Diclofenac Online

How and where to order Diclofenac (Voltaren) 50 mg, 75 mg, 100 mg tablets or capsules and 1% topical gel online on the ProHealth Chiropractic Center website:

Shop:	PHARMA SHOP - 10% discount coupon hf-5478
Sellers:	DICLOFENAC STORES
Prices:	from $0.27 per pill from $5.60 per gel
Forms:	50 mg, 75 mg, 100 mg capsules or tablets 100 mg SR tablets 1% 20 g, 30 g, 50 g topical gel in tubes
Quantity:	30-360 pills 1-20 tubes
Type:	Diclofenac brands and generics
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Delivery:	Regular airmail and express courier
Shipping:	Worldwide, including USA, UK, Europe, Canada, Australia

Indications and usage:

Voltaren Gel (Diclofenac) is a non-steroidal anti-inflammatory drug indicated for the relief of the pain of osteoarthritis of joints amenable to topical treatment, such as the knees and those of the hands.

Voltaren Gel was not evaluated for use on joints of the spine, hip, or shoulder.

Voltaren tablets are indicated:

For relief of the signs and symptoms of osteoarthritis.

For relief of the signs and symptoms of rheumatoid arthritis.

For acute or long-term use in the relief of the signs and symptomsof ankylosing spondylitis.

Dosage and administration:

Carefully consider the potential benefits and risks of Voltaren (Diclofenac Sodium enteric-coated tablets) and other treatment optionsbefore deciding to use Voltaren. Use the lowest effective dose for theshortest duration consistent with individual patient treatment goals.

After observing the response to initial therapy with Voltaren, the doseand frequency should be adjusted to suit an individual patient's needs.

Use the lowest effective dosage for shortest duration consistent with individual patient treatment goals.

Lower extremities: apply the gel (4 g) to the affected area 4 times daily. Do not apply more than 16 g daily to any one affected joint of the lower extremities.

Upper extremities: apply the gel (2 g) to the affected area 4 times daily. Do not apply more than 8 g daily to any one affected joint of the upper extremities.

Total dose should not exceed 32 g per day, over all affected joints.

Voltaren Gel should be measured onto the enclosed dosing card to the appropriate 2 g or 4 g designation.

Dosage forms and strengths:

Voltaren Gel (Diclofenac Sodium) topical gel 1%.

Voltaren (Diclofenac Sodium) enteric-coated tablets 25 mg, 50 mg, 75 mg.

Voltaren-XR (Diclofenac Sodium) extended-release tablets, USP 100 mg.

Contraindications:

Voltaren (Diclofenac Sodium) enteric-coated tablets is contraindicated in patients with known hypersensitivity to diclofenac.

Voltaren should not be given to patients who have experienced asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients.

Diclofenac is contraindicated for the treatment of perioperative pain inthe setting of coronary artery bypass graft (CABG) surgery.

Warnings and precautions:

Hepatotoxicity: inform patients of warning signs and symptoms of hepatotoxicity. Discontinue if abnormal liver tests persist or worsen or if clinical signs and symptoms of liver disease develop.

Hypertension: patients taking some antihypertensive medications may have impaired response to these therapies when taking NSAIDs. Monitor blood pressure.

Heart failure and edema: avoid use of Voltaren Gel in patients with severe heart failure unless benefits are expected to outweigh risk of worsening heart failure.

Renal toxicity: monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia. Avoid use of Voltaren Gel in patients with advanced renal disease unless benefits are expected to outweigh risk of worsening renal function.

Anaphylactic reactions: seek emergency help if an anaphylactic reaction occurs.

Exacerbation of asthma related to aspirin sensitivity: Diclofenac is contraindicated in patients with aspirin-sensitive asthma. Monitor patients with preexisting asthma (without aspirin sensitivity).

Serious skin reactions: discontinue Voltaren Gel at first appearance of rash or other signs of hypersensitivity.

Premature closure of fetal ductus arteriosus: avoid use in pregnant women starting at 30 weeks gestation.

Hematologic toxicity: monitor hemoglobin or hematocrit in patients with any signs or symptoms of anemia.

Overdosage:

Symptoms following acute NSAIDs and diclofenac overdoses are usually limited tolethargy, drowsiness, nausea, vomiting, and epigastric pain, which aregenerally reversible with supportive care. Gastrointestinal bleeding canoccur. Hypertension, acute renal failure, respiratory depression andcoma may occur, but are rare. Anaphylactoid reactions have beenreported with therapeutic ingestion of NSAIDs, and may occur followingan overdose.

Patients should be managed by symptomatic and supportive care fol-lowing a NSAID overdose. There are no specific antidotes. Emesis and/or activated charcoal (60 to 100 g in adults, 1 to 2 g/kg in children) and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose (5 to 10 times the usual dose). Forced diuresis, alkalinization of urine, hemodial-ysis, or hemoperfusion may not be useful due to high protein binding.

Side effects, adverse reactions:

Most common adverse reactions (incidence > 2% of patients treated with Voltaren Gel and greater than placebo) are application site reactions, including dermatitis.

In patients taking diclofenac enteric-coated tablets, or other NSAIDs, the most frequently reported adverse experiencesoccurring in approximately 1%-10% of patients are:Gastrointestinal experiences including: abdominal pain, constipation, diarrhea, dyspepsia, flatulence, gross bleeding/perforation, heartburn, nausea, GI ulcers (gastric/duodenal) and vomiting. Abnormal renal function, anemia, dizziness, edema, elevated liverenzymes, headaches, increased bleeding time, pruritus, rashes and tin-nitus.

To report suspected side effects of Voltaren (Diclofenac Sodium) pills or gel, contact Novartis pharmaceutical company or your local FDA.

Drug interactions:

Drugs that interfere with hemostasis (e.g. warfarin, aspirin, SSRIs/SNRIs): monitor patients for bleeding who are concomitantly using Voltaren with drugs that interfere with hemostasis. Concomitant use of Diclofenac and analgesic doses of aspirin is not generally recommended.

ACE inhibitors, angiotensin receptor blockers (ARB), or beta-blockers: concomitant use with Voltaren may diminish the antihypertensive effect of these drugs. Monitor blood pressure.

ACE Inhibitors and ARBs: concomitant use with Diclofenac Sodium in elderly, volume depleted, or those with renal impairment may result in deterioration of renal function. In such high risk patients, monitor for signs of worsening renal function.

Diuretics: NSAIDs can reduce natriuretic effect of furosemide and thiazide diuretics. Monitor patients to assure diuretic efficacy including antihypertensive effects.

Digoxin: concomitant use with Voltaren can increase serum concentration and prolong half-life of digoxin. Monitor serum digoxin levels.

Use in specific populations:

Pregnancy

Use of NSAIDs during the third trimester of pregnancy increases the risk of premature closure of the fetal ductus arteriosus. Avoid use of NSAIDs in pregnant women starting at 30 weeks gestation.

Infertility

NSAIDs are associated with reversible infertility. Consider withdrawal of Voltaren (Diclofenac) in women who have difficulties conceiving.