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Drug Interactions With Diclofenac Potassium
A few of the drugs that can potentially interact with diclofenac potassium include aspirin, lithium, diuretics, and ACE inhibitors. Drug interactions with diclofenac potassium can change how your body metabolizes the drugs, raise your risk of stomach ulcers, and make some drugs less effective, among other things. Also, taking diclofenac potassium along with other NSAIDs or certain herbal and nutritional supplements can increase your risk of bleeding.
Diclofenac potassium (Cambia™, Cataflam®, Zipsor™) can potentially interact with a number of other medicines. Some of these diclofenac potassium drug interactions include:
- ACE inhibitors, including:
- Benazepril (Lotensin®), benazepril-hydrochlorothiazide (Lotensin® HCT), or benazepril-amlodipine (Lotrel®)
- Captopril (Capoten®) or captopril-hydrochlorothiazide (Capozide®)
- Enalapril (Vasotec®), enalapril-hydrochlorothiazide (Vaseretic®), or enalapril-felodipine (Lexxel®)
- Fosinopril (Monopril®) or fosinopril-hydrochlorothiazide (Monopril-HCT®)
- Lisinopril (Prinivil®, Zestril®) or lisinopril-hydrochlorothiazide (Prinzide®, Zestoretic®)
- Quinapril (Accupril®) or quinapril-hydrochlorothiazide (Accuretic®, Quinaretic™)
- Ramipril (Altace®)
- Angiotensin II receptor blockers (ARBs), such as:
- Azilsartan (Edarbi™) or azilsartan/chlorthalidone (Edarbyclor™)
- Candesartan (Atacand®) or candesartan-hydrochlorothiazide (Atacand HCT®)
- Eposartan (Teveten®) or eposartan-hydrochlorothiazide (Teveten® HCT)
- Irbesartan (Avapro®) or irbesartan-hydrochlorothiazide (Avalide®)
- Losartan (Cozaar®) or losartan-hydrochlorothiazide (Hyzaar®)
- Olmesartan (Benicar®), olmesartan-hydrochlorothiazide (Benicar HCT®), or amlodipine and olmesartan (AZOR™)
- Telmisartan (Micardis®) or telmisartan-hydrochlorothiazide (Micardis® HCT)
- Valsartan (Diovan®) or valsartan-hydrochlorothiazide (Diovan HCT®)
- Beta blockers, such as:
- Acebutolol (Sectral®)
- Atenolol (Tenormin®)
- Betaxolol (Kerlone®)
- Bisoprolol (Zebeta®)
- Carvedilol (Coreg®, Coreg CR®)
- Esmolol (Brevibloc®)
- Labetalol (Trandate®)
- Metoprolol (Lopressor®, Toprol-XL®)
- Nadolol (Corgard®)
- Nebivolol (Bystolic®)
- Penbutolol (Levatol®)
- Propranolol (Inderal®, Inderal® LA, InnoPran XL™)
- Sotalol (Betapace®)
- Timolol
- Bile acid sequestrant cholesterol medications, including:
- Cholestyramine (Prevalite®, Questran®, Questran® Light)
- Colesevelam (WelChol®)
- Colestipol (Colestid®)
- Corticosteroids, including but not limited to:
- Betamethasone (Celestone®)
- Cortisone
- Dexamethasone (Decadron®)
- Fludrocortisone (Florinef®)
- Hydrocortisone (Cortef®)
- Methylprednisolone (Depo-Medrol®, Medrol®)
- Prednisolone (Orapred®, Pediapred®)
- Prednisone
- Triamcinolone (Kenalog®, Aristospan®)
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- CYP 2C9 inducers, including but not limited to:
- CYP 2C9 inhibitors, including but not limited to:
- Capecitabine (Xeloda®)
- Delavirdine (Rescriptor®)
- Floxuridine
- Fluconazole (Diflucan®)
- Fluorouracil (Carac®, Efudex®, Fluoroplex®)
- Gemfibrozil (Lopid®)
- Ketoconazole (Nizoral®)
- Nicardipine (Cardene®, Cardene® SR)
- Sulfadiazine
- Sulfisoxazole (Gantrisin®)
- Tolbutamide (Orinase®)
- Digoxin (Digitek®, Lanoxin®)
- Diuretics, such as:
- Amiloride (Midamor®) or amiloride-HCTZ (Moduretic®)
- Bumetanide (Bumex®)
- Chlorothiazide (Diuril®)
- Chlorthalidone (Thalitone®)
- Ethacrynic acid (Edecrin®)
- Furosemide (Lasix®)
- Hydrochlorothiazide (Esidrix®, HydroDIURIL®, Microzide®, Oretic®)
- Metolazone (Zaroxolyn®)
- Spironolactone (Aldactone®) or spironolactone-HCTZ (Aldactazide®)
- Torsemide (Demadex®)
- Triamterene (Dyrenium®) or triamterene/HCTZ (Dyazide®, Maxzide®)
- Lithium (Eskalith®, Lithobid®)
- Medications that "thin" the blood or otherwise increase bleeding risk (such as anticoagulant and antiplatelet drugs), such as:
- Antithrombin (ATryn®, Thrombate III®)
- Apixaban (Eliquis®)
- Argatroban
- Aspirin (Bayer® and others)
- Bivalirudin (Angiomax®)
- Cilostazol (Pletal®)
- Clopidogrel (Plavix®)
- Dabigatran etexilate mesylate (Pradaxa®)
- Dipyridamole (Persantine®)
- Drotrecogin alfa (Xigris®)
- Eptifibatide (Integrilin®)
- Fondaparinux (Arixtra®)
- Heparin or heparin-like products, including dalteparin (Fragmin®), enoxaparin (Lovenox®), or tinzaparin (Innohep®)
- Lepirudin (Refludan®)
- Other nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- Celecoxib (Celebrex®)
- Diclofenac (Flector®, Pennsaid®, Solaraze® Gel, Voltaren®, Voltaren® Gel, Voltaren®-XR, Voltaren Ophthalmic®)
- Ibuprofen (Motrin®, Advil®, Nuprin®)
- Indomethacin (Indocin®, Indocin SR®)
- Ketoprofen (Orudis®, Actron®, Oruvail®)
- Ketorolac (Toradol®)
- Meloxicam (Mobic®)
- Naproxen (Naprosyn®) or naproxen sodium (Aleve®, Anaprox®, Naprelan®)
- Several others (see List of NSAIDs for a more complete list of these medications)
-
- Thrombolytics, such as:
- Alteplase (Activase®)
- Reteplase (Retavase®)
- Streptokinase (Streptase®)
- Tenecteplase (TNKase®)
- Ticagrelor (Brilinta®)
- Ticlopidine (Ticlid®)
- Methotrexate (Rheumatrex®, Trexall®)
- Probenecid
- SSRI or SNRI medications, including:
- Citalopram (Celexa®)
- Duloxetine (Cymbalta®)
- Desvenlafaxine (Pristiq®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Fluvoxamine (Luvox®, Luvox® CR)
- Levomilnacipran (Fetzima™)
- Milnacipran (Savella™)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®, Brisdelle™)
- Sertraline (Zoloft®)
- Venlafaxine (Effexor®, Effexor XR®).
Several herbal and nutritional supplements can also interact with diclofenac potassium and may increase the risk of bleeding. Examples of these include, but are not limited to:
- Dong quai
- Feverfew
- Garlic
- Ginger
- Ginkgo biloba
- Ginseng
- St. John's wort
- Fish oil supplements.
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD