Itami (Diclofenac Sodium)

Diclofenac Sodium is a topical NSAID that reduces inflammation in various musculoskeletal conditions.

• Osteoarthritis (knee): provides localized pain relief and reduces joint inflammation.
• Rheumatoid arthritis (localized): diminishes swelling and tenderness in affected joints.
• Acute muscle sprain: eases pain and limits secondary inflammation.
• Tendonitis: helps restore function by decreasing tendon inflammation.
• Bursitis: relieves discomfort and swelling around bursae.

• Diclofenac Sodium inhibits cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes in peripheral tissues, leading to reduced synthesis of prostaglandins that mediate pain, edema and inflammation. By limiting prostaglandin production at the site of application, the drug lowers local inflammatory responses without significant systemic exposure when used topically.

Topical diclofenac is generally well tolerated, but adverse skin reactions can occur.

Common Side Effects

• Skin irritation: mild burning or stinging at the application site.
• Redness: localized erythema.
• Itching: pruritus around the treated area.
• Dryness: flaky or scaly skin.
• Rash: transient maculopapular eruption.
• Peeling: superficial desquamation.

Serious or Rare Side Effects

• Allergic reaction: hives, swelling, or angioedema.
• Severe skin disorders: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Systemic toxicity: rare hepatic or renal impairment.
• Cardiovascular events: rare increase in blood pressure or thrombotic events.
• Photosensitivity: exaggerated sunburn response.
• Contact dermatitis: persistent eczema at the site.

When using Itami, consider the following safety measures.

• Avoid use on broken skin: do not apply to open wounds, cuts or infected areas.
• Limit application area: restrict to the recommended surface area to reduce systemic absorption.
• Monitor for allergic signs: discontinue if rash, swelling or breathing difficulty occurs.
• Caution with anticoagulants: inform healthcare provider if you are taking blood thinners.
• Use in pregnancy and lactation only if clearly indicated: discuss risks with a physician.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Topical diclofenac can interact with other medicines, especially those affecting bleeding or inflammation.

Major Interactions (Avoid)

• Systemic NSAIDs: concurrent use may increase risk of gastrointestinal bleeding.
• Anticoagulants (e.g., warfarin): may enhance anticoagulant effect and bleeding risk.
• Systemic corticosteroids: combined use can raise ulceration risk.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may attenuate antihypertensive response.
• Diuretics: monitor renal function if both are used.
• Lithium: potential for increased lithium levels.
• Methotrexate: monitor for additive toxicity.