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When using diclofenac, there are several important safety considerations and warnings to be aware of. These concerns include potential risks, necessary precautions, and specific instructions for certain populations. Here is a summary of the key points:

• Heart Attack and Stroke Risk: Diclofenac may increase the likelihood of blood clots, heart attacks, or strokes, especially in individuals with pre-existing heart conditions or those using high doses over extended periods. It is crucial to use the lowest effective dosage for the shortest duration possible. Avoid diclofenac if you are undergoing or have recently had heart bypass surgery. Seek immediate medical attention if you experience chest pain, difficulty breathing, or weakness on one side of the body.

• Gastrointestinal Bleeding and Ulcers: This medication can cause serious stomach bleeding and ulcers. Risks are heightened for older adults and those with a history of ulcers or gastrointestinal issues. Avoid combining diclofenac with other NSAIDs, alcohol, or certain medications that increase bleeding risk. Discontinue use and consult a healthcare provider if you notice blood in vomit or stools, or experience persistent abdominal pain.

• Liver Damage: Diclofenac poses a rare risk of serious liver damage, which can occur early in treatment. The risk increases when combined with other liver-affecting drugs like acetaminophen. Regular liver function monitoring is advised for long-term users. Signs of liver damage include jaundice, dark urine, or clay-colored stools; stop taking the medication and seek medical help if these symptoms appear.

• High Blood Pressure and Heart Failure: Diclofenac can elevate blood pressure and cause fluid retention, leading to heart failure or exacerbating existing conditions. It may also interfere with certain blood pressure medications. It is not recommended for individuals with severe heart failure. Monitor blood pressure regularly, and alert a healthcare provider if you experience significant changes or symptoms such as unexplained swelling or weight gain.

• Kidney Issues and High Potassium Levels: This drug can negatively impact kidney function, especially in those with pre-existing kidney issues or when used alongside certain blood pressure medications. Kidney damage is often reversible upon discontinuation. Inform your healthcare provider if you notice changes in urination patterns.

• Asthma and Respiratory Reactions: Diclofenac may provoke asthma attacks in susceptible individuals. Those with a history of NSAID-induced asthma should avoid this medication. Seek emergency care if you experience severe breathing difficulties.

• Allergic Reactions: Severe allergic reactions, including skin reactions, are possible. Avoid diclofenac if you have known allergies to NSAIDs or bovine-derived ingredients in specific formulations like Zipsor. Discontinue use and seek immediate help if you develop symptoms such as rash, swelling, or difficulty breathing.

• Pregnancy Risks: Diclofenac may harm unborn babies, particularly when taken during the second and third trimesters, potentially causing kidney and heart problems. Pregnant individuals should discuss the risks with their healthcare provider.

Contraindications include a history of asthma or allergic reactions to NSAIDs, recent heart surgery, and specific allergies to ingredients such as those found in diclofenac potassium capsules. Always consult your healthcare provider before starting diclofenac to ensure it is safe for you.

When taking this medication, some common side effects you might experience include upset stomach, nausea, heartburn, diarrhea, constipation, and gas. These are generally mild, but if they persist or worsen, seek advice from your healthcare provider. You may also encounter headaches, dizziness, or blurred vision. It's important to monitor your blood pressure, as this medication can elevate it. If you notice high readings, inform your healthcare provider.

Serious side effects, although less common, require immediate medical attention. These include hearing changes, mental or mood changes, and easy bleeding or bruising. Additionally, symptoms such as the swelling of ankles or feet, unusual tiredness, or sudden weight gain could indicate heart failure. Kidney-related issues might present as changes in urination or pink/bloody urine.

Rarely, this medication can cause severe liver damage. Warning signs include persistent nausea or vomiting, loss of appetite, abdominal pain, yellowing of the skin or eyes, and dark urine. A serious allergic reaction is also uncommon but needs urgent medical help if you experience symptoms like fever, swollen lymph nodes, rash, or trouble breathing.

In very rare cases, this medication may lead to significant health issues like heart attacks or strokes. Symptoms such as chest pain, cold sweat, trouble breathing, or sudden weakness on one side of the body require emergency care. Similarly, any signs of kidney damage, high potassium levels, or severe asthma attacks should be addressed promptly. Always consult your healthcare provider for guidance if you experience any unusual or severe effects.

When taking diclofenac, it's important to be aware of its potential interactions with other medications. Some drugs that can interact with diclofenac include aliskiren, ACE inhibitors (like benazepril and lisinopril), angiotensin II receptor blockers (such as losartan and valsartan), cidofovir, corticosteroids (for example, dexamethasone and prednisone), lithium, methotrexate, and diuretics (like furosemide). The combination of diclofenac with these medications might increase the risk of side effects.

Furthermore, diclofenac can heighten the chance of bleeding when used alongside other drugs that also cause bleeding. This includes anti-platelet medications such as clopidogrel and anticoagulants like dabigatran, enoxaparin, and warfarin. It is advisable to review all prescription and non-prescription medicine labels carefully, as many contain pain relievers or fever reducers (such as aspirin, ibuprofen, ketorolac, and naproxen), which are similar to diclofenac and could amplify side effects if taken together. However, if your healthcare provider has recommended low-dose aspirin to prevent heart attacks or strokes, you should continue this treatment unless advised otherwise by your doctor.

Always inform your doctor and pharmacist about all medications and supplements you are taking to manage these potential interactions effectively.