Diclofenac decreases the amount of calcium lost in the urine,1 which may help prevent bone loss in postmenopausal women.2
Diclofenac causes complex changes to L-tryptophan levels in the blood,3 but the clinical implications of this are unknown. More research is needed to determine whether supplementation with L-tryptophan is a good idea for people taking diclofenac.
In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle.4 More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.
Trikatu, an Ayurvedic herbal preparation that contains Piper nigrum (black pepper), Piper longum (Indian Long pepper), and Zingiber officinale (ginger), decreased both blood levels and the medicinal effect of diclofenac in a study in rabbits.5
Willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of aspirin to individuals taking diclofenac results in a significant reduction in blood levels of diclofenac.6 Though there are no studies investigating interactions between willow bark and diclofenac, people taking the drug should avoid the herb until more information is available.
A common side effect of misoprostol is diarrhea, which is aggravated by taking magnesium.7 Consequently, individuals who experience diarrhea while taking misoprostol should avoid magnesium supplementation.
White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs.8 Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.
1. Sharma S, Vaidyanathan S, Thind SK, et al. The effect of diclofenac sodium on urinary concentration of calcium, uric acid and glycosaminoglycans in traumatic paraplegics. Br J Urol 1991;68:240–2.
2. Bell NH, Hollis BW, Shary JR, et al. Diclofenac sodium inhibits bone resorption in postmenopausal women. Am J Med 1994;96:349–53.
3. Davies NM, Anderson KE. Clinical pharmacokinetics of diclofenac. Therapeutic insights and pitfalls. Clin Pharmacokinet 1997;33:184–213.
4. Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105–8.
5. Lala LG, D'Mello PM, Naik SR. Pharmacokinetic and pharmacodynamic studies on interaction of Trikatu with diclofenac sodium. J Ethnopharmacol 2004;91:277–80.
6. Davies NM, Anderson KE. Clinical pharmacokinetics of diclofenac. Therapeutic insights and pitfalls. Clin Pharmacokinet 1997;33:184–213.
7. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2888–91.
8. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
Last Review: 05-01-2013
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