The proposed mechanism, demonstrated in rats, is through stimulation by diclofenac (and possibly other nonsteroidal anti-inflammatory agents) of the porphyrin precursor, delta-aminolevulinic acid. Anemia has been reported occasionally. In addition, there is evidence that COX-2 inhibitors may delay healing of gastric ulcers, and likely to the same extent as traditional NSAIDs. Patients should be advised to discontinue the NSAID and seek medical attention promptly at the first sign of rash, blisters, fever, itching, or any other sign of hypersensitivity.Major Potential Hazard, High plausibility. The risk may increase with duration of use. Particular vigilance is necessary when treating elderly (i.e., age 60 years or more) and/or debilitated patients, since they are often more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than younger, healthier individuals. Applies to: Renal Dysfunction, Dehydration, Congestive Heart Failure, Hyponatremia, Liver DiseaseChronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with renal toxicities, including elevations in serum creatinine and BUN, tubular necrosis, glomerulitis, renal papillary necrosis, acute interstitial nephritis, nephrotic syndrome, and renal failure. Although not all NSAIDs have been studied, investigators believe it may be a class effect, and that the risk may be similar for all NSAIDs, both COX-2 selective and nonselective. The decreases in hemoglobin concentration tend to be slight with average doses but may exceed 1 g/dL when large doses are given, such as those used to treat osteoarthritis or rheumatoid arthritis. Brand names: Solaraze, Voltaren. Therapy with NSAIDs should be administered cautiously in patients with or predisposed to anemia. Drug Interactions (376) Alcohol/Food Interactions (3) Disease Interactions (13) There are 13 disease interactions with Voltaren (diclofenac): Asthma. Diclofenac topical gel is available as a brand-name drug and a generic drug. Patients with such a history who use NSAIDs have a greater than 10-fold increased risk for developing a GI bleed compared to patients with neither of these risk factors. Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure. NSAIDs are generally not recommended for patients with advanced renal disease due to the lack of information from controlled clinical studies regarding their use in such patients.Major Potential Hazard, High plausibility. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Severe Interactions. The study is created by eHealthMe based on reports of 366 people who take Diclofenac sodium and Albuterol from the Food and Drug Administration (FDA), and is updated regularly. Fluid retention. GI … Applies to: Liver DiseaseBorderline elevations of serum transaminases, LDH, and alkaline phosphatase have been reported in up to 15% of patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs). Drugs A-Z Pill Identifier Supplements Symptom Checker Diseases Dictionary Media Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. Applies to: AsthmaApproximately 10% of patients with asthma may have aspirin-sensitive asthma, characterized by nasal polyposis, pansinusitis, eosinophilia, and precipitation of asthma and rhinitis attacks after ingestion of aspirin. With other medications, herbs, or regress with continuing therapy reported rarely during NSAID use with fluid or. 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