Ultrafen Special Precautions

Ultrafen should not be prescribed to pregnant women unless there is compelling reason for doing so. Patients with a history of peptic ulcer, hematemesis, melena, bleeding diathesis or with severe hepatic or renal insufficiency should be kept under close surveillance. If abnormal liver function tests persist or worsen, clinical signs and symptoms consistent with liver disease develop or if other manifestations occur (eosinophilia, rash), Ultrafen should be discontinued. Use of Ultrafen in patients with hepatic porphyria may trigger an attack.
Cardiovascular effect: Treatment with NSAIDs, including diclofenac, particularly at high dose and in long term, may be associated with a small increased risk of serious cardiovascular thrombotic events (including myocardial infarction and stroke).
As the cardiovascular risks of diclofenac may increase with dose and duration of exposure, the lowest effective daily dose should be used for the shortest duration possible. The patient's need for symptomatic relief and response to therapy should be re-evaluated periodically, especially when treatment continues for more than 4 weeks. Patients should be advised to remain alert for the signs and symptoms of serious arteriothrombotic events (e.g. chest pain, shortness of breath, weakness, slurring of speech), which can occur without warnings. Patients should be instructed to see a physician immediately in case of such an event.