Voltarol

What is it?

An NSAID and phenylacetic acid diclofenac sodium, available as enteric-coated tablets in 2 strengths containing diclofenac sodium; yellow, contain 25mg and brown contain 50mg, both marked with name and strength on one side and GEIGY on the other. Also, VOLTAROL DISPERSIBLE available as pink, triangular tablets containing 50mg of diclofenac sodium marked V on one side and GEIGY on the other, for adding to water. Also, VOLTAROL RETARD, available as sustained-release red tablets containing 100mg of diclofenac sodium marked VOLTAROL R and GEIGY. Also, VOLTAROL SUPPOSITORIES available in 4 strengths containing 12.5mg, 25mg, 50mg and 100mg of diclofenac sodium. Also, VOLTAROL RAPID, sugar-coated tablets in 2 strengths containing diclofenac sodium; pale red, contain 25mg, marked DD CG; reddish-borown, contain 50mg, marked CG PP. Also, VOLTAROL INJECTION available as a solution in ampoules containing 25mg of diclofenac sodium per ml.

Medical Uses

Oral preparations and suppositories, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, chronic juvenile arthritis, acute gout, pain from minor surgery, dental and orthopaedic procedures or trauma. Voltarol Rapid Also, used for pyrophosphate arthropathy and related disorders and migraine in adults. Injection, acute gout, osteo- and rheumatoid arthritis, acute pain after trauma, surgery, acute back pain, renal colic, fractures.

Dosage

Adults, Voltarol tablets, 75 to 150mg in 2 or 3 divided doses each day; Voltarol dispersible, 100 to 150mg added to water in 2 or 3 divided doses each day. Maximum period of treatment is 3 months. Voltarol SR, 1 tablet once or twice each day taken with meals and swallowed whole. Voltarol Retard, 1 each day taken with meal and swallowed whole. Suppositories, 75 to 150mg in divided doses, inserted into rectum. Voltarol Rapid, 100 to 150mg each day in 2 or 3 divided doses; for migraine, 50mg at start of attack, repeated after 2 hours, if required, then 50mg every 4 to 6 hours, if needed to a daily maximum of 200mg. Voltarol injection, 75mg once or twice each day by deep intramuscular injection into gluteal muscle (buttock) to a daily maximum of 150mg. For pain after operation, 75mg by intravenous infusion given over 30 minutes to 2 hours. If necessary, can be repeated after 4 to 6 hours to a maximum daily dose of 150mg. To prevent post-operative pain, 25 to 50mg by intravenous infusion over 15minutes to 1 hour then continuous infusion at rate of 5mg per hour to a daily maximum of 150mg. In all cases, treatment duration should be no more than 2 days and then patient should be transferred to tablets or suppositories. Children, Voltarol tablets for juvenile rheumatoid arthritis, aged over 12 months, 1 to 3mg per kg of body weight each day in divided doses. Suppositories, using 12.5mg or 25mg strength only, 1 to 3mg per kg of body weight each day in divided doses. Voltarol rapid, aged over 14 years only, 75 to 100mg each day in 2 to 3 divided doses.

Special Care

Elderly, pregnancy, breastfeeding, impaired liver, kidney or heart function, porphyria (inherited, metabolic disorder involving porphyrins), previous gastrointestinal lesions, blood abnormalities, asthma, high blood pressure, heart failure. Patients receiving long-term treatment should be monitored.

Avoid Use

Children (most preparations except where indicated above), allergy to aspirin or anti-inflammatory drugs, stomach ulcer. With suppositories or Rapid, proctitis (inflammation of anus and rectum). With intravenous route, risk of haemorrhage with surgery, low blood volume, bleeding tendency, asthma, cerebrovascular haemorrhage, dehydrated patients, moderate to severely impaired kidney function.

Possible Drug and Food Interactions

Lithium, anticoagulants, cardiac glycosides, diuretics, digoxin, methotrexate, salicylates, cyclosporin, oral hypoglycaemics, NSAIDs, steroids, mifepristone, quinolones, methotrexate, antihypertensives.

Known Side Effects

Headache, dizziness, stomach pain, rash, bleeding, gastrointestinal upset. In rare cases, abnormal kidney and liver function, pain and tissue death at injection site, blood changes, stomach ulcer, high blood pressure, hypersensitivity reactions, fits, nephrotic syndrome (a kidney disorder), aseptic meningitis, vasculitis (inflammation of blood vessels), papillary necrosis, congestive heart failure, pneumonitis.