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    Diclofenac

    Topic Contents

    Diclofenac

    Drug Information

    Diclofenac is used in the treatment of osteoarthritis , rheumatoid arthritis , and ankylosing spondylitis. It is in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).

    Common brand names:

    Solaraze, Voltaren

    Summary of Interactions with Vitamins, Herbs, & Foods

    Types of interactions: Beneficial Adverse Check

    Replenish Depleted Nutrients

    • Calcium

      Diclofenac decreases the amount of calcium lost in the urine,1 which may help prevent bone loss in postmenopausal women.2

    • L-Tryptophan

      Diclofenac causes complex changes to L-tryptophan levels in the blood,3 but the clinical implications of this are unknown. More research is needed to determine whether supplementation with L-tryptophan is a good idea for people taking diclofenac.

      The interaction is supported by preliminary,weak, fragmentary, and/or contradictory scientific evidence.

    Reduce Side Effects

    • none

    Support Medicine

    • Stinging Nettle

      In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle.4 More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.

    Reduces Effectiveness

    • Trikatu

      Trikatu, an Ayurvedic herbal preparation that contains Piper nigrum (black pepper), Piper longum (Indian Long pepper), and Zingiber officinale (ginger), decreased both blood levels and the medicinal effect of diclofenac in a study in rabbits.5

    • White Willow

      Willow bark (Salix alba) contains salicin, which is related to aspirin . Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of aspirin to individuals taking diclofenac results in a significant reduction in blood levels of diclofenac.6 Though there are no studies investigating interactions between willow bark and diclofenac, people taking the drug should avoid the herb until more information is available.

      The interaction is supported by preliminary,weak, fragmentary, and/or contradictory scientific evidence.

    Potential Negative Interaction

    • none

    Explanation Required

    • none

    The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers? package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

    References

    1. Sharma S, Vaidyanathan S, Thind SK, et al. The effect of diclofenac sodium on urinary concentration of calcium, uric acid and glycosaminoglycans in traumatic paraplegics. Br J Urol 1991;68:240?2.

    2. Bell NH, Hollis BW, Shary JR, et al. Diclofenac sodium inhibits bone resorption in postmenopausal women. Am J Med 1994;96:349?53.

    3. Davies NM, Anderson KE. Clinical pharmacokinetics of diclofenac. Therapeutic insights and pitfalls. Clin Pharmacokinet 1997;33:184?213.

    4. Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105?8.

    5. Lala LG, D'Mello PM, Naik SR. Pharmacokinetic and pharmacodynamic studies on interaction of Trikatu with diclofenac sodium. J Ethnopharmacol 2004;91:277?80.

    6. Davies NM, Anderson KE. Clinical pharmacokinetics of diclofenac. Therapeutic insights and pitfalls. Clin Pharmacokinet 1997;33:184?213.

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