Dicofen Special Precautions

Close medical surveillance is imperative in patients with symptoms indicative of GI disorders, or a history of gastric or intestinal ulceration, in patients with ulcerative colitis or Crohn's disease, and in patients suffering from impaired hepatic function.
As with NSAIDs, values of one or more liver enzymes may increase. During prolonged treatment with Diclofenac sodium, monitoring of hepatic function is indicated as a precautionary measure. If abnormal liver function is indicated or worsen, if clinical signs or symptoms consistent with liver disease develop, or if other manifestations occur (eg, eosinophilia, rash, etc) Diclofenac sodium should be discontinued. Hepatitis may occur without prodromal symptoms. Caution is called for when using Diclofenac sodium in patients with hepatic porphyria, since it triggers an attack.
Owing to the importance of prostaglandins in maintaining renal blood flow, particular caution is called for in patients with impaired cardiac or renal function, the elderly, patients being treated with diuretics and in those with extracellular volume depletion from any cause eg, before or after a major surgical operation. Monitoring of renal function is recommended as a precautionary measure when using Diclofenac sodium in such cases. Discontinuation of therapy is usually followed by recovery to the pre-treatment state.
Caution is indicated in the elderly on basic medical grounds. In particular, it is recommended that the lowest effective dosage be used in frail, elderly patients or those with a low body weight. During prolonged treatment with Diclofenac sodium, as with other NSAIDs monitoring of the blood count is recommended. Like other NSAIDs, Diclofenac sodium may temporarily inhibit platelet aggregation. Patients with defective of hemostasis should be carefully monitored.
Insufficient data are available as yet on the use of Diclofenac sodium ampoules during pregnancy and lactation. For this reason, their use is not recommended during pregnancy and lactation.
Effects on the Ability to Drive or Operate Machinery: Patients experiencing dizziness or other central nervous disturbances including visual disturbances should refrain from including a vehicle or operating machines.