Diclofenac - Adventist HealthCare

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:BeneficialAdverseCheck

Replenish Depleted Nutrients

  • Calcium

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

  • Iron

    NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and nabumetone are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.

  • L-Tryptophan

    Diclofenac causes complex changes to L-tryptophan levels in the blood, 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

  • Licorice

    The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.

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. 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.

  • 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. 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 

  • Resveratrol
    In a study of healthy volunteers, the rise in blood levels of diclofenac was significantly greater and the clearance of the drug was significantly slower when the volunteers were pretreated with 500 mg of resveratrol per day for 10 days than when they did not receive resveratrol. Thus, taking resveratrol could increase both the efficacy and the adverse effects of diclofenac. People interested in taking both diclofenac and resveratrol should consult a doctor.
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.

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