Painkillers are probably the most popular drugs in the world, as any person experiences severe pain or ache (requiring medical treatment) at least once during lifetime, usually much more. Diclofenac is a well-known and widely used painkilling medication. What are its key features? How does it work? Are side effects possible to occur?
What is Diclofenac?
Diclofenac is a medication which belongs to NSAID (nonsteroidal anti-inflammatory drug) category. It helps to fight mild-to-moderate painful sensations, and also to eliminate symptoms of rheumatoid arthritis and osteoporosis (bone weakening disease). Cataflam brand, immediate-release pills, are also administered for menstrual cramps.
This pharmaceutical substance was developed in 1966. It was initially prescribed to treat rheumatologic diseases, however, the sphere of its application significantly widened.
Use of Diclofenac for Treating Ache and Pain
This pharmaceutical product relieves pains and aches, in addition, it helps to cope with swelling (caused by inflammation) and joint stiffness. So a patient can perform everyday activities with regular easiness.
What’s the difference between aches and pains?
Ache is a discomfortable feeling which continues for some time. Typically, people associate it with long-lasting pain in some part of the body, for example, headache, toothache, backache, etc. If you have trained in a gym after a long break, you will experience muscle ache (or, in worse case, slight aching pain in the elbows or knees). Pain has more sudden nature and is more pronounced, so it is hard to ignore it. Say, a dentist pulled your tooth out, you will most probably experience extreme pain, so to prevent it the doctor prescribes painkillers in advance.
How Does Diclofenac Work?
The pill works by decreasing substances in the body that lead to inflammation and pain. It stops the activity of cyclooxygenase (COX) enzyme (officially named prostaglandin-endoperoxide synthase). It is responsible for formation of prostanoids, more precisely, their type called prostaglandins, which are mediators of inflammatory and allergic reactions. The substance reduces the intracellular level of free arachidonic acid (E. Ku et al., Am J Med. 1986), which is converted by COX to prostaglandins.
If a person has an injury, gout, rheumatism etc., the body begins to produce prostaglandin substances which cause pain, aches, inflammation, and swelling. It should be noted that these effects are natural for human bodies, but sometimes they are annoying and insufferable, so treatment is necessary. The drug blocks production of prostaglandins by affecting COX enzyme, due to which analgesic action is achieved. A desired effect usually occurs after the first dosage, but if you take Diclofenac regularly, its anti-inflammatory action may build up with subsequent doses.
However, some scientists have noted that often the analgesic effect of diclofenac, which manifests itself along with the anti-inflammatory, is not caused by suppression of inflammatory processes, but develops by involving specific mechanisms that are not the same in different NSAIDs. This confirms the fact that the analgesic effect of NSAIDs is not always associated with inhibition of COX.
Like other NSAIDs, Diclofenac produces a symptomatic effect, that is it only treats symptoms but provides no cure for a disease.
On the picture below, you can see a mechanism of NSAIDs’ action, which generally applies to the product described in this article.i
Warnings and Side Effects of the Medication
Diclofenac is a highly efficient medicine, but its use may be associated with severe side effects. Some specialists even propose to fully prohibit it due to elevated risk of cardiovascular events linked to Diclofenac administration. According to a Danish-American study by Morten Schmidt et al. (BMJ, 2018), the drug poses a hazard of major adverse cardiovascular events compared with non-administration, paracetamol and other NSAID use within 30 days of initiation. But from this it can be concluded that short-term use is generally safe for health. Despite that, new findings of above-mentioned and other researchers lead to removal of Diclofenac from an OTC catalogue in some countries.
The list of other potential adverse events of the medication include:
- development of ulceration or bleeding
- reversible liver damage
- worsening of kidneys’ functioning
- anxiety, depression, irritability and similar mental health effects (rarely)
Avoid consumption of alcohol when treating with Diclofenac. Such a combination may increase a risk of gastrointestinal bleeding.
If you use any medication for pain, allergic disease or cold, discuss the possibility of Diclofenac co-administration with pharmacist or doctor (or at least carefully read a leaflet with composition and instructions). Some meds may contain substances that are similar to Diclofenac, and you can get too much of painkilling substance.
The Bottom Line
Diclofenac acts effectively and can be used over-the-counter in many countries. However, don’t overuse it, as long-lasting administration may be harmful for your health. Moderation is a key, moreover, if your systems don’t go away during a long time, probably their underlying cause is deep and requires a more serious medical intervention.
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