Itami (Diclofenac Sodium)

Diclofenac Sodium is a topical NSAID that acts on inflammatory pathways to alleviate pain and swelling.

• Local pain relief: reduces pain from minor injuries, sprains and strains applied to the affected area.
• Inflammation reduction: diminishes localized swelling and erythema associated with soft‑tissue inflammation.
• Musculoskeletal pain: eases discomfort in joints and muscles caused by overuse or minor trauma.

• Diclofenac Sodium exerts its effect by reversibly inhibiting cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes in peripheral tissues. This inhibition lowers prostaglandin synthesis, which in turn decreases inflammation, pain signaling, and fever responses at the site of application.

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

Common Side Effects

• Skin irritation: mild redness or discomfort at the application site.
• Erythema: localized redness that usually resolves with continued use.
• Itching: transient pruritus where the gel is applied.
• Burning sensation: brief warmth or stinging after application.
• Dryness: mild desiccation of the skin surface.

Serious or Rare Side Effects

• Allergic reaction: hives, swelling, or difficulty breathing.
• Stevens‑Johnson syndrome: severe skin blistering and detachment.
• Necrotizing skin lesions: ulceration or necrosis of the treated area.
• Systemic toxicity: signs of gastrointestinal bleeding or renal impairment.
• Hepatic injury: elevated liver enzymes or jaundice.

When using topical diclofenac, consider the following safety measures.

• Medical history review: assess for known NSAID hypersensitivity or cardiovascular disease.
• Avoid infected or broken skin: do not apply to open wounds or areas with active infection.
• Limit application area: restrict use to the recommended surface area to reduce systemic absorption.
• Monitor for systemic effects: watch for signs of gastrointestinal bleeding or renal dysfunction.
• Use with caution in the elderly: age‑related changes may increase risk of adverse events.
• Store at room temperature: keep in the original container, protect from moisture and direct heat.

Diclofenac sodium can interact with other medicines, influencing safety and efficacy.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of bleeding.
• Other NSAIDs or aspirin: additive gastrointestinal toxicity.
• Lithium: heightened lithium serum concentrations.
• Methotrexate: reduced clearance leading to toxicity.
• Corticosteroids: amplified risk of ulceration and bleeding.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: possible reduction in renal function.
• Diuretics: potential for decreased renal perfusion.
• Selective serotonin reuptake inhibitors (SSRIs): modestly increased bleeding risk.
• Alcohol: may exacerbate gastrointestinal irritation.