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Generic name: Diclofenac sodium
Brand names: Cataflam, Voltaren

Why is Cataflam prescribed?

Voltaren and Cataflam are nonsteroidal anti-inflammatory drugs used to relieve the inflammation, swelling, stiffness, and joint pain associated with rheumatoid arthritis, osteoarthritis (the most common form of arthritis), and ankylosing spondylitis (arthritis and stiffness of the spine). Voltaren-XR, the extended-release form of Voltaren, is used only for long-term treatment. Cataflam is also prescribed for immediate relief of pain and menstrual discomfort.

Most important fact about Cataflam

You should have frequent checkups with your doctor if you take Voltaren regularly. Ulcers or internal bleeding can occur without warning.

How should you take Cataflam?

To minimize stomach upset and related side effects, your doctor may recommend taking this medicine with food, milk, or an antacid. However, this may delay onset of relief.

Take Cataflam with a full glass of water. Also, do not lie down for about 20 minutes after taking it. This will help to prevent irritation in your upper digestive tract.

Take Cataflam exactly as prescribed.

--If you miss a dose...

If you take this medicine on a regular schedule, take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature. Keep the container tightly closed and protect from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Voltaren.

• More common side effects may include:
  Abdominal bleeding, abdominal pain or cramps, abdominal swelling, anemia, blood clotting problems, constipation, diarrhea, dizziness, fluid retention, gas, headache, heartburn, indigestion, itching, nausea, peptic ulcers, rash, ringing in the ears, vomiting

This side effects list is not complete. If you have any questions about side effects you should consult your doctor. Report any new or continuing symptoms to your doctor right away.

Why should Cataflam not be prescribed?

If you have an allergic reaction to Voltaren or Cataflam, or if you have had asthma attacks, hives, or other allergic reactions caused by aspirin or other nonsteroidal anti-inflammatory drugs, you should not take Cataflam. Make sure your doctor is aware of any drug reactions you have experienced.

Special warnings about Cataflam

Remember that Cataflam has been known to cause peptic ulcers and bleeding. Contact your doctor immediately if you suspect a problem.

Use Cataflam cautiously if you have kidney problems, heart disease, or high blood pressure. It can cause fluid retention.

This medication can also cause liver problems. If you develop signs of liver disease such as nausea, fatigue, lethargy, itching, yellowish eyes and skin, tenderness in the upper right area of your abdomen, or flu-like symptoms, notify your doctor at once.

Rare cases of meningitis (inflammation of the membrane enclosing the brain) have been linked to Cataflam. If symptoms such as fever and coma develop, alert the doctor immediately.

In rare instances, Cataflam may also affect your vision. If you notice any problems, stop taking the drug and check with your doctor.

Possible food and drug interactions when taking Cataflam

If Voltaren or Cataflam is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Voltaren with the following:

Aspirin
Blood thinners such as Coumadin
Cyclosporine (Sandimmune)
Digitalis drugs such as Lanoxin
Diuretics such as Dyazide, Midamor, and Lasix
Insulin or oral antidiabetes medications such as Micronase
Lithium (Eskalith, Lithobid)
Methotrexate
Phenobarbital

Special information if you are pregnant or breastfeeding

Do not take Cataflam late in your pregnancy; it could harm the baby. Check with your doctor before taking the drug early in pregnancy; it should be used only if necessary. The drug does appear in breast milk and could affect a nursing infant. If Cataflam is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Voltaren is finished.

Recommended dosage

ADULTS

Osteoarthritis

The usual dose is 100 to 150 milligrams a day, divided into smaller doses of 50 milligrams 2 or 3 times a day (for Voltaren or Cataflam) or 75 milligrams twice a day (for Voltaren). The usual dose of Voltaren-XR (extended-release) is 100 milligrams taken once a day.

Rheumatoid Arthritis

The usual dose is 100 to 200 milligrams a day, divided into smaller doses of 50 milligrams 3 to 4 times a day (for Voltaren or Cataflam), 75 milligrams twice a day (for Voltaren), or 100 milligrams once or twice a day (for Voltaren-XR).

People with rheumatoid arthritis should not take more than 225 milligrams a day.

Ankylosing Spondylitis

The usual dose is 100 to 125 milligrams of Voltaren a day, divided into smaller doses of 25 milligrams 4 times a day, with another 25 milligrams at bedtime if necessary.

Pain and menstrual discomfort

The usual starting dose of Cataflam is 50 milligrams every 8 hours as needed, although to provide better relief on the first day doctors sometimes prescribe a starting dose of 100 milligrams followed by two 50-milligram doses. After the first day, you should not take more than 150 milligrams in a day.

CHILDREN

The safety and effectiveness of Voltaren have not been established in children.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• The symptoms of Voltaren overdose may include:
  Acute kidney failure, drowsiness, loss of consciousness, lung inflammation nausea, vomiting