Voltaren

Voltaren is a prescription medication used to treat inflammation and pain caused by osteoarthritis and rheumatoid arthritis as well as postoperative eye pain after cataract removal or corneal surgery.

Voltaren belongs to a group of drugs called NSAIDs, which work by stopping the substances in the body that cause inflammation and pain. 

Voltaren comes in a variety of forms including extended-release tablets, a gel, and eye drops. The directions for taking it will depend on which form you are prescribed. Follow the directions carefully.

Common side effects of Voltaren eye drops and gel include irritation and redness at the site of application.

Common side effects of Voltaren tablets include nausea, upset stomach, stomach pain, and dizziness. Do not drive or operate heavy machinery until you know how Voltaren can affect you.

Voltaren is a prescription medication used to treat inflammation and pain due to due osteoarthritis or rheumatoid arthritis as well as postoperative eye pain after cataract removal or corneal surgery. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Novartis Pharmaceuticals Corporation

The most common side effects of Voltaren include the following:

Tablets:

• swelling
• nausea
• headache
• dizziness
• vomiting
• constipation
• pruritus
• pain in extremity
• upset stomach

Gel:

• itching
• redness
• irritation
• rash
• dryness
• scaling or peeling

Eye Drops:

• abnormal or blurred vision
• redness
• eye or eyelid swelling
• eye pain

This is not a complete list of Voltaren side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• other NSAIDs such as aspirin, ibuprofen, or naproxen
• 'blood thinners' such as warfarin (Coumadin, Jantoven)
• voriconazole (Vfend)
• angiotensin-converting enzyme (ACE) blockers such as
  • benazepril (Lotensin, Lotensin HCT)
  • captopril (Capoten, Capozide)
  • enalapril (Vasotec, Vaseretic)
  • fosinopril (Monopril, Monopril HCT)
  • lisinopril (Prinivil, Prinzide, Zestril, Zestoretic)
  • moexipril (Univasc, Uniretic)
  • quinapril (Accupril, Accuretic, Quinaretic)
  • ramipril (Altace)
  • trandolapril (Mavik, Tarka)
• diuretics such as
  • acetazolamide (Diamox)
  • amiloride (Midamor)
  • bumetanide (Bumex)
  • chlorothiazide (Diuril)
  • chlorthalidone (Thalitone)
  • ethacrynic acid (Edecrin)
  • furosemide (Lasix)
  • hydrochlorothiazide (Microzide, HCTZ)
  • metolazone (Zaroxolyn)
  • torsemide (Demadex)
  • triamterene (Dyrenium, Dyazide, Maxzide)
• methotrexate (Trexall)
• lithium (Eskalith, Lithobid)
• cyclosporine (Gengraf, Neoral, Sandimmune)

This is not a complete list of Voltaren drug interactions. Ask your doctor or pharmacist for more information.

• Do not use Voltaren if you are allergic to diclofenac (the active ingredient), any inactive ingredient, or aspirin.
• Voltaren is an NSAID medication. Although some forms of Voltaren can be applied to the skin, some of the medication is absorbed into the blood stream. NSAIDs have been linked to stomach and intestinal bleeding, ulcers, heart attack, stroke, congestive heart failure, allergic reactions, and worsening asthma.NSAID medicines should never be used right before or after a heart surgery called a "coronary artery bypass graft (CABG).
• Tell your doctor right away if you experience symptoms of ulcers or bleeding including:
  • black, tarry stools
  • blood in stools
  • stomach pain
  • vomiting blood
• Call 911 if you experience heart attack symptoms:
  • chest discomfort (uncomfortable pressure, fullness, or pain in chest)
  • shortness of breath
• Voltaren can also cause or worsen existing high blood pressure. Blood pressure should be monitored closely during treatment with Voltaren treatment.
• Fluid retention and swelling have been observed in those who have taken NSAIDs. Voltaren should be used with caution in patients with fluid retention or heart failure.
• Anemia. Your doctor will monitor your blood counts. 
• Kidney injury may occur with long-term use. Voltaren should be used with caution in patients at greatest risk of this, including the elderly, those with impaired kidney function, heart failure, liver dysfunction, and those taking diuretics and ACE inhibitors.
• Severe allergic reactions have occurred in patients with the aspirin triad or in patients without prior exposure to Voltaren. Tell your healthcare provider about any signs or symptoms of hypersensitivity, which include the following:
  • chest pain
  • swelling of the face, eyes, lips, tongue, arms, or legs
  • difficulty breathing or swallowing
  • rash
• Serious skin adverse events have occurred with Voltaren use. Discontinue Voltaren if rash or other signs of a skin reaction occur.
• Voltaren can cause dizziness. Do not drive or operate heavy machinery until you know how Voltaren can affect you.

Do not take this medication:

• if you had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAID medicine
• for pain right before or after heart bypass surgery

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Voltaren there are no specific foods that you must exclude from your diet when receiving Voltaren.

Before using Voltaren, tell your doctor if you:

• are allergic to any medications, foods, or dyes
• have asthma or nasal polyps
• have heart, liver, or kidney disease
• have ulcers or stomach bleeding
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. NSAIDs can adversely affect the development of the unborn baby's cardiovascular system. Use during pregnancy (particularly late pregnancy) should be avoided.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if Voltaren is excreted in human breast milk or if it will harm your nursing baby.

Take Voltaren exactly as prescribed. Voltaren comes in extended-release tablet, gel, and eye drop forms. Do not break, divide, chew, or crush the extended-release tablets.

Tablet:

• Voltaren tablets are typically taken once a day. 

Gel

• Use exactly as prescribed. Do not use more or less of it, or use it more often than prescribed by your doctor.
• Wash your hands.
• Apply a small amount of gel on the affected skin, covering it completely, gently smoothing the gel on affected area.
• The gel is usually applied four times a day. Use the dosing card supplied in the drug product carton to ensure you are applying the right amount of medication. 
• Showering/bathing should be avoided for at least 1 hour after the application. Patient should wash his/her hands after use, unless the hands are the treated joint. If Voltaren Gel is applied to the hand(s) for treatment; patient should not wash the treated hand(s) for at least 1 hour after the application.

What to avoid:

• Be careful not to get this medication in your eyes if you are applying it to your face.
• Do not apply to open wounds (broken skin), infections, or red, scaly skin.
• Wear protective clothing, and avoid prolonged sun exposure.
• Do not apply sunscreens, cosmetics, or other medications at the same time as Voltaren gel. 

Eye drop solutions

• One drop should be applied to the affected eye, 4 times daily beginning 24 hours after cataract surgery and continuing throughout the first 2 weeks of the postoperative period.
• One or two drops should be applied to the operative eye within the hour prior to corneal refractive surgery. Within 15 minutes after surgery, one or two drops should be applied to the operative eye and continued 4 times daily for up to 3 days.

Extended-release tablet

• For the relief of osteoarthritis, the recommended dosage is 100 mg a day.
• For the relief of rheumatoid arthritis, the recommended dosage is 100 mg a day. If once a day dosing does not provide relief, your s may increase the dose to 100 mg twice a day. 

Gel:

• Apply to lesion areas for times a day. It is to be smoothed onto the affected skin gently.
• Your doctor will tell you how much gel to apply. 

Eye drop solutions

• One drop should be applied to the affected eye, 4 times daily beginning 24 hours after cataract surgery and continuing throughout the first 2 weeks of the postoperative period.
• One or two drops should be applied to the operative eye within the hour prior to corneal refractive surgery. Within 15 minutes after surgery, one or two drops should be applied to the operative eye and continued 4 times daily for up to 3 days.

If you take too much or apply too much Voltaren, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

Cardiovascular Risk

• Nonsteroidal anti-inflammatory drugs (NSAIDs) may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.
• Voltaren is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Risk

• NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events.