Diclofenac oral tablets are generic drugs that are prescribed for certain types of arthritis and other conditions. Diclofenac has interactions with alcohol, some other drugs, and certain supplements. Examples include ibuprofen and blood thinners.
Diclofenac is prescribed to treat the following conditions in adults:
- osteoarthritis
- rheumatoid arthritis
- ankylosing spondylitis
- mild to moderate pain
- dysmenorrhea (period pain)
Diclofenac oral tablet is available as the brand-name drug Lofena. Diclofenac extended-release* oral tablet and diclofenac delayed-release† oral tablet are not available in brand-name versions.
An interaction occurs when one substance causes another substance to have a different effect than expected.
Diclofenac also comes in different forms, and they have different interactions. These include eye drops, oral capsule, and certain topical forms. This article will focus on interactions for the oral tablets of diclofenac. You can talk with your doctor to learn more about interactions of the other forms.
To learn more about diclofenac’s interactions, keep reading. For additional information about diclofenac, including details about its uses, see this article.
* Extended-release means the drug is slowly released into your body over a long period of time.
† Delayed-release means the drug is released into your body after it passes through your stomach.
Before you start treatment with diclofenac, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether diclofenac interacts with supplements, herbs, or vitamins, see the “Diclofenac and other interactions” section.)
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with diclofenac. Keep in mind that this table doesn’t include all drugs that may interact with diclofenac. Some of these interactions are described in detail in “Drug interactions in depth.”
| Drug class or drug name | Drug examples | Interaction result with diclofenac |
| cyclosporine (Sandimmune, Neoral, others) | — | can increase the risk of kidney problems |
| methotrexate (Trexall, others) | — | can increase the risk of side effects of methotrexate |
| blood thinners | • warfarin (Coumadin, Jantoven) • apixaban (Eliquis) • dabigatran (Pradaxa) | can increase the risk of bleeding |
| selective serotonin reuptake inhibitors (SSRIs) | • fluoxetine (Prozac) • paroxetine (Paxil) • escitalopram (Lexapro) | can increase the risk of bleeding |
| serotonin-norepinephrine reuptake inhibitors (SNRIs) | • venlafaxine (Effexor XR) • duloxetine (Cymbalta) | can increase the risk of bleeding |
| angiotensin converting enzyme (ACE) inhibitors | • lisinopril (Zestril, others) • benazepril (Lotensin) | may cause kidney problems and make the ACE inhibitor less effective |
| angiotensin II receptor blockers (ARBs) | • losartan (Cozaar) • valsartan (Diovan) | may cause kidney problems and make the ARB less effective |
| beta-blockers | • metoprolol (Lopressor) • carvedilol (Coreg) | can make the beta-blocker less effective |
| diuretics (water pills) | • furosemide (Lasix) • hydrochlorothiazide (Microzide) | may cause kidney problems and make the diuretic less effective |
| other NSAIDs | • ibuprofen (Motrin, Advil) • naproxen (Naprosyn, Aleve) • aspirin | can increase the risk of serious GI problems and bleeding |
In some cases, factors or conditions could prevent your doctor from prescribing diclofenac due to the risk of harm. These are known as contraindications. The contraindications of diclofenac include:
Having asthma, hives, or another allergic-type reaction after taking any NSAID or aspirin
Your doctor likely won’t prescribe diclofenac if you’ve experienced asthma, hives, or another allergic-type reaction after taking other NSAIDs or aspirin. Taking the drug could lead to severe, life threatening allergic reactions. Your doctor can discuss alternative medications that are safer for you.
Having recent heart bypass surgery
Doctors typically won’t prescribe diclofenac for people who’ve recently had coronary artery bypass graft surgery (also known as heart bypass surgery). This is because, in studies, people who took diclofenac the first 10 to 14 days after heart bypass surgery had a higher rate of heart attack and stroke.
If you’ve had heart bypass surgery, talk with your doctor before taking diclofenac. They’ll likely prescribe a treatment other than diclofenac for your condition.
Having had an allergic reaction to diclofenac or any of its ingredients
If you have had an allergic reaction to diclofenac or any of its ingredients, your doctor will likely not prescribe diclofenac. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
Note:Before you start treatment with diclofenac, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe diclofenac.
Your doctor will likely recommend that you not drink alcohol while taking diclofenac. They’ll also usually advise you not to take any prescription or over-the-counter drugs that contain alcohol during diclofenac treatment.
Consuming alcohol and taking diclofenac may increase the risk of serious and life threatening gastrointestinal (GI) problems. These include bleeding, holes, and ulcers (sores) in the GI tract.
If you have concerns about avoiding alcohol while you’re taking diclofenac, talk with your doctor before starting treatment.
Here’s a closer look at certain drug interactions of diclofenac.
Other NSAIDs
NSAIDs are medications used to treat pain and inflammation.
Interaction result: Taking diclofenac oral tablets with other NSAIDs can increase the risk of serious side effects of both diclofenac and the other NSAID.
Interaction explained: Diclofenac belongs to the class of drugs called NSAIDs. All NSAIDs work similarly to reduce pain and inflammation. They also cause similar side effects. Taking multiple NSAIDs at the same time can increase the risk of side effects of diclofenac and the other NSAID. This includes serious GI problems and bleeding.
Examples of NSAIDs: Here are some NSAIDs that may interact with diclofenac:
- ibuprofen (Motrin, Advil)
- aspirin
- naproxen (Aleve, Naprosyn)
- indomethacin (Indocin)
- nabumetone (Relafen)
Steps you or your doctor may take: NSAIDs are available both over the counter (OTC) and by prescription. Before taking any new medications with diclofenac, talk with your doctor or pharmacist. They can discuss whether your new medication is an NSAID and if it’s safe to take with diclofenac.
If you’re taking diclofenac with other NSAIDs and develop any signs or symptoms of GI problems or bleeding, call 911 or your local emergency number right away. These may include:
- vomiting blood
- bloody stool
- black or sticky stools that look like tar
- severe abdominal pain
- bleeding from the anus
In some cases, these side effects can be life threatening and require immediate medical attention.
ACE inhibitors
ACE inhibitors are typically used to treat high blood pressure, heart problems, and kidney problems.
Interaction result: Taking diclofenac oral tablet with ACE inhibitors can make the ACE inhibitor less effective at managing blood pressure. It may also increase the risk of kidney problems in certain people. These include people who are ages 65 and older, have existing kidney problems, or are hypovolemic (have a low volume of blood in their body).
Interaction explained: NSAIDs, such as diclofenac, can increase blood pressure. When taken with a blood pressure medication such as an ACE inhibitor, it can counteract its effects. This can make the ACE inhibitor less effective at managing your blood pressure.
Diclofenac and ACE inhibitors can both cause kidney problems as a side effect. Taking these drugs together can increase your risk of kidney problems. If you have certain risk factors, such as the ones listed above, your risk of kidney problems may be higher.
Examples of ACE inhibitor drugs: Here are some ACE inhibitors that may interact with diclofenac:
- lisinopril (Zestril)
- enalapril (Vasotec)
- benazepril (Lotensin)
- quinapril (Accupril)
- ramipril (Altace)
- fosinopril
Steps you or your doctor may take: Tell your doctor that you take an ACE inhibitor before you start diclofenac oral tablets. They can help determine if it’s safe for you to take these drugs together. If you and your doctor decide to start diclofenac, they’ll likely monitor your blood pressure more closely. They’ll also order blood tests to check on your kidney health.
Blood thinners
Blood thinners are used to lower the risk of blood clots forming in the bloodstream.
Interaction result: Taking diclofenac oral tablets with a blood thinner can increase your risk of bleeding.
Interaction explained: Blood thinners work by preventing your blood’s ability to clot. While this is an effective way to prevent blood clots, it can increase your risk of bleeding. NSAIDs can also cause bleeding as a side effect. This means taking these drugs together may increase the risk of bleeding.
Examples of blood thinning drugs: Here are some blood thinners that may interact with diclofenac:
- warfarin (Coumadin, Jantoven)
- dabigatran (Pradaxa)
- apixaban (Eliquis)
- rivaroxaban (Xarelto)
Steps you or your doctor may take: Before starting diclofenac, be sure to tell your doctor if you take a blood thinner. They can help determine if it’s safe for you to take diclofenac. If you take these drugs together, your doctor will likely monitor you closely for signs or symptoms of bleeding.
If you experience mild to moderate signs or symptoms of bleeding, tell your doctor right away. If your bleeding seems life threatening, call 911 or your local emergency number or visit your nearest emergency room for medical help.
Diclofenac may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with diclofenac.
Diclofenac interactions with supplements
Before you start treatment with diclofenac, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Diclofenac interactions with herbs
It’s possible for diclofenac to interact with an herb called ginkgo biloba. Some people take this herb to boost theirmemory, reduce anxiety, and manage glaucoma. If you take ginkgo biloba during diclofenac treatment, it may increase the risk of bleeding.
If you take any ginkgo biloba supplements, talk with your doctor before starting diclofenac treatment. They’ll likely advise you to stop taking the supplements.
Diclofenac interactions with vitamins
There are no specific reports of vitamins interacting with diclofenac potassium oral tablet, diclofenac ER oral tablet, or diclofenac DR oral tablet. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with diclofenac.
Diclofenac interactions with food
Although ginger may interact with diclofenac, there were no reports of food interactions with diclofenac potassium oral tablet, diclofenac ER oral tablet, or diclofenac DR oral tablet.
If you consume ginger during diclofenac treatment, it may increase the risk of bleeding.
If you have additional questions or want more information about eating certain foods during diclofenac treatment, talk with your doctor.
Diclofenac interactions with vaccines
There aren’t any known interactions between diclofenac and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.
Diclofenac interactions with lab tests
Diclofenac isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.
DICLOFENAC INTERACTION WITH CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with diclofenac. Using cannabis while taking diclofenac may increase your risk of side effects from diclofenac. Due to this risk, your doctor may reduce your dose of diclofenac.
Before you start treatment with diclofenac, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.
Certain medical conditions and other factors may increase the risk of interactions with diclofenac. Before you take this drug, be sure to talk with your doctor about your health history. Diclofenac may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with diclofenac include:
- Past heart attack or stroke: NSAIDs, including diclofenac, increase your risk of heart attack and stroke. This risk is especially high if you take an NSAID after a recent heart attack. If you’ve had a heart attack or stroke in the past, tell your doctor. They can discuss whether diclofenac is safe for you or whether you should take an alternative medication.
- Liver problems: Diclofenac can increase your risk of liver problems. If you already have liver problems, diclofenac can worsen your condition. Due to this risk, your doctor will likely prescribe the lowest effective dose for the shortest time possible. They may also order blood tests to monitor your liver health.
- Asthma: Some people with asthma experience a reaction to aspirin, including nasal polyps and severe bronchospasm. Because aspirin and diclofenac are chemically similar, you may experience a reaction to diclofenac as well. Due to this risk, doctors typically won’t prescribe diclofenac to people with an aspirin sensitivity.
- Kidney problems: Diclofenac can cause and worsen existing kidney problems. Be sure to tell your doctor if you have kidney problems before you start taking diclofenac. They may monitor your kidney health closely during treatment.
- High blood pressure: NSAIDs, such as diclofenac, can cause new or worsening high blood pressure. If you have high blood pressure, this drug can worsen your condition. Talk with your doctor about all of your medical conditions before you start diclofenac treatment. They can help determine if the drug is safe for you.
- Allergic reaction: If you’ve had an allergic reaction to diclofenac or any of its ingredients, your doctor will likely not prescribe diclofenac. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
- Breastfeeding: It’s not known whether it’s safe to use diclofenac while breastfeeding. There isn’t enough information to determine what effects diclofenac may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using diclofenac. They can talk with you about treatment options and ways to feed your child.
- Pregnancy: If taken at week 30 of pregnancy and beyond, diclofenac can cause harm to your developing fetus. Due to this risk, doctors typically won’t prescribe diclofenac at week 30 of pregnancy and beyond. In most cases, diclofenac is also avoided after week 20 of pregnancy, except in certain circumstances. If you’re pregnant or planning to become pregnant, tell your doctor before starting diclofenac. They can advise you on the right treatment plan for you.
You can take certain steps to help prevent interactions with diclofenac. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:
- Let them know if you drink alcohol or use cannabis.
- Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
- Create a
medication list , which your doctor and pharmacist can help you fill out.
It’s also important to read the diclofenac label and other
If diclofenac doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
You can also help prevent interactions with diclofenac by taking it exactly as your doctor prescribes.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.