When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to diclofenac, aspirin, or similar medicines.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.
• Drink extra fluids so you will urinate more often and help prevent kidney problems.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with other NSAID medicines (including aspirin, diflunisal, ibuprofen, naproxen, salsalate), unless your doctor says it is okay.
• Some foods and medicines can affect how diclofenac works. Tell your doctor if you are using any of the following:
  
  • Acetaminophen, cyclosporine, digoxin, lithium, methotrexate, pemetrexed, rifampin, voriconazole
  • Blood pressure medicine
  • Blood thinner (including warfarin)
  • Diuretic (water pill)
  • Medicine to treat depression
  • Steroid medicine (including dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone)

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding. Do not use this medicine during the later part of a pregnancy, unless your doctor tells you to.
• Tell your doctor if you have kidney disease, liver disease, asthma, high blood pressure, heart or blood vessel problems, heart failure, a recent heart attack, or a history of stomach ulcers or bleeding problems. Also tell your doctor if you smoke or drink alcohol.
• This medicine may cause the following problems:
  
  • Increased risk for blood clots, heart attack, heart failure, or stroke
  • Stomach or bowel bleeding
  • Liver problems
  • High blood pressure
  • Kidney problems and high potassium levels in the blood
  • Serious skin reactions
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Bloody or black, tarry stools, severe stomach pain, vomiting blood or material that looks like coffee grounds
• Change in how much or how often you urinate
• Chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, unusual sweating, faintness
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Numbness or weakness in your arm or leg, or on one side of your body, pain in your lower leg, sudden or severe headache, or problems with vision, speech, or walking
• Rapid weight gain, swelling in your hands, ankles, or feet

If you notice these less serious side effects, talk with your doctor:

• Constipation
• Dizziness
• Pain, itching, burning, swelling, or a lump under your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088