Forum: diclofenac advice?


reflux, man clutches stomach

“It wasn’t too long ago that we were advised that diclofenac was the NSAID with most gastric and renal adverse effects. Recent Medscape article today – Achieving effective and safe pain control with NSAIDS, appears to refute this and claims diclofenac to be one of the safer options?? Comments?”

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2 Comments

  1. Geraldine Moses
    10/08/2016

    Hmmmm, I remember 4-5 years ago lots of evidence saying diclofenac carries the highest cardiovascular risk, due to evidence it caused more heart attacks and stroke than other NSAIDs. ( eg Trelle BMJ 2011) But not Gi and renal risk. ….. in fact, lots of evidence says it carries a good GI profile. Perhaps what you are remembering was longer ago than that . And that is the nature of evidence, isnt it. It’s always bloomin’ changing! And often conflicting, So you’ve got to keep up-to-date and read evidence with a critical eye. Am a bit skeptical of some of the evidence presented in this Medscape module, as the doses of ibuprofen quoted / used in the studies are 2400mg/day which is not used much in Australia.

    • Michelle Gerrie
      12/08/2016

      Thanks Geraldine. It is frustrating with the ever changing landscape and you are correct, it us up to the individual to keep abreast of new evidence ( I am also registered in the USA so it is difficult for me sometimes to understand why the guidelines are so damn different between countries. )Yes – the USA does use different dosing so i must bear that in mind with a critical eye as you say. I notice that Naproxen comes up frequently as an option in the USA but not much mention of it here in Oz. Your opinion on that one?

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