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What is Voltarol?

Voltarol contains the active ingredient diclofenac sodium, which is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are used to relieve pain and inflammation.

How does it work?

Diclofenac works by blocking the action of a substance in the body called cyclo-oxygenase (COX). Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced by the body in response to injury and certain diseases and conditions, and cause pain, swelling and inflammation. Diclofenac blocks the production of these prostaglandins and is therefore effective at reducing inflammation and pain.
Diclofenac is used to relieve pain and inflammation in a wide range of musculoskeletal conditions, including various forms of arthritis, gout, sprains, fractures, dislocations, back pain, tendonitis and frozen shoulder. It is also used to relieve pain and inflammation following dental, orthopaedic (bone) and other minor surgery.
Voltarol e/c tablets have a special 'enteric coating' that is designed to prevent the absorption of the diclofenac in the stomach, and thus reduce the risk of stomach irritation. The diclofenac is absorbed when the tablet reaches the intestine. The tablets should be swallowed whole to avoid damaging this coating.
Voltarol dispersible tablets are dissolved in water before taking. The diclofenac solution is rapidly absorbed from the gut, so this type of Voltarol tablet provides pain relief more quickly than the other types of tablet. However, the solution is more likely to irritate the stomach lining, because it doesn't have the advantage of the protective enteric-coat. The dispersible tablets are therefore most suitable for short-term use. They shouldn't be used for longer than three months.
Voltarol SR tablets and Voltarol Retard tablets are sustained-release tablets. They contain higher doses of diclofenac and are designed to release this slowly and continuously over a few hours. This provides more prolonged pain relief, so these tablets are usually taken once a day. These tablets must also be swallowed whole to avoid damaging the sustained-release action.

Who can get it?

This medicine is available on prescription.

How is it used?

All types of Voltarol tablets should preferably be taken with food to help avoid irritating the stomach.

What are the side effects?

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

  • Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain
  • Indigestion (dyspepsia)
  • Excess gas in the stomach and intestines (flatulence)
  • Loss of appetite
  • Headache
  • Dizziness
  • Balance disorders involving the inner ear (vertigo)
  • Skin rashes
  • Ulceration of the stomach or intestine
  • Bleeding from the stomach or intestine
  • Allergic reactions such as skin rashes, swelling of the lips, tongue and throat (angioedema) or narrowing of the airways (bronchospasm)
  • Drowsiness
  • Fluid retention (oedema)
  • Kidney, liver or blood disorders

Diclofenac Cardiac Warning

Recent cardiovascular safety concerns have led the MHRA to issue new prescribing advice for systemic forumlations of diclofenac.

The Agency cited a recently published meta-analysis that provided further evidence of an increased risk of arterial thrombosis with diclofenac, similar to that observed with COX-2 inhibitors.

The use of diclofenac is now contraindicated in patients with ischaemic heart disease, peripheral arterial disease, cerebrovascular disease or  congestive heart failure.

Patients with any of these conditions who are currently receiving diclofenac should be switched to an alternative treatment at their next appointment.

In addition, caution should be used when prescribing diclofenac in patients with significant risk factors for cardiovascular events, such as hypertension, hyperlipidaemia, diabetes mellitus and smoking.

These new contraindications and warnings apply to systemic formulations of diclofenac (tablets, capsules, suppositories and injections) but not topical products (creams and gels).

Reference: Mims August 2013 Product Update

You can report adverse drug reactions to the MHRA via the Yellow Card scheme.

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Voltarol is marketed in the UK by Novartis Pharmaceuticals UK Ltd