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Additional Info
Voltaren Emulgel Back & Muscle Pain has a unique formula that penetrates into the skin and to the source of pain. Reduces inflammation, provides relief from muscle pain, back pain and more, to help you get back to moving sooner. Relieves pain associated with acute, localized, minor muscle or joint injuries such as sprains, strains, or sports injuries (e.g. ankle sprain, shoulder pain/strain or back muscle pain). It is available in four sizes: 30g, 50g, 100g, 120g.
Medicinal Ingredients: 1 g contains 11.6 mg of the active ingredient, diclofenac diethylamine.

Non-Medicinal Ingredients: carbomer, cocoyl caprylocaprate, diethylamine, isopropyl alcohol, liquid paraffin, macrogol cetostearyl ether, perfume, propylene glycol, water.

Do not exceed the stated dose. Always read the enclosed insert before use to check if this product is suitable for you.

For adults and adolescents 16 years and older: apply Voltaren Emulgel to the skin 3 to 4 times a day. See package insert for more detailed instructions.
Voltaren Emulgel Joint Pain Regular Strength can be used for up to 7 days for muscle/joint injuries. See a doctor if symptoms get worse, or do not improve within 7 days.

Diclofenac topical gel, like Voltaren Emulgel Back and Muscle Pain is used to help relieve pain affecting muscles and joints (including those in hands and knees) that can benefit from treatment through the skin.

How it works
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). The drug blocks a substance in your body involved in the inflammatory process, called prostaglandins. When these are blocked, your body decreases the amount of inflammatory chemicals it makes, which then helps to reduce inflammation and pain.

Diclofenac side effects
Diclofenac topical gel may cause drowsiness. Don’t drive or use machinery until you know how this drug affects you.

Diclofenac can also cause other side effects.

More common side effects
The more common side effects that can occur with diclofenac gel include:
• itching or rash at application site
• stomach pain
• constipation
• diarrhea
• gas
• heartburn
• nausea
• vomiting
• sleepiness

Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Allergic reaction. Symptoms can include:
• itching
• rash
• breathing problems
• hives

Edema. Symptoms can include:
• swelling of the feet or ankles
• increased blood pressure
• increased weight

Stomach ulcer or stomach bleeding. Symptoms can include:
• very dark stools
• blood in your stool

Bruising more easily

Diclofenac may interact with other medications
Diclofenac topical gel can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with diclofenac are listed below.

Blood pressure drugs
Diclofenac may decrease the blood pressure-lowering effects of some drugs used to control blood pressure. Using diclofenac with certain blood pressure medications may also increase your risk of kidney damage.

Examples of these blood pressure drugs include:
•angiotensin-converting enzyme (ACE) inhibitors, such as benazepril, captopril, enalapril, and lisinopril
•angiotensin II receptor blockers, such as candesartan, irbesartan, losartan, and olmesartan
•beta blockers, such as acebutolol, atenolol, metoprolol, and propranolol
•diuretics (water pills) such as furosemide or hydrochlorothiazide

Cancer drug
Using the cancer drug pemetrexed with diclofenac may increase the effects of pemetrexed. Symptoms may include fever, chills, body aches, mouth sores, and severe diarrhea.

Other NSAIDs
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). Don’t combine it with other NSAIDs unless directed by your doctor, as this may increase your risk of stomach and bleeding issues. Examples of other NSAIDs include:

Drugs that affect the flow of blood
Taking diclofenac with other drugs that affect the flow of blood through your body can increase your risk of bleeding. Examples of these drugs include:

selective serotonin reuptake inhibitors (SSRIs), such as escitalopram, fluoxetine, paroxetine, and sertraline
serotonin norepinephrine reuptake inhibitors (SNRIs), such as desvenlafaxine, duloxetine, venlafaxine, and levomilnacipran

Bipolar disorder drug
If you take lithium withdiclofenac, it may increase the lithium in your body to harmful levels. Your doctor may monitor your lithium levels closely.

Immunosuppressant drug
Taking cyclosporine, a drug that weakens your immune system, with diclofenac may increase your risk for kidney problems.

Taking methotrexate with diclofenac can lead to harmful levels of methotrexate in your body. This can raise your risk of infection and kidney issues.

Taking digoxin with diclofenac can lead to increased levels of digoxin in your body and increased side effects. Your doctor may monitor your digoxin levels closely.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Diclofenac warnings
This drug comes with several warnings.

Allergy warning
If you have an allergy to aspirin or other similar NSAIDs, such as ibuprofen or naproxen, you could have an allergic reaction to diclofenac. Call your doctor right away if you have any signs of:
•trouble breathing
•itchy rash
If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t use this drug again if you’ve ever had an allergic reaction to it. Using it again could be fatal (cause death).

Alcohol interaction warning
Avoid drinking alcohol when using this drug. Alcohol can increase your risk of stomach ulcers from using diclofenac.

Contact with drug warning
Diclofenac gel can transfer to others. Make sure the gel has dried on your skin before you touch anyone else.

Warnings for people with certain health conditions
For people with high blood pressure or water retention: Tell your doctor before using diclofenac. Your heart may already be working hard, and adding an NSAID can increase this workload.

For people with ulcer or digestive bleeding: If you’ve had an ulcer or bleeding from your digestive system, ask your doctor before using diclofenac. You’re at increased risk for another bleed.

For people with kidney disease or taking diuretics: If you have kidney disease or take diuretics (water pills), there’s a risk this drug can affect your kidneys’ ability to remove excess water from your body. Ask your doctor if diclofenac is the right drug for you.

For people with asthma and aspirin reactions: If you have asthma and you react to aspirin, you could have a bad reaction to diclofenac. Talk to your doctor before using the drug.

Warnings for other groups
For pregnant women: Before 30 weeks of pregnancy, this drug is a pregnancy category C drug. After 30 weeks of pregnancy, it’s a pregnancy category D drug.

A category C drug means that means that studies have shown that the drug can be a risk to the offspring of lab animals. However, not enough studies have been done to show risk in humans.

Category D means two things:

Studies show a risk of adverse effects to the fetus when the mother uses the drug.
The benefits of using diclofenac during pregnancy may outweigh the potential risks in certain cases.
Do not use diclofenac if you’re pregnant, unless your doctor advises you to. Be especially sure to avoid using diclofenac at 30 weeks of pregnancy and later.

For women who are breastfeeding: This drug may pass into the breast milk, which means it may pass to a child who is breastfed. This may lead to dangerous effects for the child.

Talk to your doctor regarding whether breastfeeding is a good choice for you.

For seniors: Seniors are at higher risk for stomach problems, bleeding, water retention, and other side effects from diclofenac. Seniors may also have kidneys that aren’t working at peak levels, so the drug can build up and cause more side effects.

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