Diclokim® ( diclofenac ) inhibits prostaglandin synthesis by decreasing the activity of enzyme cyclooxygenase , which results in decreased formation of prostaglandin precursors from arachidonic acid.

Diclokim® is used for chronic treatment of rheumatoid arthritis and osteoarthritis.

Abdominal cramps and pain ; Constipation ; Diarrhea ; Flatulence ; Indigestion ; Nausea ; Peptic ulcer / GI bleeding ; Pancreatitis ; Vomiting ; Increased ALT / AST ; Cirrhosis ; Hepatic necrosis ; Headache ; Dizziness ; Pruritus ; Rash ; Alopecia ; Photosensitivity ; Fluid retention ; Acute renal failure ; Aseptic meningitis ; Agranulocytosis ; Aplastic anemia ; Thrombocytopenia ; Leukopenia ; Anaphylaxis ; Asthma ; Angioedema ; Eosinophilia ; Erythema multiforme major ; Hearing loss ; Visual changes ; Nephrotic syndrome .

Hypersensitivity to diclofenac , any component of the formulation , aspirin or other NSAIDs ; Porphyria ; Pregnancy ( 3 rd trimester ).

Use with caution in patients with CHF , dehydration , hypertension , decreased renal or hepatic function , history of GI disease , active GI ulceration or bleeding , pre – existing asthma , or those receiving anticoagulants . Elderly are at a high risk for adverse effects from NSAIDs ; therefore use lowest effective dose for shortest period possible . Withhold for at least 4 – 6 half – lives prior to surgical or dental procedures.

Concurrent use with diclokim® may decrease the antihypertensive effects of ACE inhibitors , angiotensin II antagonists , loop diuretics , thiazides and hydralazine . Anticoagulants and antiplatelet drugs can cause an increased risk of bleeding . Cholestyramine and colestipol reduce the bioavailability of diclokim . Corticosteroids may increase the risk of GI ulceration ; avoid concurrent use . NSAIDs may increase serum creatinine and cyclosporine levels ; monitor cyclosporine level and renal function . Lithium levels can be increased ; avoid concurrent use or monitor lithium levels . Avoid use during moderate or high – dose methotrexate ( increased and prolonged methotrexate levels ) . Verapamil plasma concentration is decreased ; avoid concurrent use . Sucralfate decreases the plasma concentration of diclofenac.

Monitor CBC , liver enzymes , urine output and serum BUN / creatinine , occult blood loss , hemoglobin , hematocrit.

Diclokim® may be taken with food to decrease GI distress.

Usual adult dose:
Rheumatoid arthritis – Oral , 100 mg once a day , in the morning or evening . Osteoarthitis – Oral , 100 – 200 mg once a day , in morning or evening . Diclokim® is not intended as initial therapy ; the daily maintenance dose should be determined using an immediate or delayed – release formulation of diclofenac . Then , diclokim® dosage may be used . Diclokim® tablets are to be swallowed whole , not crushed or chewed .
Usual pediatric dose:
Safety and efficacy have not been established.

• Tablet, 100 mg

• USP DI, 2005
• Up To Date, Vol. 13.3 (2005)
• Martindale, The Complete Drug Reference, 34 rd edition 2005