Itami Diario (Diclofenac Sodium)

Diclofenac sodium is used topically to address inflammatory and painful conditions affecting the musculoskeletal system.

• Osteoarthritis of the knee: reduces joint pain and improves function in patients with localized knee osteoarthritis.
• Rheumatoid arthritis flare‑ups: alleviates localized joint inflammation and discomfort.
• Acute muscle or tendon injury: provides pain relief and diminishes swelling in strained muscles, tendons, or bursae.
• Soft‑tissue inflammation: eases redness, heat, and tenderness in conditions such as bursitis or tendinitis.

• Diclofenac sodium inhibits both cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes, leading to decreased conversion of arachidonic acid to prostaglandins. The reduction in prostaglandin synthesis diminishes inflammation, pain signaling, and fever at the site of application, providing localized therapeutic effects without substantial systemic exposure when used topically.

Topical diclofenac may cause skin‑related reactions and, rarely, systemic adverse events.

Common Side Effects

• Skin irritation: mild burning or stinging at the application site.
• Redness: localized erythema around the treated area.
• Itching: pruritus developing after use.
• Dryness: flaky or dry skin where the product is applied.

Serious or Rare Side Effects

• Allergic dermatitis: severe rash or hives requiring medical attention.
• Stevens‑Johnson syndrome: rare but serious skin reaction with blistering.
• Systemic NSAID effects: gastrointestinal ulceration, renal impairment, or hepatic injury when absorbed in significant amounts.
• Photosensitivity: increased skin sensitivity to sunlight.

When using topical diclofenac, consider the following precautions to ensure safe and effective therapy.

• Cardiovascular risk assessment: avoid use in patients with uncontrolled hypertension or recent cardiovascular events.
• Renal and hepatic function: evaluate kidney and liver status before initiating therapy.
• Concomitant NSAIDs: do not combine with oral NSAIDs or other topical NSAIDs to reduce toxicity risk.
• Pregnancy and lactation: use only if clearly needed and after professional advice.
• Skin integrity: do not apply on broken, infected, or irritated skin.
• Store at room temperature: keep in original packaging, protect from moisture and direct sunlight.

Diclofenac sodium can interact with several medicines; some combinations should be avoided while others require monitoring.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of bleeding.
• Other NSAIDs or aspirin: heightened gastrointestinal and renal toxicity.
• Corticosteroids: amplified risk of ulceration and bleeding.
• Lithium: diclofenac may raise lithium serum levels.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: possible reduction in renal function.
• Diuretics: may enhance renal adverse effects.
• Selective serotonin reuptake inhibitors (SSRIs): increased bleeding tendency.
• Methotrexate: potential for increased toxicity.