Sign Out
Diclofenac has been reported to increase the plasma concentrations of digoxin and lithium when used concurrently, therefore their levels should be monitored.
Although clinical studies have shown that diclofenac prescribed together with oral antidiabetic agents does not influence their efficacy, isolated cases have been reported of hypoglycaemic and hyperglycaemic reactions leading to an adjustment in the dosage of antidiabetic drugs.
Concurrent use of potassium-sparing diuretics may increase the serum potassium levels leading to hyperkalaemia.
Concomitant administration of corticosteroids, glucocorticoids or potassium supplements may increase the risk of gastrointestinal side effects.
Patients receiving diclofenac and anticoagulant or thrombolytic therapy concomitantly may induce gastrointestinal ulceration or bleeding.
With usual doses, diclofenac may be less likely to significantly alter platelet aggregation than other NSAIDs.
Concurrent use of two or more NSAIDs, including aspirin is not recommended since it may increase the risk of gastrointestinal side effects, including ulceration or haemorrhage. Inhibition of renal prostaglandin activity by NSAIDs may increase the risk of cyclosporine-induced nephrotoxicity.
Concurrent use with methotrexate may increase the risk of agranulocytosis or bone marrow depression. Therefore, NSAID therapy should not be resumed until the methotrexate plasma concentration has decreased to a non-toxic level, usually at least 12 hours.
