Pharmacist Steve & anyone else- help with diclofenac

[curiousforever]

I got this prescribed today along with my other pain meds.

Reading the insert - I am a little scared of this one. I did take it, and ended up vomiting within an hour....Could it be cause I ate about 10 minutes AFTER taking it?

Also, I've had an ulcer before, mainly due to untreated (by docs) headaches, so I ended up taking excedrin at least once a day for years. I so sometimes still take excedrin - it works well for headaches. Is this a problem?

Has anyone had success with this med? Better or worse than naproxen?

Oh - and it mentions stroke. I understand I'm at a higher risk due to pregnancy related migraines (I heard like 19 times more likely to have a stoke after pregnancy migraines)....Stroke is my biggest fear after seeing those happen and the aftermath of them.

How likely is a stroke - I smoke as well. Doc isn't worried about me quitting for now....but should I even take this?

[Gimpy]

This one has worked great for me, BUT, and it's a big but, it caused severe abdominal distress. Gas, diarrhea, plain ole' feeling like yuck. My husband too.

Gimpy

[Pharmacist.steve]

I got this prescribed today along with my other pain meds.

Reading the insert - I am a little scared of this one. I did take it, and ended up vomiting within an hour....Could it be cause I ate about 10 minutes AFTER taking it?

Also, I've had an ulcer before, mainly due to untreated (by docs) headaches, so I ended up taking excedrin at least once a day for years. I so sometimes still take excedrin - it works well for headaches. Is this a problem?

Has anyone had success with this med? Better or worse than naproxen?

Oh - and it mentions stroke. I understand I'm at a higher risk due to pregnancy related migraines (I heard like 19 times more likely to have a stoke after pregnancy migraines)....Stroke is my biggest fear after seeing those happen and the aftermath of them.

How likely is a stroke - I smoke as well. Doc isn't worried about me quitting for now....but should I even take this?

This drug should not be taken on a empty stomach nor should it be taken in combination with any aspirin product - doing so .. increases the risk of ulcer/stomach bleeding and doing so lessens the effectiveness of a NSAID.

Smoking causes cardiovascular problems.. how much it adds to the risk of stroke with pre-existing condition is anybody's guess.

Is 19 times a very small incident <0.1% or a very large incident >2%. All therapies have a risk/reward balance and there are no black/white answers in medicine ... only probabilities

[mrsdoubtfyre]

There are two kinds of diclofenac.

What does your label say exactly? I will then answer the question in more
detail.

[Kathi49]

CF,

I take it as I can't take all the others. But, I do NOT take it every day. I try to get by as long as I can without it. It works great but you do have to take with it a meal. I usually eat; then down the thing with lots of water and even wait 30 minutes or so before I lie down. Anyway, Steve is right...don't combine it with any other aspirin product.

[dag_FL]

Yeah I took that before I had taken Voltaren and felt like I got stabbed in the stomach, I have had good luck with Celebrex and Arthrotec, which you might check but I think are the same type or rather used for the same condition at least in my case. It's hard to get a script for Celebrex these days...seems like it to me anyway my Dr. only gives me Arthrotec. good luck

[Gimpy]

Yeah I took that before I had taken Voltaren and felt like I got stabbed in the stomach, I have had good luck with Celebrex and Arthrotec, which you might check but I think are the same type or rather used for the same condition at least in my case. It's hard to get a script for Celebrex these days...seems like it to me anyway my Dr. only gives me Arthrotec. good luck

It must be in the fillers that makes the difference than, because Voltaren (name brand) IS Diclofenac (generic). The fillers can be the big difference between name and generic medications, even though the active ingrediants have to be within a certain percentage of the name brand drug.

Gimpy

[mrsdoubtfyre]

Voltaren is enteric coated and cannot upset the stomach directly. This drug is called diclofenac sodium generically.

Over TIME it changes cytokine ratios in the stomach and lowers Cox-1 activity.
Cox-1 activity is needed for maintaining the lining of the stomach/intestines and esophagus (among other things). So with time, even tho it is enteric coated,
it can affect the linining of the stomach thru the bloodstream and metabolism.

Diclofenac POTASSIUM is brand name Cataflam...which only comes in 50mg size.
It is not enteric coated to allow for speed in onset. It is typically reserved for acute temporary pain. It is not used much and this difference is similar to
Anaprox DS (naproxen sodium) and Naprosyn (naproxen).

Arthrotec is Voltaren mixed with Cytotec (mistoprostol) which is a cytokine in the Cox-1 family. It is hoped that taking this mix protects the stomach some.
But in reality just taking a "stomach protection" drug like Prilosec daily helps about as well.

[curiousforever]

It's diclofenac SOD 75 mg.

Might have to talk with doc about my stomach issues. I end up vomiting at least one day a month. This month's was somewhat severe....ended up in er.

[mrsdoubtfyre]

It is not directly affecting your stomach by "contact" ...it causes the disruption metabolically thru its actions on Cox-1 enzymes. There are 3 cox systems.
For example Celebrex is targeted as a more cox-2 blocker (hence sparing the stomach effects).

Voltaren/ibuprofen/naprosyn/ are both blockers of cox-1 and 2 hence with time stomach issues occur. Long term use of these NSAIDs can lead to GI disturbance...so stomach blockers are used. Either switch to Arthrotec (which is a combo product, or get an additional RX for Cytotec (not for reproductive females planning pregnancy--will cause miscarriage) or daily proton pump inhibitor like Prilosec OTC or Nexium Rx etc.

You can strengthen your stomach or if you have GERD, by taking essential fatty acids. These improve normal Cox-1 functions and since people are not getting these essential fats commonly in the diet, many Americans have terrible stomach status.
Some foods now have these added:
Smart Balance Peanut butter
Smart Balance Mayo
Smart Balance spreads (butter substitutes)
Omega-3 eggs.
Flax oil
Fish oil caps etc. I cured my GERD 10 yrs ago with dietary changes and some EFA supplements.

I have a thread at Neuro Talk in the vitamin forum with details ...
(I hope the words Neuro Talk are not blocked in this post, since BT is censoring links to there).

Have you been evaluated for abdominal migraine or cyclical vomiting syndrome? Both are connected to chronic
head pain.

[GJZH]

I have been using this drug for about a month with little or no side effects...I was switched to this from Lodine...I think that was the name...The Lodine was creating terrible tinitus....I thought the smoke alarm was going off in the house...Anyway...The Voltaren....has created no problems for me...and works nicely to remove morning stiffness and pain...I actually take this twice a day...75 mgs...along with my other pain meds...

[bluebirdy]

I've switched to both the Smart Balance mayo and the Smart Balance peanut butter - and they both taste great! I never thought I would give up Jif but I didn't want the rapeseed oil anymore and the Smart Balance looks like a great alternative with the omegas. I've eaten flax seeds for years and am taking flax oil capsules as well.

I didn't know that these products also help with GIRD (which I have) via Cox-1. Thanks for the info! bluebirdy

[curiousforever]

It is not directly affecting your stomach by "contact" ...it causes the disruption metabolically thru its actions on Cox-1 enzymes. There are 3 cox systems.
For example Celebrex is targeted as a more cox-2 blocker (hence sparing the stomach effects).

Voltaren/ibuprofen/naprosyn/ are both blockers of cox-1 and 2 hence with time stomach issues occur. Long term use of these NSAIDs can lead to GI disturbance...so stomach blockers are used. Either switch to Arthrotec (which is a combo product, or get an additional RX for Cytotec (not for reproductive females planning pregnancy--will cause miscarriage) or daily proton pump inhibitor like Prilosec OTC or Nexium Rx etc.

You can strengthen your stomach or if you have GERD, by taking essential fatty acids. These improve normal Cox-1 functions and since people are not getting these essential fats commonly in the diet, many Americans have terrible stomach status.
Some foods now have these added:
Smart Balance Peanut butter
Smart Balance Mayo
Smart Balance spreads (butter substitutes)
Omega-3 eggs.
Flax oil
Fish oil caps etc. I cured my GERD 10 yrs ago with dietary changes and some EFA supplements.

I have a thread at Neuro Talk in the vitamin forum with details ...
(I hope the words Neuro Talk are not blocked in this post, since BT is censoring links to there).

Have you been evaluated for abdominal migraine or cyclical vomiting syndrome? Both are connected to chronic
head pain.

I've only heard of cyclical vomiting on here from Kira I think. I'll look into both...thanks!

And I will try the med tonight. With a snack. I'll try the peanut butter - but I love Jif...and the other stuff. I might have to put it into the 'real' butter containers, etc - or the rest of my family might not eat it!

[curiousforever]

Thanks everyone!

I'll try it tonight with a snack.

[jena1225]

Mrs D. Do those things cause a - great, can't think of the word :rolleyes: - uh, do they make you have to go really bad?! lol (______ effect??)

[mrsdoubtfyre]

could you clarify your question?

What "things"... the drugs, or the foods? Are you talking about diarrhea?
Cytotec may increase cramping in some people.

[bluebirdy]

And I will try the med tonight. With a snack. I'll try the peanut butter - but I love Jif...and the other stuff. I might have to put it into the 'real' butter containers, etc - or the rest of my family might not eat it!

curiosforever - Let me tell you a little more about what to expect. The Smart Balance Mayo tastes just like Miracle Whip to me. I was using Light M.W. before so I really like this stuff. As for the lifetime Jif ... the S.B. doesn't taste the same and it does take some getting used to. I've tried several natural PB's and Smart Balance is a good one and doesn't require refrigeration. I don't like PB cold! But ... it's not nearly as sweet as Jif nor quite as salty. In fact, I added some sugar to it at first, but now I don't bother. bb