Diclofenac
Common brand names:
Solaraze, VoltarenDiclofenac is used in the treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It is in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).
Summary of Interactions with Vitamins, Herbs, & Foods
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Negative Interactions
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Reduces Effectiveness
Diclofenac
Trikatu
Trikatu, an Ayurvedic herbal preparation that contains Piper nigrum (black pepper), Piper longum (Indian Long pepper), and Zingiber officinale (ginger), decreased both blood levels and the medicinal effect of diclofenac in a study in rabbits.
TrikatuDiclofenac- Lala LG, D'Mello PM, Naik SR. Pharmacokinetic and pharmacodynamic studies on interaction of Trikatu with diclofenac sodium. J Ethnopharmacol 2004;91:277-80.
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Reduces Effectiveness
Diclofenac
White Willow
Willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of aspirin to individuals taking diclofenac results in a significant reduction in blood levels of diclofenac. Though there are no studies investigating interactions between willow bark and diclofenac, people taking the drug should avoid the herb until more information is available.
White WillowDiclofenac- Davies NM, Anderson KE. Clinical pharmacokinetics of diclofenac. Therapeutic insights and pitfalls. Clin Pharmacokinet 1997;33:184-213.
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Supportive Interactions
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Replenish Depleted Nutrients
Diclofenac
Calcium
Diclofenac decreases the amount of calcium lost in the urine, which may help prevent bone loss in postmenopausal women.
CalciumDiclofenac- Sharma S, Vaidyanathan S, Thind SK, et al. The effect of diclofenac sodium on urinary concentration of calcium, uric acid and glycosaminoglycans in traumatic paraplegics. Br J Urol 1991;68:240-2.
- Bell NH, Hollis BW, Shary JR, et al. Diclofenac sodium inhibits bone resorption in postmenopausal women. Am J Med 1994;96:349-53.
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Replenish Depleted Nutrients
Diclofenac
Iron
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and nabumetone are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.
IronDiclofenac- Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145-57.
- Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62-9a.
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Replenish Depleted Nutrients
Diclofenac
L-Tryptophan
Diclofenac causes complex changes to L-tryptophan levels in the blood, but the clinical implications of this are unknown. More research is needed to determine whether supplementation with L-tryptophan is a good idea for people taking diclofenac.
L-TryptophanDiclofenac- Davies NM, Anderson KE. Clinical pharmacokinetics of diclofenac. Therapeutic insights and pitfalls. Clin Pharmacokinet 1997;33:184-213.
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Support Medicine
Diclofenac
Stinging Nettle
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.
Stinging NettleDiclofenac- Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105-8.
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Reduce Side Effects
Diclofenac
Licorice
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.
LicoriceDiclofenac- Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605-7.
- Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545-51.
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Explanation Required
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Needs Explanation
Diclofenac
Resveratrol
In a study of healthy volunteers, the rise in blood levels of diclofenac was significantly greater and the clearance of the drug was significantly slower when the volunteers were pretreated with 500 mg of resveratrol per day for 10 days than when they did not receive resveratrol. Thus, taking resveratrol could increase both the efficacy and the adverse effects of diclofenac. People interested in taking both diclofenac and resveratrol should consult a doctor.ResveratrolDiclofenac- Bedada SK, Yellu NR, Neerati P. Effect of resveratrol treatment on the pharmacokinetics of diclofenac in healthy human volunteers. Phytother Res 2016;30:397–401.
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