Voltarol rapid tablets (diclofenac)

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before taking this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

Diclofenac should not be taken in combination with painkilling doses of aspirin or any other oral NSAID, eg ibuprofen, as this increases the risk of side effects on the stomach and intestines. Selective inhibitors of COX-2 such as celecoxib or etoricoxib should also be avoided for the same reason.

There may be an increased risk of ulceration or bleeding from the gut if diclofenac is taken with corticosteroids such as prednisolone.

There may also be an increased risk of bleeding from the gut if diclofenac is taken with the following medicines:

anti-blood-clotting (anticoagulant) medicines such as warfarin

anti-platelet medicines to reduce the risk of blood clots or 'thin the blood', eg low-dose aspirin, clopidogrel, dipyridamole

SSRI antidepressants, eg fluoxetine, paroxetine, citalopram

venlafaxine.

Diclofenac may enhance the effect of blood-thinning or anti-clotting medicines (anticoagulants) such as warfarin. As this may increase the risk of bleeding, people taking diclofenac with an anticoagulant should be closely monitored by their doctor.

Diclofenac may reduce the removal of the following medicines from the body and so may increase the blood levels and risk of side effects of these medicines. People taking diclofenac with any of these should be closely monitored by their doctor:

digoxin

lithium

methotrexate.

Ciclosporin may increase the blood level of diclofenac, and your doctor may prescribe a lower than normal dose of diclofenac if you are taking ciclosporin.

There may be an increased risk of side effects on the kidneys if diclofenac is taken with any of the following medicines:

ACE inhibitors, eg enalapril

angiotensin II receptor antagonists, eg losartan

ciclosporin

diuretics, eg furosemide

tacrolimus.

Diclofenac may oppose the blood pressure lowering effects of certain medicines to treat high blood pressure, such as the following:

ACE inhibitors such as captopril

angiotensin II receptor antagonists, eg losartan

beta-blockers such as propranolol

diuretics such as furosemide.

Other medicines containing the same active ingredient

Defanac	Dexomon SR	Dicloflex
Diclomax	Diclozip	Econac suppositories
Fenactol	Flamatak MR	Flamrase
Motifene	Pennsaid	Rheumatac retard
Rhumalgan	Volsaid retard	Voltarol emulgel
Voltarol emulgel P	Voltarol gel patch	Voltarol injection
Voltarol ophtha	Voltarol suppositories	Voltarol tablets

Diclofenac enteric-coated tablets, sustained-release tablets, suppositories and injection are also available without brand names, ie as the generic medicine.

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