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Diclofenac

Drug Information

Diclofenac is used in the treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It is in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).

Common brand names:

Solaraze, Voltaren

Summary of Interactions with Vitamins, Herbs, & Foods

What Are Nutrient Interactions

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

Calcium

Diclofenac decreases the amount of calcium lost in the urine,¹ which may help prevent bone loss in postmenopausal women.²
L-Tryptophan

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.

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

none

Support Medicine

Stinging Nettle

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.

Reduces Effectiveness

Trikatu

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
White Willow

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.

The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Potential Negative Interaction

none

Explanation Required

none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

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.

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Last Review: 11-07-2012

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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2013.

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