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Several authors have speculated that the enteric, or "delayed release", form of diclofenac may be at fault, as tablet fragments have been found at the site of the pathology. PsychiatricPsychiatric side effects of diclofenac include rare reports of depression, anxiety, irritability, nightmares, and psychotic reactions. 17% of patients following short-term (duration not defined) and long-term (up to 58 weeks) treatment with diclofenac, respectively. RenalDiclofenac may impair the ability of the kidney to cope with low renal blood flow states due to inhibition of prostaglandin-dependent afferent arteriolar vasodilation. A 44-year-old man with recurring knee pain treated himself with diclofenac 75 mg intramuscularly for 6 days followed by 75 mg orally three times a day for seven days. Comparison of the antiinflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis. These events were generally minor, but led to discontinuation of therapy in 9% of patients on Arthrotec and 5% of patients on diclofenac. Autoimmune hemolytic anemia and thrombocytopenia during diclofenac therapy have been associated with the development of autoantibodies as well as drug- or metabolite-dependent antibodies, implicating a drug hypersensitivity. In one case, diclofenac-induced thrombocytopenic purpura was accompanied by renal and hepatic toxicity. Nervous systemAseptic meningitis was reported in a 42-year-old female following two weeks of therapy with diclofenac 50 mg three times a day. Blood dyscrasias are usually reversible upon cessation of diclofenac, although rare fatalities are reported. OtherOther diclofenac side effects include tinnitus, blurred vision, taste disturbance, reversible hearing loss, dry eyes, scotoma, night blindness, and amblyopia. In addition, blood pressure may be elevated by diclofenac which may have clinical relevance in patients with comorbid illnesses. Serum CPK levels peaked at 83,770 units/L 11 days following diclofenac cessation. I really like that fact that very little of the diclofenac goes systemic. The manufacturer reports a higher incidence, 2 to 4%, of serious gastrointestinal events in patients treated with diclofenac for up to 1 year. Colonic strictures, ulcerations, and bleeding associated with diclofenac use have been reported in the literature. Fatal cases of fulminant hepatitis during diclofenac therapy are reported in the literature. A disproportionate amount of postoperative hemorrhage requiring operative intervention has been reported with the use of diclofenac when used for analgesia after adenotonsillectomy. Six months following cessation of diclofenac, the patient was asymptomatic and strength was normal. The patient was diagnosed with erythema multiforme and rhabdomyolysis due to diclofenac. The patient's symptoms spontaneously resolved over 48 hours following the discontinuation of diclofenac. Diclofenac-induced hepatitis may be a result of a hypersensitivity reaction in some cases. In one review of 26 cases of diclofenac-induced hepatitis, the authors found a correlation between the cumulative diclofenac dose and severity of liver damage as well as the logarithm of the peak and mean transaminase levels. The events, which have been chosen for inclusion due to either their seriousness, frequency of reporting, possible causal connection to topical diclofenac sodium ophthalmic solution, 0. During the last three days of diclofenac treatment, he became anorexic and complained of nausea, epigastric pain and developed erythematous pruritic eruptions over his back, abdomen, chest, face and scalp.


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