Voltaren Retard (Diclofenac 100mg) Tablets

Voltaren Retard general information

What is Voltaren Retard used for?

When you are injured, suffer a disease that causes tissue damage, or are attacked by harmful pathogens, this triggers a local inflammatory response, which causes pain.  The sensation of pain tells you that something is wrong and brings with it a warning to take extra care when using that part of your body.  Voltaren Retard tablets are used to treat the pain and inflammation caused by chronic inflammatory joint diseases.  These include rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and painful syndromes of the vertebral column.  Voltaren Retard tablets are also used to treat acute gout, soft tissue injury, and to reduce pain, inflammation, and swelling following surgery such as dental or orthopaedic surgery, and to relieve menstrual pain or dysmenorrhoea.

Symptoms of inflammation

Inflammation is a process that heals and restores damaged tissues.  Vascular changes are the first stage of the inflammatory response when small blood vessels dilate (widen) and become more permeable (leaky).  This allows proteins and blood cells into the tissues to fight invading pathogens, remove dead tissue, and promote healing.  These changes result in swelling and redness, and heat is generated by increased blood flow.  Cells of the immune system produce several chemicals such as prostaglandins at the site of inflammation, causing pain. 

Soft tissue injury

Soft tissue injury includes injury or damage to tendons, ligaments, or muscles, also bursa, which are fluid-filled sacs surrounding joints that protect against friction.  Soft tissues within superficial joints include synovial lining of the joint surfaces and cavities, and the joint capsule, the fibrous tissue that attaches to the surface of bone in an articular joint.  Soft tissue injuries include sprains and strains due to trauma, such as sports injuries.  Overuse of a particular part of the body can cause tendinitis, which is inflammation of a tendon resulting in swelling around the elbow or knee.  Tennis elbow is an example of a sports injury caused by overuse of the elbow tendons.  Tenosynovitis is inflammation of the tendon sheath, which is the membrane around a tendon that allows it to stretch.  Bursitis is inflammation around the bursa and is most common in the shoulder, elbow, and hip.  Frozen shoulder is an example of inflammation of a joint capsule.  A soft tissue injury can also cause bruising in the underlying tissues.

Chronic inflammatory joint disease

Rheumatoid arthritis (including juvenile rheumatoid arthritis) is an autoimmune inflammatory joint disease where the synovial membrane becomes inflamed.  The synovium forms a protective lining over the joints.  When it becomes inflamed, it thickens, causing swelling and pain in the joints.  Eventually, the cartilage and bone are damaged and can cause deformities.

Ankylosing spondylitis is an autoimmune inflammatory disease that affects the joints in the spine and pelvis and can cause fusion of the spine. 

Osteoarthritis is more common with increasing age and can also develop as a result of a joint injury, infection, or due to being overweight.  It is often referred to as wear and tear of the bone with gradual disintegration of the cartilage that covers and protects the ends of the bones in an articular joint.  As cartilage becomes eroded, it leaves the underlying bones exposed and unprotected so that they rub against each other, causing inflammation, pain, and stiffness, which restricts the movement of that joint.  Osteoarthritis is most common in the knees and hips but can also occur in the fingers and spine. 

Gout is a form of arthritis caused by excess uric acid in the blood.  Uric acid crystals become deposited in the joints as crystals that cause inflammation, pain, and swelling. 

Dysmenorrhoea

Primary dysmenorrhoea, or painful periods, is caused by the overproduction of prostaglandins by the lining of the uterus during menstruation.  These prostaglandins cause contractions of the uterine muscle, which is the mechanism that expels the uterine lining during menstruation.  Overproduction can result in increased contractions with muscle cramps and menstrual pain.

How does Voltaren Retard work?

Voltaren Retard tablets contain diclofenac, a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation in a range of acute and chronic conditions.  Diclofenac in Voltaren Retard tablets has antirheumatic (reduces pain and inflammation in joints), anti-inflammatory (reduces general inflammation), analgesic (pain-relieving) and antipyretic (fever-reducing) properties. 

Diclofenac in Voltaren Retard tablets works by inhibiting the action of the enzyme cyclooxygenase (COX).  The COX enzyme is critical in the pathway for the synthesis of chemicals called prostaglandins, which are cellular messengers that mediate many cellular processes.  Some prostaglandins (PG) like PGE2 are produced at sites of injury or inflammation and cause pain, swelling, and other symptoms of inflammation.  There are two forms of COX, cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2).  COX-2 is induced during the inflammation process and is responsible for the synthesis of inflammatory prostaglandins, and inhibition of COX-2 helps relieve the symptoms of inflammation, including pain, swelling, and joint stiffness.  Inhibition of COX-1 is responsible for the gastrointestinal side effects that are due to inhibition of protective prostaglandins in the gut and disruption of the regulation of acid content.  Blocking the local production of prostaglandins at the site of inflammation reduces pain and swelling associated with inflammation.

Voltaren Retard tablets are enteric-coated so that the active ingredient is not released until the tablets have passed through the stomach and is then completely absorbed in the intestines.  This allows for prolonged release of diclofenac from Voltaren Retard tablets and a single daily dose.

What does Voltaren Retard contain?

Voltaren Retard tablets contain the active ingredient diclofenac 100mg, a nonsteroidal anti-inflammatory drug (NSAID) used to relieve symptoms of pain and inflammation in a variety of conditions. 

What are the side effects of Voltaren Retard?

Most medications have some side effects, but they are not experienced by everyone.  Some side effects are commonly experienced when taking Voltaren Retard tablets, but others are not so common, and you should discuss any problems or concerns with your primary care physician. 

Common side effects when taking Voltaren Retard include gastrointestinal upset (stomach or stomach pain, diarrhoea, indigestion, bloating, wind, heartburn, indigestion, constipation) headache, dizziness, vertigo, rash.

When should Voltaren Retard not be used?

Have a talk with your primary healthcare physician before taking Voltaren Retard tablets so that you have a full understanding of what this medicine is for and how to use it.  There are some reasons for not taking a medication; these are called contraindications, and for Voltaren Retard you should consider the following before taking Voltaren Retard:

• Have you ever had an unusual reaction or an allergy when taking Voltaren Retard?
• Are you allergic to diclofenac, aspirin or any other nonsteroidal anti-inflammatory drug (NSAID)?
• Are you pregnant or breastfeeding?
• Do you have any problems with your kidneys or your liver?
• Do you have a history of stomach ulcer, or gastrointestinal bleeding or perforation due to an ulcer?
• Do you tend to bleed easily?
• Do you have severe heart failure or have had a heart attack within the last 12 months?
• Do you have asthma or have you had an asthma attack when taking diclofenac, aspirin or any other nonsteroidal anti-inflammatory drug (NSAID)?
• Are you taking any other NSAID or aspirin?

What medications interact with Voltaren Retard?

Some medicines interact with Voltaren Retard tablets and may affect the way it works, or are affected by Voltaren Retard or increase side effects; you should discuss possible interactions with your primary care physician.  These may include aspirin or other NSAIDs, anticoagulants like warfarin or heparin, cholestyramine for high cholesterol, probenecid for gout, the anti-cancer drug methotrexate, lithium for mood disorders, diuretics like frusemide, beta-blockers for high blood pressure, digoxin for heart failure, sulphonamide antibiotics, sulphonylureas for diabetes.

If other medications may interact with Voltaren Retard, your doctor will discuss these with you. 

How should Voltaren Retard be taken and for how long?

You should take your Voltaren Retard tablets swallowed whole with a glass of water once daily, preferably in the evening and with a meal, just before eating.  The dose you take depends on what you are being treated for and your doctor’s recommendation and may be reduced or increased depending on side effects and how well you respond.  You should continue to take your Voltaren Retard tablets for as long as recommended by your doctor, which may be for a few days, several weeks or longer, depending on what you are being treated for. 

Missed dose of Voltaren Retard

If you miss a dose of Voltaren Retard tablets take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Voltaren Retard be stored?

You should store your Voltaren Retard tablets below 25°C in a cool dry place.