What side effects can diclofenac cause?
Diclofenac (a NSAID) can cause common side effects, including stomach and digestive issues such as indigestion, nausea, vomiting, diarrhea, and stomach pain. It can also cause dizziness and headaches in some people.
What are the serious side effects people worry about?
Serious side effects with diclofenac can include:
- Stomach or intestinal bleeding, ulcers, or perforation, which may present with black/tarry stools, vomiting blood, or severe abdominal pain.
- Cardiovascular risks such as increased risk of heart attack or stroke, particularly at higher doses or longer use.
- Kidney problems, including reduced kidney function or fluid retention (swelling in legs/ankles).
- Allergic reactions, including rash, hives, facial swelling, or trouble breathing.
- Liver injury, which may show up as yellowing of the skin or eyes, dark urine, or severe fatigue.
Does the risk depend on the form (pill vs gel vs injections)?
Side effects are influenced by how diclofenac is used:
- Oral diclofenac generally has a higher risk of stomach, cardiovascular, and kidney-related adverse effects because more of the drug reaches the bloodstream.
- Topical diclofenac gel tends to cause fewer systemic (whole-body) side effects, but can still cause skin irritation at the application site and may still rarely be associated with systemic NSAID effects, especially with heavy or long-term use.
- Diclofenac injections carry risks similar to other systemic NSAIDs.
What side effects mean you should get medical help now?
Seek urgent care if you have signs of:
- Serious allergic reaction (swelling of face/lips, hives, breathing trouble).
- GI bleeding (black/tarry stools, vomiting blood, severe or persistent stomach pain).
- Possible heart attack or stroke (chest pain, shortness of breath, weakness on one side, trouble speaking).
- Kidney or severe fluid problems (rapid weight gain, marked swelling).
- Liver injury (yellow skin/eyes, dark urine, severe right-sided abdominal pain).
Who should be extra cautious with diclofenac?
Risk is higher for people with a history of:
- Stomach ulcers or GI bleeding
- Heart disease or prior stroke
- Kidney disease
- Liver disease
- NSAID allergy or asthma that worsens with NSAIDs
Using higher doses or taking diclofenac for longer periods also increases the chance of serious side effects.
What patients ask about: Can you take diclofenac with other pain relievers?
NSAIDs should generally not be combined with other NSAIDs (for example, ibuprofen or naproxen) because it increases risk of GI bleeding and kidney problems. Some people also combine diclofenac with acetaminophen, but the best approach depends on their medical history and other medications.
Sources
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