Last update Dec. 21, 2021

Диклофенак

Compatible

Safe substance and/or breastfeeding is the best option.

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). Indicated in rheumatic diseases, gout, dysmenorrhea, adnexitis, and post-traumatic or post-operative pain and inflammation. Oral administration in two to three daily doses. It can also be administered intramuscularly or intravenously.

Its pharmacokinetic data (high percentage of protein binding and short half-life) explain the zero or miniscule transfer into breastmilk observed: The drug is excreted in milk in insignificant or undetectable quantities. (AEMPS 2017, Sandoz 2017, Hale 2017 p.277, Hutchinson 2013, Worthington 2013, ABM 2012, Østensen 2007, Sioufi 1982)

No adverse effects have been detected in breastfed babies whose mothers were taking it. (Yefet 2017, Davanzo 2014, Hutchinson 2013, Hirose 1996)

For all these reasons it is considered compatible with breastfeeding. (Hale 2017 p277, Yefet 2017, Briggs 2015, Schaefer 2015, Davanzo 2014, Hutchinson 2013, Amir 2011, Nice 2004, Lee 1993, Brooks 1990, Goldsmith 1989, Needs 1985)

Most non-steroidal anti-inflammatories can increase jaundice, so it is preferable to avoid them during the neonatal period in mothers of jaundiced infants. (Janssen 2000)

TOPICAL USE: The small dose and poor plasma uptake of most topical dermatological or ophthalmological preparations make it very unlikely that significant amounts will pass into breast milk. Ophthalmic or dermatological use is completely compatible with breastfeeding.

Alternatives

  • Ibuprofen (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Диклофенак is Diclofenac in Cyrillic.

Is written in other languages:

Диклофенак is also known as

Tradenames

Main tradenames from several countries containing Диклофенак in its composition:

  • Algicler™. Contains other elements than Диклофенак in its composition
  • Algicler Flex™. Contains other elements than Диклофенак in its composition
  • Arthrotec
  • Artrotec
  • Befol Flex™. Contains other elements than Диклофенак in its composition
  • Belmalen™. Contains other elements than Диклофенак in its composition
  • Blokium (Argentina)
  • Blokium Flex™. Contains other elements than Диклофенак in its composition
  • Blokium Gesic™. Contains other elements than Диклофенак in its composition
  • Cambia
  • Cataflam
  • Diclofenac Flex™. Contains other elements than Диклофенак in its composition
  • Diclogesic Relax™. Contains other elements than Диклофенак in its composition
  • Difenac
  • Dioxaflex Duo™. Contains other elements than Диклофенак in its composition
  • Dolaren™. Contains other elements than Диклофенак in its composition
  • Dolaren Доларен™. Contains other elements than Диклофенак in its composition
  • Fenac
  • Fortical (Mexico)™. Contains other elements than Диклофенак in its composition
  • Logesic
  • Metaflex Plus™. Contains other elements than Диклофенак in its composition
  • Nalgiflex Relax™. Contains other elements than Диклофенак in its composition
  • Olfen
  • Oxadisten™. Contains other elements than Диклофенак in its composition
  • Oxafem™. Contains other elements than Диклофенак in its composition
  • Pancloflex™. Contains other elements than Диклофенак in its composition
  • Pennsaid
  • Reactine (India)
  • Tafirol AC™. Contains other elements than Диклофенак in its composition
  • Voltadol
  • Voltaren
  • Voltaren Flex™. Contains other elements than Диклофенак in its composition
  • Voltarol
  • Xedenol Flex™. Contains other elements than Диклофенак in its composition
  • Zipsor

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 318 daltons
Protein Binding 100 %
VD 0.6 l/Kg
pKa 4 -
Tmax 1 - 2 hours
1 - 2 hours
Theoretical Dose 0.00075 - 0.015 mg/Kg/d
Relative Dose 0.03 - 0.9 %
Ped.Relat.Dose 0.025 - 3 %

References

  1. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  2. Sandoz. Diclofenac. Data Sheet. 2017 Full text (in our servers)
  3. AEMPS. Diclofenaco Ficha técnica. 2017 Full text (in our servers)
  4. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  5. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  6. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014 Abstract
  7. Hutchinson S, Marmura MJ, Calhoun A, Lucas S, Silberstein S, Peterlin BL. Use of common migraine treatments in breast-feeding women: a summary of recommendations. Headache. 2013 Abstract Full text (link to original source) Full text (in our servers)
  8. Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ; Canadian Headache Society Acute Migraine Treatment Guideline Development Group. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013 Sep;40(5 Suppl 3):S1-S80. Review. Abstract Full text (in our servers)
  9. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract Full text (link to original source) Full text (in our servers)
  10. Østensen M, Motta M. Therapy insight: the use of antirheumatic drugs during nursing. Nat Clin Pract Rheumatol. 2007 Abstract
  11. Nice FJ, De Eugenio D, Dimino TA, Freeny IC, Rovnack MB, Gromelski JS. Medications and Breast-Feeding: A Guide for Pharmacists, Pharmacy Technicians, and Other Healthcare Professionals. Part I. J Pharm Technol 2004;20:17-27. doi: 10.1177/875512250402000106.
  12. Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Arch Intern Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  13. Hirose M, Hara Y, Hosokawa T, Tanaka Y. The effect of postoperative analgesia with continuous epidural bupivacaine after cesarean section on the amount of breast feeding and infant weight gain. Anesth Analg. 1996 Abstract
  14. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  15. Brooks PM, Needs CJ. Antirheumatic drugs in pregnancy and lactation. Baillieres Clin Rheumatol. 1990 Abstract
  16. Goldsmith DP. Neonatal rheumatic disorders. View of the pediatrician. Rheum Dis Clin North Am. 1989 Abstract
  17. Needs CJ, Brooks PM. Antirheumatic medication during lactation. Br J Rheumatol. 1985 Abstract
  18. Sioufi A, Stierlin H, Schweizer A et al. Recent findings concerning clinically relevant pharmacokinetics of diclofenac sodium. Kass E. Voltaren new findings. Bern: Hans Huber Publishers, 1982:19-30. 1982

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