely safe during breastfeeding.[11] Diclofenac is believed to work by decreasing the production of prostaglandins, like other drugs in this class.[12]
In 2021, diclofenac was the 61st most commonly prescribed medication in the United States, with more than 11 million prescriptions.[13][14] It is available as its acid or in two salts, as either diclofenac sodium or potassium.[11]
It is also widely used for livestock; such use was responsible for the Indian vulture crisis, during which in a few years 95% of the country's vulture population was killed, and in many countries agricultural use is now forbidden.[15][16][17][18]