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Diclofenac Sodium

A Reappraisal of its Pharmacodynamic and Pharmacokinetic Properties, and Therapeutic Efficacy

Drugs volume 35, pages 244–285 (1988)Cite this article

Summary

Synopsis

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) advocated for use in painful and inflammatory rheumatic and certain non-rheumatic conditions. It is available in a number of administration forms which can be given orally, rectally or intramuscularly. Conveniently, dosage adjustments are not required in the elderly or in those patients with renal or hepatic impairment. The drug has a relatively short elimination half-life, which limits the potential for drug accumulation.

In numerous clinical trials the efficacy of diclofenac is equivalent to that of the many newer and established NSAIDs with which it has been compared. As an analgesic it has a fast onset and long duration of action. When administered intramuscularly it is at least comparable to, and frequently superior to, many narcotic and spasmolytic combinations in renal and biliary colic.

Extensive clinical experience has been gained with diclofenac, clearly establishing its safety profile. It is well tolerated compared with other NSAIDs and rarely produces gastrointestinal ulceration or other serious side effects.

Thus, diclofenac can be considered as one of the few NSAIDs of ‘first choice’ in the treatment of acute and chronic painful and inflammatory conditions.

Pharmacodynamic Properties

Diclofenac suppresses acute and chronic inflammation, pain and hyperthermia in various animal models, and in these models the drug has generally proven more potent, weight for weight, than aspirin, ibuprofen, naproxen and phenylbutazone, less potent than piroxicam, and similar to indomethacin. The therapeutic index (ratio of gastrointestinal irritant and therapeutic dosages) of diclofenac is generally good in animals, but varies relative to other non-steroidal anti-inflammatory drugs (NSAIDs) according to the model used. However, controlled studies in healthy subjects show that usual therapeutic dosages of diclofenac cause less gastrointestinal damage than aspirin, feprazone, indomethacin and naproxen but more than fenclofenac.

The anti-inflammatory activity of diclofenac, and most of its other pharmacological effects, are generally thought to be related to its inhibition of prostaglandin synthesis. Diclofenac is a potent inhibitor of cyclo-oxygenase in vitro and in vivo, thereby decreasing the synthesis of prostaglandins, prostacyclin and thromboxane products. This is reflected in animals and humans in vivo by reduced concentrations of various prostaglandins in urine, gastric mucosa and synovial fluid during treatment with diclofenac. Also, in common with other NSAIDs, diclofenac is a potent reversible inhibitor of the secondary phase of induced platelet aggregation. However, diclofenac at usual therapeutic dosages has little effect on bleeding time in humans. The drug also affects polymorphonuclear leucocyte function, thereby reducing chemotaxis, superoxide production and protease production.

Pharmacokinetic Properties

Diclofenac is rapidly and efficiently absorbed after conventional oral, rectal or intramuscular administration. After intramuscular administration peak plasma concentrations are attained after 10 to 30 minutes. With the enteric-coated formulation peak concentrations are reached after 1.5 to 2.5 hours, and this is delayed by food to 2.5 to 12 hours. After a single 50mg dose of these formulations, mean peak plasma concentrations of unchanged diclofenac are 0.7 to 1.5 mg/L. No clear peak concentrations are found after a single 100mg dose of sustained release diclofenac, although the mean concentration was about 0.1 mg/L at 2 hours. Peak plasma concentrations and area under the plasma concentration-time curve are linearly related to dose over the range of 25 to 150mg, regardless of administration route, and no accumulation occurs after repeated doses.

Like other NSAIDs, diclofenac is highly (≥ 99.5%) protein bound. The mean total volume of distribution is 0.12 to 0.17 L/kg and that of the central compartment is 0.04 L/kg. The drug efficiently penetrates inflamed synovial fluid where high concentrations are maintained compared with plasma concentrations. Diclofenac and its metabolites cross the placenta in animals, and small amounts may be found in the breast milk of women.

Diclofenac undergoes significant first-pass metabolism and only 60% of the drug reaches systemic circulation unchanged following oral administration. It is eliminated principally by hepatic metabolism and subsequent urinary and biliary excretion of glucuronide and sulphate conjugates of the metabolites. The principal metabolite in humans is 4′-hydroxydiclofenac, which possesses negligible anti-inflammatory activity compared with the parent drug; the amount excreted in urine accounts for 20 to 30% of the dose and that in bile for 10 to 20%. In healthy volunteers, mean plasma clearance of diclofenac is 16 L/h, and the mean elimination half-life of the terminal phase is 1.1 to 1.8 hours. The mean elimination half-life after a radiolabelled dose is about 30 hours for the tracer.

Age and renal or hepatic impairment do not appear to have any significant effect on plasma concentrations of unchanged diclofenac, although metabolite concentrations may be increased by severe renal impairment.

Therapeutic Use

Diclofenac 75 to 150mg daily administered orally or rectally has been well studied in controlled clinical trials in patients with rheumatoid arthritis, osteoarthritis and ankylosing spondylitis, showing similar analgesic and anti-inflammatory efficacy to usual therapeutic dosages of other NSAIDs, e.g. acemetacin, aspirin, carprofen, diflunisal, fenclofenac, flurbiprofen, ibuprofen, indomethacin, indoprofen, isoxicam, ketoprofen, mefenamic acid, naproxen, piroxicam, proglumetacin, proquazone, sulindac and tiaprofenic acid. As would be expected in such a large number of comparisons, statistically significant differences were found for some assessment parameters, but these differences were not of any clinical significance. In these controlled trials efficacy was usually examined over several weeks to several months. Longer term efficacy (up to several years) has been confirmed in non-comparative studies involving many thousands of patients. Most improvement occurred in the first 6 months, and an ‘excellent to good’ response was found in 60 to 90% of patients. Once improvement has occurred with diclofenac 150mg daily, the dosage can usually be reduced to 100mg daily without loss of efficacy.

Diclofenac 75 to 150mg daily administered orally or intramuscularly appears effective in the treatment of acute gout and is as effective as phenylbutazone 600mg daily and indomethacin 150mg daily. In a single study, diclofenac 2 to 3 mg/kg/day appeared more effective and better tolerated than aspirin 50 to 100 mg/kg/day in patients with juvenile rheumatoid arthritis.

Diclofenac 75 to 150mg daily administered orally, rectally or intramuscularly is an effective analgesic and anti-inflammatory agent in the treatment of various rheumatic conditions (e.g. tendinitis, bursitis, sciatica, myalgia) and acute soft tissue injuries (e.g. strains, sprains). It is also effective in treating the signs and symptoms of dysmenorrhoea. Diclofenac is as effective as, and occasionally superior to, usual therapeutic dosages of other NSAIDs such as flufenamic acid, ibuprofen, indomethacin, ketoprofen, naproxen and piroxicam. The onset of analgesia was frequently more rapid with diclofenac.

Diclofenac (administered orally, rectally or intramuscularly as single doses of 50 to 100mg or up to 150mg daily) is an effective analgesic agent in cases such as dental or minor surgical pain, postpartum pain and headache. It was at least as effective as usual therapeutic dosages of NSAIDs (e.g. indomethacin) and narcotic analgesics [e.g. oxycodone, dihydrocodeine plus paracetamol (acetaminophen), pentazocine, pethidine], but was devoid of the CNS effects associated with narcotics. Again, the onset of analgesia was frequently noted to be more rapid with diclofenac.

Intramuscularly administered diclofenac 50 to 100mg provides rapid and long lasting analgesia in patients with renal or biliary colic. It is at least as effective as, and superior to, many narcotic and spasmolytic combinations [e.g. pethidine 100mg, hyoscine (scopolamine) butylbromide 20mg]. Even when narcotic analgesics show similar efficacy, diclofenac possesses superior tolerability, being devoid of significant CNS effects.

Orally, rectally and intramuscularly administered diclofenac 0.25 to 0.5 mg/kg in children and 50 to 150mg in adults is an effective antipyretic agent, but must be used with caution in intensive care patients with compromised renal or circulatory function as oliguria or circulatory shock may rarely occur.

Side Effects

The tolerability profile of diclofenac is well established, as wide experience has been gained with the drug in clinical practice. About 12% of patients experience side effects, which are usually mild and transient, and 1.5% to 2% have the drug withdrawn. Side effects usually occur in the first 6 months of treatment, and they are not more frequent in the elderly. As with other NSAIDs, gastrointestinal problems are the most frequent effects, followed by minor CNS symptoms and allergic or local reactions.

Diclofenac is well tolerated compared with other NSAIDs, and no other agent of this class appears to have a side effect profile which is clearly superior to diclofenac. Aspirin produces more frequent and more severe gastrointestinal effects than diclofenac, and tinnitus and hearing loss are only extremely rarely associated with diclofenac. Indomethacin clearly produces more CNS effects than diclofenac, and gastrointestinal complaints are also somewhat more frequent with indomethacin. The tolerability of diclofenac appears similar to other commonly used NSAIDs such as ibuprofen, ketoprofen and naproxen.

As with any drug which has been used so extensively, a number of extremely rare or serious adverse effects have been associated with diclofenac. Gastrointestinal ulceration appears rarely associated with diclofenac compared with many other NSAIDs: there were only 8 reports in 85,361 patients (0.009%) treated with the drug. Although rare and isolated cases of hepatitis, severe renal damage and severe haematological complications have been reported, other NSAIDs have also been associated with these problems. In addition, diclofenac is rarely or never associated with some other serious side effects caused by other commonly used NSAIDs, e.g. acute pancreatitis, aseptic meningitis, or severe cutaneous or phototoxic reactions.

Changes in laboratory test values may occur during diclofenac therapy, but these are usually minor, transient and unrelated to therapy. However, persistently abnormal or worsening renal, hepatic or haematological test values should be followed up carefully, as with any drug, since they may in rare cases be related to therapy.

Drug Interactions

Diclofenac does not appear to interact with oral anticoagulants, parenteral gold, penicillamine, chloroquine, azathioprine, prednisolone, cefadroxil, doxycycline, codeine and oral hypoglycaemics. Antacids delay the absorption of diclofenac but do not affect the overall extent of absorption. Plasma concentrations of diclofenac are decreased by concomitant aspirin administration. Diclofenac decreases the clearance of lithium, and plasma lithium concentrations can become toxic during coadministration. It is probably inadvisable to administer diclofenac, or any NSAID, with triamterene or methotrexate. Diclofenac has been noted to increase plasma concentrations of digoxin.

Dosage and Administration

The initial dosage of conventional or enteric-coated tablets of diclofenac is 150mg daily in 2 or 3 divided doses with meals, and in most patients therapeutic control can be maintained on 100mg daily. In children the dosage is 2 to 3 mg/kg/day. Diclofenac can be used in rheumatic conditions such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, tendinitis and bursitis, and in other inflammatory or painful conditions such as strains and sprains, dysmenorrhoea, back pain, sciatica and postoperative pain. A sustained release formulation can be administered once daily, and suppositories can be administered once or twice daily. Intramuscular diclofenac 75mg can be given for the urgent relief of acute pain such as renal or biliary colic. A further dose may be administered after 30 minutes if necessary, but as with oral administration the daily dosage should not exceed 150mg.

Diclofenac is not recommended for children less than 18 months of age, and only when essential in pregnant or lactating women. Dosage reductions are not required in the elderly or in patients with hepatic or renal insufficiency. However, these patients should remain under close supervision as should those with a history of gastrointestinal disease.

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References

  • Abrams GJ, Solomon L, Meyers OL. A long-term study of diclofenac sodium in the treatment of rheumatoid arthritis and osteo-arthrosis. South African Medical Journal 53: 442–445, 1978

    PubMed  CAS  Google Scholar 

  • Alcalay M, Bussiere JL, Peltier A. Le Voltaren 100 suppositoire en rhumatologie: bilan-clinique a propos de 16419 nouvelles observations recueillies par 2895 omnipracticiens en France. Gazette Médicale 87: 2036, 1980

    Google Scholar 

  • Al-Sharkawi MS. A multicentre study of diclofenac sodium slow-release (Voltaren® Retard) in the treatment of rheumatic disorders in the Kingdom of Saudi Arabia. Journal of International Medical Research 12: 244–249, 1984

    PubMed  CAS  Google Scholar 

  • Altman R. International experiences with diclofenac in osteoarthritis. American Journal of Medicine 80 (Suppl. 4B): 48–52, 1986

    PubMed  CAS  Google Scholar 

  • Alvarez JLP, de Vallado PF, Ballarin JMP. A comparative study with tiaprofenic acid versus diclofenac in knee osteoarthritis. In Berry & Franchimont (Eds) Tiaprofenic acid, pp. 71–76, Excerpta Medica, Geneva, 1984

    Google Scholar 

  • Al-Waili NS. Diclofenac sodium and intractable epilepsy. Acta Neurologica Scandinavica 73: 507, 1986a

    PubMed  CAS  Google Scholar 

  • Al-Waili NS. Diclofenac sodium in the treatment of primary nocturnal enuresis: double-blind crossover study. Clinical and Experimental Pharmacology and Physiology 13: 139–142, 1986b

    PubMed  CAS  Google Scholar 

  • Amundsen T, Bleken L, Børkje B, Eidsaunet W, Eidsbø P, et al. Variation in response to naproxen and diclofenac in patients with osteoarthritis. Current Therapeutic Research 33: 793–801, 1983

    Google Scholar 

  • Appelboom T, Balthazar-Letawe D, Boes P, Ciaessens J, Famaey J-P. A test of 100mg Voltaren suppositories in osteoarthritis. Bruxelles-Medicale 56: 273–277, 1976

    Google Scholar 

  • Araie M, Sawa M, Takase M. Topical flurbiprofen and diclofenac suppress blood-aqueous barrier breakdown in cataract surgery: a fluorophotometric study. Japanese Journal of Ophthalmology 27: 535–542, 1983

    PubMed  CAS  Google Scholar 

  • Astbury C, Taggart AJ, Zebouni LNP, Bird HA. Single dose sulphasalazine pharmacokinetics in rheumatoid arthritis with and without concomitant NSAID therapy. Abstract no. 249. Acta Pharmacologica et Toxicologica 59 (Suppl. 5): 95, 1986

    Google Scholar 

  • Avendano-Espinosa O. Analgesia with diclofenac sodium in anorectal surgery. Prensa Medica Mexicana 42: 347–350, 1977

    Google Scholar 

  • Aylward M, Maddock J, Jones M. Simultaneous pharmacokinetics of antirheumatic drugs in plasma and synovial fluids of rheumatoid patients. Abstract presented at the World Congress of Clinical Pharmacology and Therapeutics, London, 1980

  • Aylward M, Maddock J, Lewis PA, Dewland PM. Mefenamic acid and diclofenac sodium in osteoarthritis of the weight bearing joints: a double blind comparison. British Journal of Clinical Practice 39: 135–139, 1985

    PubMed  CAS  Google Scholar 

  • Ayrolles D, Fournie A. Study on a new anti-inflammatory nonhormonal drug, diclofenac sodium, in 50 cases. Rhumatologie 28: 53–56, 1976

    Google Scholar 

  • Babany G, Bernuau J, Danan G, Rueff B, Benhamou J-P. Hépatite fulminante chez une femme prenant de la glafénine et du diclofénac. Gastroenterologie Clinique et Biologique 9: 185, 1985

    PubMed  CAS  Google Scholar 

  • Bach GL. Comparative clinical trials with diclofenac sodium (Voltarol®) and naproxen in rheumatic conditions: investigation of possible changes in diclofenac dose and dose interval. Rheumatology and Rehabilitation (Suppl. 2): 69–71, 1979a

  • Bach GL. The acute gouty attack: comparative treatment with two non-steroidal antirheumatic drugs. Medizinische Welt 30: 1696, 1979b

    PubMed  CAS  Google Scholar 

  • Badia-Flores J, Garcia-Rubio R, Barradas FM. Efecto sintomatico y tolerabilidad del diclofenac sodico en la artritis reumatoide. Investigacion Medica International 2: 194–199, 1975

    Google Scholar 

  • Bahous I. Diflunisal — ein neues, lang wirksames steroidfreies Antirheumatikum: klinische Prüfung gegen Diclofenac. Praxis 68: 390–393, 1979

    PubMed  CAS  Google Scholar 

  • Balthazar-Letawe D, Cleppe D, Coigne E, Decrans L, Dhondt E, et al. Single daily dose of diclofenac retard tablets for the treatment of osteo-arthritis: a double-blind comparison with piroxicam. Acta Therapeutica 10: 413–420, 1984

    Google Scholar 

  • Barnes CG, Berry H, Carter ME, Downie WW, Fowler PD, et al. Diclofenac sodium (Voltarol) and indomethacin: a multicentre comparative study in rheumatoid arthritis and osteoarthritis. Rheumatology and Rehabilitation (Suppl. 2): 135–143, 1979

  • Baumgartner H. Comparison of sulindac and diclofenac in the treatment of degenerative joint diseases. Praxis 68: 916–922, 1979

    PubMed  CAS  Google Scholar 

  • Bedi SS, Eberl R, Million R, Silas AM. Fenclofenac and diclofenac in the treatment of rheumatoid arthritis. British Journal of Rheumatology 23: 214–219, 1984

    PubMed  CAS  Google Scholar 

  • Behrens U, Dumpert HP, Thummler W, Vetter G. A double-blind multicenter comparison of isoxicam and diclofenac in the treatment of osteoarthritis. Current Therapeutic Research 37: 739–746, 1985

    Google Scholar 

  • Bendix T, Schmidt I, Rasmussen K-JE, Ibfelt HH. Diclofenac (Voltaren®) and ketoprofen (Orudis®), in rheumatoid arthritis: a randomized double-blind multicentre trial. Current Therapeutic Research 33: 192–199, 1983

    Google Scholar 

  • Benson MD, Aldo-Benson M, Brandt KD. Synovial fluid concentrations of diclofenac in patients with rheumatoid arthritis or osteoarthritis. Seminars in Arthritis and Rheumatism 15 (Suppl. 1): 65–67, 1985

    PubMed  CAS  Google Scholar 

  • Benvenuti C, Guidoni G, Longoni A, Mordini M. Controlled study of flurbiprofen and diclofenac in the treatment of rheumatic disorders. International Journal of Tissue Reactions 5: 61–65, 1983

    PubMed  CAS  Google Scholar 

  • Berry H, Bloom B, Hamilton EBD. A comparative study of piroxicam (Feldene), diclofenac and placebo in osteoarthritis. Clinical Trials Journal 19: 349–358, 1982a

    Google Scholar 

  • Berry H, Bloom B, Mace BEW, Hamilton EBD. Comparison of indoprofen (Flosint) and diclofenac in rheumatoid arthritis. Clinical Trials Journal 19: 248–257, 1982b

    Google Scholar 

  • Bethlen L, Dannhorn R. Results of testing diclofenac sodium in general practice. Therapiewoche 26: 3039–3047, 1976

    Google Scholar 

  • Bettini R, Grossi E, Rapazzini R, Giardina G. Diclofenac sodium versus acetylsalicylic acid: a randomized study in febrile patients. Journal of International Medical Research 14: 95–100, 1986

    PubMed  CAS  Google Scholar 

  • Beur GDM, Leunissen KML, Van Breda Vriesman PJC, Van Hooff JP, Grave W. Isolated minimal change nephropathy associated with diclofenac. British Medical Journal 295: 182–183, 1987

    Google Scholar 

  • Bijlsma A. The long term efficacy and tolerability of Voltaren (diclofenac sodium) and indomethacin in rheumatoid arthritis. Scandinavian Journal of Rheumatology (Suppl. 22): 74–80, 1978

    Google Scholar 

  • Bijlsma A, ten Pas JG. A study of the anti-inflammatory effect of Voltaren in patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology (Suppl. 22): 46–50, 1978

    Google Scholar 

  • Bird HA, Hill J, Leatham P, Wright V. A study to determine the clinical relevance of the pharmacokinetic interaction between aspirin and diclofenac. Agents and Actions 18: 447–449, 1986

    PubMed  CAS  Google Scholar 

  • Bodem H, Häringer E, Maier-Lenz H. Open multicentre study comparing the efficacy and tolerability of diclofenac sodium and piroxicam in degenerative joint diseases. Presented at the 15th International Congress of Rheumatology, Paris, 1981

    Google Scholar 

  • Bonfiglioli D, Sommariva D, Zanaboni L, Scarpellini P, Bott A, et al. Influence of two non-steroidal anti-inflammatory drugs on lipolysis and on plasma post-heparin lipoprotein lipase activity in normal man. European Journal of Clinical Pharmacology 20: 263–267, 1981

    PubMed  CAS  Google Scholar 

  • Borghi C, Corno C, Palummeri E, Giorgi D. Pharmacokinetics, efficacy and safety of diclofenac: elderly vs non elderly arthritic patients. Abstract no. 270. Acta Pharmacologica et Toxicologica 59 (Suppl. 5): 101, 1986

    Google Scholar 

  • Breen EG, McNicholl J, Cosgrove E, McCabe J, Stevens FM. Fatal hepatitis associated with diclofenac. Gut 27: 1390–1393,1986

    PubMed  CAS  Google Scholar 

  • Brendl K, Bruhn R, Ganote DP, Lücker PW, Scholz H-J. Imadyl®: die gastrische Irritation in Vergleich zu Acetylsalicylsäure, Indometacin, Piroxicam und Diclofenac-Na. Methods and Findings in Experimental and Clinical Pharmacology 5: 579–580, 1983

    PubMed  CAS  Google Scholar 

  • Brogden RN, Heel RC, Pakes GE, Speight TM, Avery GS. Diclofenac sodium: a review of its pharmacological properties and therapeutic use in rheumatic diseases and pain of varying origin. Drugs 20: 24–48, 1980

    PubMed  CAS  Google Scholar 

  • Broggini M, Corbetta E, Grossi E, Borghi C. Diclofenac sodium in biliary colic: a double blind trial. British Medical Journal 288: 1042, 1984

    PubMed  CAS  Google Scholar 

  • Brooks PM, Hill W, Geddes R. Diclofenac and ibuprofen in rheumatoid arthritis and osteoarthritis. Medical Journal of Australia 1: 29–30, 1980

    PubMed  CAS  Google Scholar 

  • Bruhn R, Brendl K, Ganote DP, Lücker PW, Scholz H-J. Magenverträglichkeit nicht-steroidaler Antirheumatika. Forschritte der Medizin 100: 1661–1667, 1982

    CAS  Google Scholar 

  • Calabro JJ. Efficacy of diclofenac in ankylosing spondylitis. American Journal of Medicine 80 (Suppl. 4B): 58–63, 1986

    PubMed  CAS  Google Scholar 

  • Caldwell JR. Diclofenac sodium in the treatment of rheumatoid arthritis and osteoarthritis. Seminars in Arthritis and Rheumatism 15 (Suppl. 1): 73–79, 1985

    PubMed  CAS  Google Scholar 

  • Caldwell JR. Efficacy and safety of diclofenac sodium in rheumatoid arthritis. American Journal of Medicine 80 (Suppl. 4B): 43–47, 1986

    PubMed  CAS  Google Scholar 

  • Cancino León A, Juan L. Estudio comparativo de tres antiinflamatorios no esteroides en la enfermedad articular degenerativa. Investigacíon Médica Internacional 8: 422–428, 1981

    Google Scholar 

  • Car A, Jajic I, Krampač I, Vitauš M, Zivokovič M. A double-blind multicentre comparison of diclofenac sodium and naproxen in osteoarthritis of the hip. Scandinavian Journal of Rheumatology (Suppl. 22): 63–68, 1978

    Google Scholar 

  • Cardoe N, Fowler PD. Diclofenac sodium (Voltarol®): a double-blind comparative study with ibuprofen in patients with rheumatoid arthritis. Rheumatology and Rehabilitation (Suppl. 2): 89–97, 1979

  • Carević O. Effects of D-penicillamine, diclofenac sodium and gold sodium thiomalate upon the selective release of lysosomal en zymes from human polymorphonuclear leucocytes to immune complexes. Agents and Actions 16: 407–410, 1985

    PubMed  Google Scholar 

  • Carlborg L, Lindoff C, Hellman A. Diclofenac versus pethidine in the treatment of pain after hysterectomy. European Journal of Anaesthesiology 4: 241–247. 1987

    PubMed  CAS  Google Scholar 

  • Catalano MA. Worldwide safety experience with diclofenac. American Journal of Medicine 80 (Suppl. 4B): 81–87, 1986

    PubMed  CAS  Google Scholar 

  • Caviezel F, Cattaneo AG, Tell A, Corino T, Mascherpa M. The effect of acetylsalicylic acid and diclofenac on stimulated growth hormone and prolactin secretions in humans. International Journal of Clinical Pharmacology, Therapy and Toxicology 21: 502–504, 1983

    CAS  Google Scholar 

  • Chamouard J-M, Barre J, Urien S, Houin G, Tillement J-P. Diclofenac binding to albumin and lipoproteins in human serum. Biochemical Pharmacology 34: 1695–1700, 1985

    PubMed  CAS  Google Scholar 

  • Chiswell RJ, Grieve AP, MacDonald IR. An interim report on a multicentre general practice study of Voltarol. I. Rheumatoid arthritis. British Journal of Clinical Practice 34: 203–206, 1980a

    PubMed  CAS  Google Scholar 

  • Chiswell RJ, Grieve AP, MacDonald IR. An interim report on a multicentre general practice study of Voltarol. II. Osteoarthritis. British Journal of Clinical Practice 34: 207–210, 1980b

    PubMed  CAS  Google Scholar 

  • Chiswell RJ, Seldrup J. Voltarol 50mg in arthritis: a dosage study. British Journal of Clinical Practice 36: 315–320, 1982

    PubMed  CAS  Google Scholar 

  • Ciccolunghi SN, Chaudri HA, Schubiger BI. How long should long be? Long-term trials in rheumatic diseases. Annals of the Rheumatic Diseases 38: 155–160, 1979c

    PubMed  CAS  Google Scholar 

  • Ciccolunghi SN, Chaudri HA, Schubiger BI. The value and results of long term studies with diclofenac sodium. Rheumatology and Rehabilitation (Suppl. 2): 100–110, 1979a

  • Ciccolunghi SN, Chaudri HA, Schubiger BI, Reddrop R. Report on a long term tolerability study of up to 2 years with diclofenac sodium (Voltaren). Scandinavian Journal of Rheumatology (Supply 22): 86–96, 1978

  • Ciccolunghi SN, Levi B, Chaudri H. Clinical experience with Voltaren, a new nonsteroidal anti-rheumatic drug. Therapiewoche 26: 2908–2914, 1976

    Google Scholar 

  • Ciccolunghi SN, Schubiger BI, Reddrop R. Comparisons of tolerability findings in international clinical trials. Rheumatology and Rehabilitation (Suppl. 2): 122–130, 1979b

  • Ciucci AG. A review of spontaneously reported adverse drug reactions with diclofenac sodium (Voltarol®). Rheumatology and Rehabilitation (Suppl. 2): 116–120, 1979

  • Coimbra FA. Report from the general out-patient hospital rheumatological department, Rio de Janeiro. XIth Congress of Rheumatology, Mesa-Redonda, Brasil, Jul 26–30, 1976

  • Coimbra FA, Seda H. Double-blind comparative trial with diclofenac sodium and indomethacin, combining 25mg tablets and 100mg suppositories in the treatment of rheumatoid arthritis. Revista Brasileira de Medicina 36: 166–168, 1979

    Google Scholar 

  • Comeri C, Radice GP, Duvia R, Manganini V, Monza G. Efficacy and safety of non-steroidal anti-inflammatory drugs in ureteral colic: a double-blind controlled trial. Abstract no. 71. Urological Research 12: 45, 1984

    Google Scholar 

  • Corli O, Sargentoni A, Cataria S, Selvaggio G, Reggiani A, et al. Use of an NSAID (diclofenac sodium) in neurolepto-analgesia: preliminary open study. Giornale di Chirurgia 7: 1613–1618, 1986

    Google Scholar 

  • Crook PR, Fowler PD, Hothersall TE, Chiswell RJ. A study of the efficacy and tolerability of diclofenac and ibuprofen in osteoarthritis of the hip. British Journal of Clinical Practice 35: 309–312, 1981

    PubMed  CAS  Google Scholar 

  • Crook PR, Willis JV, Kendall MJ, Jack DB, Fowler PD. The pharmacokinetics of diclofenac sodium in patients with active rheumatoid disease. European Journal of Clinical Pharmacology 21: 331–334, 1982

    PubMed  CAS  Google Scholar 

  • Daly HM, Boyle J, Roberts CJC, Scott GL. Interaction between methotrexate and non-steroidal anti-inflammatory drugs. Lancet 1: 557, 1986

    PubMed  CAS  Google Scholar 

  • D’Angelo D, Gomes JV. Experiência com o diclofenac śodico em traumato-ortopedia. Revista Brasileira de Clinica & Terapeutica 7: 766–770, 1978

    Google Scholar 

  • De Joubert JJ. An assessment of the efficacy and tolerability of Voltaren in the treatment of inflammation after extraction of teeth. Journal of the Dental Association of South Africa 32: 581–583, 1977

    PubMed  Google Scholar 

  • Del Bene E, Poggioni M, Garagiola U, Maresca V. Intramuscular treatment of migraine attacks using diclofenac sodium: a crossover clinical trial. Journal of International Medical Research 15: 44–48, 1987

    PubMed  Google Scholar 

  • Derendorf H, Mullersman G, Barth J, Grüner A, Möllmann H. Pharmacokinetics of diclofenac sodium after intramuscular administration in combination with triamcirolone acetate. European Journal of Clinical Pharmacology 31: 363–365, 1986

    PubMed  CAS  Google Scholar 

  • Desnuelle C, Acquaviva PC. Étude comparative de l’Indocid 50mg injectable versus diclofenac injectable dans les lombo-sciatiques. Semaine des Hôpitaux 62: 2197–2201, 1986

    Google Scholar 

  • DiPasquale G, Mellace D. Inhibition of arachidonic acid induced mortality in rabbits with several non-steroidal anti-inflammatory agents. Agents and Actions 7: 481–485, 1977

    PubMed  CAS  Google Scholar 

  • Dittrich P, Brunner F. Bioavailability of slow release forms of indomethacin and diclofenac. Abstract no. 3. Naunyn-Schmiedeberg’s Archives of Pharmacology 316 (Suppl.): R1, 1981

    Google Scholar 

  • Djaldetti M, Fishman P, Cohen A, Roffman E, Levinsky H, et al. Effect of diclofenac-sodium (Voltaren) on the electrical charge of human platelet membrane. Acta Haematologica 70: 296–301, 1983

    PubMed  CAS  Google Scholar 

  • Djaldetti M, Fishman P, Creter D, Notti I. Ultrastructural and functional studies on human platelets incubated with diclofenac sodium (Voltaren). Acta Haematologica 68: 285–294, 1982

    PubMed  CAS  Google Scholar 

  • Doreen MS, Boardman PL, Fowler PD, Poole PH. Diclofenac (Voltarol®) in rheumatoid arthritis: a report of a double-blind trial. Rheumatology and Rehabilitation 17: 78–80, 1978

    Google Scholar 

  • Dorietto de Menezes MR, Catanzaro-Guimaraes SA. Determination of anti-inflammatory and antimitotic activities of non-steroid anti-inflammatory drugs ibuprofen, diclofenac sodium and fentiazac. Cellular and Molecular Biology 31: 455–461,1985

    CAS  Google Scholar 

  • Doury P. Comparative study of flurbiprofen 150mg suppositories and diclofenac 100mg suppositories in arthrosis. Panminerva Medica 26: 55–56, 1984

    PubMed  CAS  Google Scholar 

  • Droste U, Siemens P. Behandlung der Spondylitis ankylosans mit der Retardform von Diclofenac-Natrium in einmal täglicher Dosierung. Fortschritte der Medizin 100: 1374–1376, 1982

    PubMed  CAS  Google Scholar 

  • Ducret F, Pointet P, Pichot C. Glomérulonéphrite extra-membraneuse au cours d’une polyarthrite rheumatoïde: rôle possible du diclofenac. Nouvelle Presse Médicale 9: 387, 1980

    PubMed  CAS  Google Scholar 

  • Dunk AA, Walt RP, Jenkins WJ, Sherlock SS. Diclofenac hepatitis. British Medical Journal 284: 1605–1606, 1982

    PubMed  CAS  Google Scholar 

  • Dürrigl T, Vitaus M, Pucar I, Miko M. Diclofenac sodium (Voltaren): results of a multi-centre comparative trial in adult-onset rheumatoid arthritis. Journal of International Medical Research 3: 139–144, 1975

    PubMed  Google Scholar 

  • Dux S, Groslop I, Garty M, Rosenfeld JB. Anaphylactic shock induced by diclofenac. British Medical Journal 286: 1861, 1983

    PubMed  CAS  Google Scholar 

  • Editorial. Diclofenac sodium and hepatic injury. Australian Adverse Drug Reactions Bulletin, Jun 1986

  • Editorial. Voltaren 3 years. SADRAC Bulletin 43: 3–4, 1984

  • Ehmann L, Tyberghein JM. Diclofenac suppositories in osteoarthrosis: a double-blind comparison with indomethacin. Practitioner 225: 757–758; 1981

    PubMed  CAS  Google Scholar 

  • Eidsaunet W, Børkje B, Larsen S, Sandvik L, Spongeen KL. Response to two NSAIDs: diclofenac and naproxen in rheumatoid arthritis. Current Therapeutic Research 33: 966–975, 1983

    Google Scholar 

  • Ellison NM, Servi RJ. Acute renal failure and death following sequential intermediate-dose methotrexate and 5-FU: a possible adverse effect due to concomitant indomethacin administration. Cancer Treatment Reports 69: 342–343, 1985

    PubMed  CAS  Google Scholar 

  • Famaey JP, Ginsberg F. Treatment of osteoarthrosis of the spine: a comparison of flurbiprofen and diclofenac. Journal of International Medical Research 11: 212–217, 1983

    PubMed  CAS  Google Scholar 

  • Famaey JP, Ginsberg F. Treatment of periarthritis of the shoulder: a comparison of ibuprofen and diclofenac. Journal of International Medical Research 12: 238–243, 1984

    PubMed  CAS  Google Scholar 

  • Favre L, Glasson P, Vallotton B. Reversible acute renal failure from combined triamterene and indomethacin. Annals of Internal Medicine 96: 317–320, 1982

    PubMed  CAS  Google Scholar 

  • First Steps towards Cartilage Protection in Human Osteoarthritis. Presented at the 11th European Congress of Rheumatology, Athens, 28 Jun–4 Jul, 1987

  • Fischer M. Beeinflusst Diclofenac die plasmatische Gerinnung bei einer Thromboembolienprophylaxe mit Heparin/Dihydroergotamin? Aktuelle Rheumatologie 7: 149–151, 1982

    Google Scholar 

  • Fowler PD. A double-blind comparison of diclofenac sodium (Voltarol®) and placebo in patients with rheumatoid arthritis. Rheumatology and Rehabilitation (Suppl. 2): 75–77, 1979b

  • Fowler PD. Diclofenac sodium (Voltarol®): drug interactions and special senses. Rheumatology and Rehabilitation (Suppl. 2): 60–68, 1979a

  • Fowler PD, Shadforth MF, Crook PR, John VA. Plasma and synovial fluid concentrations of diclofenac sodium and its major hydroxylated metabolites during long-term treatment of rheumatoid arthritis. European Journal of Clinical Pharmacology 25: 389–394, 1983

    PubMed  CAS  Google Scholar 

  • Frame JW, Rout PGJ. A comparison of the analgesic efficacy of flurbiprofen, diclofenac, dihydrocodeine/paracetamol and placebo following oral surgery. British Journal of Clinical Practice 40: 463–467, 1986

    PubMed  CAS  Google Scholar 

  • Frank O. The treatment of acute gouty arthritis with phenylbutazone and Voltaren. In Wagenhauser (Ed.) Voltaren a new non-steroid antirheumatic agent, pp. 62–63, Huber Publishers, Bern, 1976

    Google Scholar 

  • Friman C, Johnston C, Chew C, Davis P. Effect of diclofenac sodium, tolfenamic acid and indomethacin on the production of Superoxide induced by N-formyl-methionyl-leucyl-phenyl-alanine in normal human polymorphonuclear leukocytes. Scandinavian Journal of Rheumatology 15: 41–46, 1986

    PubMed  CAS  Google Scholar 

  • Frost A. Diclofenac versus lidocaine as injection therapy in myofascial pain. Scandinavian Journal of Rheumatology 15: 153–156, 1986

    PubMed  CAS  Google Scholar 

  • Furberg B, Lerner A, Nyström B, Rosén M, Willig P. Antiphlogistics in acute inflammatory conditions in the soft tissues of the musculo-skeletal system: a double blind comparison of diclofenac and indomethacin. Current Therapeutic Research 38: 523–527, 1985

    Google Scholar 

  • Gabrielli A, Leoni P, Danieli G. Methotrexate and non-steroidal anti-inflammatory drugs. British Medical Journal 294: 776, 1987

    Google Scholar 

  • García León J, Rios Leal A, Surra Rojas O, Vela Sánchez GV, Zárraga Corrales J, et al. Dolor lumbar: tratamiento sintomático con diclofenac sódico injectable ensayo multicentrico. Investigatión Médica Internacional 7: 178–183, 1980

    Google Scholar 

  • Garcia Rubio R. Diclofenac sodico e ibuprofen en arthritis reumatoide: estudio comparative doble ciego. Prensa Medica Mexicana 41: 270–272, 1976

    PubMed  CAS  Google Scholar 

  • Gaucher A, Netter P, Faure G, Sioufi A, Schoeller JP. Passage du diclofenac sodium dans le liquide synovial. Thérapie 38: 431–434, 1983

    PubMed  CAS  Google Scholar 

  • Geiger UP, Degen PH, Sioufi A. Quantitative assay of diclofenac in biological material by gas-liquid chromatography. Journal of Chromatography 111: 293–298, 1975

    PubMed  CAS  Google Scholar 

  • Germain BF. A placebo-controlled study of diclofenac sodium for the treatment of osteoarthritis of the hip and knee. Current Therapeutic Research 37: 259–268, 1985

    Google Scholar 

  • Ghazi SA, Fowler PD. A clinical trial of a new anti-inflammatory/analgesic compound in rheumatoid arthritis — GP 45 840. Journal of International Medical Research 1: 591, 1973

    Google Scholar 

  • Gross W, Kroh J, Krebs A, Zöller H. Diclofenac sodium: blood concentration of the slow-release form and influence on the metabolism of kallikrein. Arzneimittel-Forschung 34: 1327–1329, 1984

    PubMed  CAS  Google Scholar 

  • Grosse-Kielisch C, Bach GL. Therapie der chronischen Polyarthritis: doppelblindstudie mit Proglumetacin in Vergleich zu Diclofenac. Münchener Medizinische Wochenschrift 125: 1105–1106, 1983

    PubMed  CAS  Google Scholar 

  • Grossi E, Broggini M, Quaranta M, Balestrino E. Different pharmacological approaches to the treatment of acute biliary colic. Current Therapeutic Research 40: 876–882, 1986

    Google Scholar 

  • Gutiérrez Méndez G. Antiflamatorio no esteroide (diclofenac sódico) en traumatología. Investigación Médica Internacional 6: 173–177, 1979

    Google Scholar 

  • Haapasaari J, Wuolijoki E, Ylijoki H. Treatment of juvenile rheumatoid arthritis with diclofenac sodium. Scandinavian Journal of Rheumatology 12: 325–330, 1983

    PubMed  CAS  Google Scholar 

  • Harima Y, Maekawa T, Miyauchi Y, Tsutsui T, Sakabe T et al. Intoxication with sulphide, tiaramide hydrochloride and diclofenac sodium. Intensive Care Medicine 13: 361–362, 1987

    PubMed  CAS  Google Scholar 

  • Härkönen M, Ekblom-Kullberg S. Reversible deterioration of renal function after diclofenac in patient receiving triamterene. British Medical Journal 293: 698–699, 1986

    Google Scholar 

  • Heindrichs K, Kreich W. Behandlung der Spondylitis ankylosans: kontrollierte Vergleichsstudie mit Tiaprofensäure und Diclofenac. Medizinische Klinik 80: 597–601, 1985

    Google Scholar 

  • Hengen N. Effects of codeine phosphate on the bioavailability of diclofenac Na from a fixed combination. Abstract no. 400. Naunyn-Schmiedeberg’s Archives of Pharmacology 329 (Suppl.): R100, 1985

    Google Scholar 

  • Henrikson P-Å, Thilander H, Wåhlander LÅ. Absorption and effect of diclofenac-sodium after surgical removal of a lower wisdom tooth. Current Therapeutic Research 31: 20–26, 1982

    Google Scholar 

  • Hetherington JW, Philp NH. Diclofenac sodium versus pethidine in acute renal colic. British Medical Journal 292: 237–238, 1986

    PubMed  CAS  Google Scholar 

  • Hirsch U. Effect and tolerability of diclofenac and indomethacin administered per os and as suppositories: a comparative trial. Current Therapeutic Research 28: 359–366, 1980

    Google Scholar 

  • Hodsman NBA, Burns J, Blyth A, Kenny GNC, McArdle CS, et al. The morphine sparing effects of diclofenac sodium following abdominal surgery. Anaesthesia 42: 1005–1008, 1987

    PubMed  CAS  Google Scholar 

  • Holman RM, Celinska E. Voltarol in the treatment of acute gout — a double-blind trial in general practice. In Chiswell RJ & Birdwood GF (Eds) Current themes in rheumatology, p. 14, Cambridge Medical Publications, Cambridge, 1981

    Google Scholar 

  • Houli J, Klein B, Coimbra FA. Efficacy and tolerability of Voltaren (diclofenac sodium GP 45,840) in rheumatoid arthritis. Folha Medica 71: 685–688, 1975

    Google Scholar 

  • Hultin M, Olander KJ. A clinical trial of the analgesic properties of Voltaren (diclofenac sodium). Scandinavian Journal of Rheumatology (Suppl. 22): 42–45, 1978

    Google Scholar 

  • Huntwork JC. Efficacy and safety of diclofenac compared with aspirin in the treatment of rheumatoid arthritis. Current Therapeutic Research 40: 576–586, 1986

    Google Scholar 

  • Hurault de Ligny B, Faure G, Béné M-C, Kessler M, Huriet C. Glomérulonéphrite extra-membraneuse au cours de traitement d’une polyarthrite rhumatoïde par diclofénac. Néphrologie 5: 135–136, 1984

    PubMed  CAS  Google Scholar 

  • Huskisson EC, Bryans R. Diclofenac sodium in the treatment of painful stiff shoulder. Current Medical Research and Opinion 8: 350–353, 1983

    PubMed  CAS  Google Scholar 

  • Huskisson EC, Dieppe PA, Scott J, Jones H. Diclofenac sodium, diflunisal and naproxen: patient preferences for anti-inflammatory drugs in rheumatoid arthritis. Rheumatology and Rehabilitation 21: 238–242, 1982

    PubMed  CAS  Google Scholar 

  • Ingemanson C-A, Carrington B, Sikström B, Björkman R. Diclofenac in the treatment of primary dysmenorrhoea. Current Therapeutic Research 30: 632–639, 1981

    Google Scholar 

  • Ingemanson C-A, Sikström B. Comparison between diclofenac and naproxen in the treatment of primary dysmenorrhoea. Current Therapeutic Research 36: 1203–1209, 1984

    Google Scholar 

  • International Agranulocytosis and Aplastic Anemia Study Group. Risks of agranulocytosis and aplastic anemia: a first report of their relation to drug use with special reference to analgesics. Journal of the American Medical Association 256: 1749–1757, 1986

    Google Scholar 

  • Jobin F, Gagnon FT. Inhibition of human platelet aggregation by a dibenzazepine compound (GP 44296) and by N-(2,6-dichlorophenyl)-o-aminophenylacetic acid (GP45840). Canadian Journal of Physiology and Pharmacology 49: 479–481, 1971

    PubMed  CAS  Google Scholar 

  • John VA. The pharmacokinetics and metabolism of diclofenac sodium (Voltarol®) in animals and man. Rheumatology and Rehabilitation (Suppl. 2): 22–35, 1979

  • Joubert PH, Kushlick AR, McNeill WG, Sheard ESC, Müller FO. South African multicentre trial with Voltaren in osteo-arthritis of the knee. South African Medical Journal 48: 1973–1978, 1974

    PubMed  CAS  Google Scholar 

  • Kageyama T, Sugawara S, Aoki T, Yoshizaki K, Murase S, et al. Clinical evaluation of sulindac in the treatment of osteoarthritis: results of a multicentre double-blind comparative study with diclofenac as the active control drug. Yakuri To Chiryo 7: 761–781, 1979

    Google Scholar 

  • Kajander A, Martio J. Diclofenac sodium (Voltaren) and naproxen in the treatment of rheumatoid arthritis: a comparative double-blind study. Scandinavian Journal of Rheumatology (Suppl. 22): 57–62, 1978

    Google Scholar 

  • Kantor TG. Use of diclofenac in analgesia. American Journal of Medicine 80 (Suppl. 4B): 64–69, 1986

    PubMed  CAS  Google Scholar 

  • Karachalios GN, Tsimiklic S, Asimakis G, Helas G. Treatment of biliary colic with prostaglandin-synthetase inhibition: diclofenac sodium. Singapore Medical Journal 27: 207–209, 1986

    PubMed  CAS  Google Scholar 

  • Katona G, Robles Gil J. Metodo doble ciego, a corto plazo, para evaluar la efficacia del diclofenac sodies en la artritis reumatoide. Revista Medica del Hospital General (Mexico) 38: 93–100, 1975

    Google Scholar 

  • Keiding G, Sørensen K. A randomized, double-blind, within-patient trial of diclofenac sodium (Voltaren®) and naproxen in the treatment of rheumatoid arthritis. Current Therapeutic Research 29: 183–192, 1981

    Google Scholar 

  • Keinänen-Kiukaanniemi S, Similä S, Käpylä H. Antipyretic therapy: evaluation of diclofenac sodium as an antipyretic agent. Clinical Therapeutics 2: 421–426, 1980

    Google Scholar 

  • Keitel W, Friedländer R, Häntzschel H, Huge W, Keysser M, et al. Diclofenac and piroxicam in a double-blind trial: results and methodological problems. European Journal of Inflammation 7: 105–113, 1984

    CAS  Google Scholar 

  • Kendall MJ, Thornhill DP, Willis JV. Factors affecting the pharmacokinetics of diclofenac sodium. Rheumatology and Rehabilitation (Suppl. 2): 38–45, 1979

  • Khan MA. A double blind comparison of diclofenac and indomethacin in the treatment of ankylosing spondylitis. Journal of Rheumatology 14: 118–123, 1987

    PubMed  CAS  Google Scholar 

  • Khan MA. Diclofenac in the treatment of ankylosing spondylitis: review of worldwide clinical experience and report of a double-blind comparison with indomethacin. Seminars in Arthritis and Rheumatism 15 (Suppl. 1): 80–84, 1985

    PubMed  CAS  Google Scholar 

  • Kirchheiner B, Trang L, Wollheim FA. Diclofenac sodium (Voltaren®) in rheumatoid arthritis: a double-blind comparison with indomethacin and placebo. International Journal of Clinical Pharmacology 13: 292–297, 1976

    CAS  Google Scholar 

  • Kittaka S, Aizawa H, Tokue I, Suge Y. Efficacy of GP-45,840 on after-pains. Medical Consultation and New Remedies 9: 1123–1134, 1972

    Google Scholar 

  • Knüsel O. Double-blind comparative clinical trial of carprofen versus diclofenac-Na in patients with coxarthrosis. European Journal of Rheumatology and Inflammation 5: 536–542, 1982

    PubMed  Google Scholar 

  • Kobayashi K, Arakawa T, Satoh H, Fukuda T, Nakamura H. Effect of indomethacin, tiaprofenic acid and diclofenac on rat gastric mucosal damage and content of prostacyclin and pros-taglandin E2. Prostaglandins 30: 609–618, 1985

    PubMed  CAS  Google Scholar 

  • Köhler G, Mohing W. Zur Kinetik von Diclofenac-NA in Plasma und Synovialflüssigkeit. Aktuelle Rheumatologie 5: 151–155, 1980

    Google Scholar 

  • Koopmans PP, Thien T, Gribnau FWJ. The influence of ibuprofen, diclofenac and sulindac on the blood pressure lowering effect of hydrochlorothiazide. European Journal of Clinical Pharmacology 31: 553–557, 1987

    PubMed  CAS  Google Scholar 

  • Kozatani J, Tada K, Shimojo F. Absorption and excretion of GP-45,840, an analgesic and anti-inflammatory drug in humans. Kiso to Rinsho (Clinical Report) 6: 34–40, 1972

    Google Scholar 

  • Kral JG. Analgesic effects of prostaglandin synthesis inhibition by diclofenac sodium. Seminars in Arthritis and Rheumatism 15 (Suppl. 1): 93–96, 1985

    PubMed  CAS  Google Scholar 

  • Kramer MR, Levene C, Hershko C. Severe reversible autoimmune haemolytic anaemia and thrombocytopenia associated with diclofenac therapy. Scandinavian Journal of Haematology 36: 118–120, 1986

    PubMed  CAS  Google Scholar 

  • Krupp P, Exer B, Menassé R, Ziel R. Neue Aspekte der Entzundungshemmung durch nicht-steroide Antiphlogistika: Wirkung von Voltaren. Schweizerische Medizinische Wochenschrift 105: 646–652, 1975

    PubMed  CAS  Google Scholar 

  • Krupp P, Menassé R, Riesterer L, Ziel R. The biological significance of inhibition of prostaglandin synthesis. In Lewis (Ed.) The role of prostaglandins in inflammation, pp. 108–121, Hans Huber Publishers, Bern, 1976

    Google Scholar 

  • Kruze D, Fehr K, Boni A. Effect of antirheumatic drugs on cathepsin B1 from bovine spleen. Zeitschrift für Rheumatologie 35: 94–102, 1976a

    Google Scholar 

  • Kruze D, Fehr K, Menninger H, Boni A. Effect of antirheumatic drugs on neutral protease from human leucocyte granules. Zeitschrift für Rheumatologie 35: 337–346, 1976b

    PubMed  CAS  Google Scholar 

  • Krzywanek HJ, Breddin K. Beeinflusst Diclofenac die orale: antikoagulantientherapie und die Plaettchenaggregation. Medizinische Welt 28: 1843–1845, 1977

    PubMed  CAS  Google Scholar 

  • Ku EC, Lee W, Kothari HV, Kimble EF, Liauw L, et al. The effects of diclofenac sodium on arachidonic acid metabolism. Seminars in Arthritis and Rheumatism 15 (Suppl. 1): 36–41, 1985

    PubMed  CAS  Google Scholar 

  • Ku EC, Lee W, Kothari HV, Scholer DW. Effect of diclofenac sodium on the arachidonic acid cascade. American Journal of Medicine 80 (Suppl. 4B): 18–23, 1986

    PubMed  CAS  Google Scholar 

  • Ku EC, Wasvary JM, Cash WD. Diclofenac sodium (GP 45840, Voltaren), a potent inhibitor of prostaglandin synthetase. Biochemical Pharmacology 24: 641–643, 1975

    PubMed  CAS  Google Scholar 

  • Kusuda M, Kumamoto S, Kurano A, Katagiri H, Shibata K. Clinical trial of an anti-inflammatory agent (GP 45,840) in dysmenorrhea. Japanese Journal of Clinical and Experimental Medicine 49: 1919–1925, 1972

    Google Scholar 

  • Lascar G, Grippon P, Lévy V-G. Hépatite aiguë mortelle au cours d’un traitement par le diclofénac (Voltarène®). Gastroentérologie Clinique et Biologique 8: 881–882, 1984

    PubMed  CAS  Google Scholar 

  • Laurent J, Belghiti D, Bruneau C, Lagrue G. Diclofenac, a non-steroidal anti-inflammatory drug decreases proteinuria in some glomerular diseases: a controlled study. American Journal of Nephrology 7: 198–202, 1987

    PubMed  CAS  Google Scholar 

  • Lehtola J, Sipponen P. A gastroscopic and histological double-blind study of the effects of diclofenac sodium and naproxen on the human gastric mucosa. Scandinavian Journal of Rheumatology 6: 97–102, 1977

    PubMed  CAS  Google Scholar 

  • Liauw H, Waiter S, Lee L, Ku E. Effects of diclofenac on synovial eicosanoid product formation in arthritic patients. Abstract. Journal of Clinical Pharmacology 25: 456, 1985

    Google Scholar 

  • Limpaphayom M, Chotigavanichaya C, Kasemsant D, Laohasurayotin S, Keokarn T. A comparative study between diclofenac sodium and indomethacin in degenerative joint and extra-articular disease. Journal of the Medical Association of Thailand 59: 349–354, 1976

    PubMed  CAS  Google Scholar 

  • Lindgrea U, Djupsjö H. Diclofenac for pain after hip surgery. Acta Orthopaedica Scandinavica 56: 28–31, 1985

    Google Scholar 

  • Lizarazo PH, Cortés MP. Single-blind parallel study comparing naproxen with sulindac and with diclofenac in rheumatoid arthritis. Current Therapeutic Research 34: 701–707, 1983

    Google Scholar 

  • Lundstam S, Ivarsson L, Lindblad L. Diclofenac compared with a narcotic analgesic in the treatment of biliary pain. Current Therapeutic Research 42: 395–399, 1987

    Google Scholar 

  • Lundstam S, Ivarsson L, Lindblad L, Kral JG. Treatment of biliary pain by prostaglandin synthetase inhibition with diclofenac sodium. Current Therapeutic Research 37: 435–439, 1985

    Google Scholar 

  • Lundstam S, Leissner K-H, Wåhlander LÅ, Kral JG. Prostaglandin-synthetase inhibition with diclofenac sodium in the treatment of renal colic: comparison with use of a narcotic analgesic. Lancet 1: 1096–1097, 1982

    PubMed  CAS  Google Scholar 

  • Lundstam S, Tveit E, Kral JG. Prostaglandins synthesis inhibition by diclofenac-Na in biliary pain. Abstract. European Journal of Clinical Investigation 13: A1, 1983

    Google Scholar 

  • Lundstam S, Wåhlander L, Kral JG. Treatment of ureteral colic by prostaglandin synthetase inhibition with diclofenac sodium. Current Therapeutic Research 28: 355458, 1980

    Google Scholar 

  • Macauley D. Worldwide experience with diclofenac in rheumatoid arthritis and osteoarthritis. Seminars in Arthritis and Rheumatism 15 (Suppl. 1): 68–72, 1985

    PubMed  CAS  Google Scholar 

  • Maccagno A, Romanowicz A, Hübscher O, et al. Diclofenac Retard en el tratamiento del mantenimiento de la artritis reumatoidea. Reumatologia International, pp. 26–33, Oct, 1982

  • Maccagno A, Santoro P. Comparative study of tiaprofenic acid and diclofenac for the treatment of rheumatoid arthritis. In Huskisson & Katona (Eds) Rheumatology: an annual review, vol. 7, pp. 143–150, Karger, Basel, 1982

    Google Scholar 

  • Machtey I. Diclofenac in the treatment of painful joints and traumatic tendinitis (including strains and sprains): a brief review. Seminars in Arthritis and Rheumatism 15 (Suppl. 1): 87–92, 1985

    PubMed  CAS  Google Scholar 

  • Machtey I, Ouaknine L, Sandowski U. Diclofenac versus ketoprofen in degenerative joint disease. Abstract. Harefuah 99: 64–67, 1980

    PubMed  CAS  Google Scholar 

  • Maier R, Menassé R, Riesterer L, Pericin C, Ruegg M, et al. The pharmacology of diclofenac sodium (Voltarol®). Rheumatology and Rehabilitation (Suppl. 2): 11–21, 1979

  • Manit L, Charoen C, Dhanyasobhak K, Sukit L, Keokam T. A short term multi-centre comparison of diclofenac sodium and indomethacin in osteoarthritis and extra-articular rheumatism. In Robinson (Ed.) Proceedings of a Symposium held during the 3rd Congress of the Southeast Asia and Pacific Area League against Rheumatism, Singapore, 1976, pp. 46–52, Hans Huber Publisher, Bern, 1977

    Google Scholar 

  • Manz G, Franke M. Diclofenac-Na bei ankylosierender Spondylitis. Forschritte der Medizin 95: 1706–1708, 1977

    CAS  Google Scholar 

  • Marcet AC, Barcelo Torrent P, Casademont Vilaseca M, De Dalmases Gosé R, Fiol Castano B. Double-blind multicentre, between patient study comparing diclofenac and indomethacin in osteoarthritis treated for 3 months: clinical and biological evaluation, and statistical analysis of results. Revista Espanola de Reumatismo y Enfermedades Osteoarticulares 20: 139–157, 1977

    Google Scholar 

  • Marchai Usobiaga JL. Diclofenac in arthritis. Gaceta Medica de Espanola 50: 282, 1976

    Google Scholar 

  • Marcolongo R, Giordano N, Bassi GP, Giannini R, Borghi C, et al. Double-blind preference and compliance study in osteoarthritis: once-a-day treatment. Clinical Rheumatology 4: 267–277, 1985

    PubMed  CAS  Google Scholar 

  • Martinez-Elizondo A. Acute gout as a model for evaluating drugs with analgesic and anti-inflammatory effects. VIIth Pan American Congress on Rheumatology, Jun 1978

  • Martinez-Elizondo P. Un estudio controlade de diclofenac sodico en reumatologia. Investigation Medica International 3: 56–60, 1976

    Google Scholar 

  • Martinez-Gallardo F. Analgesia postamigdalectomia con diclofenac sodico. Prensa Médica Mexicana 42: 264–266, 1977

    Google Scholar 

  • Martini A, Bondiolotti GP, Sacerdote P, Pierro L, Picotto GB, et al. Diclofenac increases beta-endorphin plasma concentrations. Journal of International Medical Research 12: 92–95, 1984

    PubMed  CAS  Google Scholar 

  • Masana P, Rojas G, Leal VSD. Hepatitis aguda y diclofenac sodico. Revista Clinica Española 9: 476, 1986

    Google Scholar 

  • Mauracher E, Dannhorn R. Praxisnahe Beurteiling eines neuen Antirheumatikums. Therapiewoche 26: 2981–2987, 1976

    Google Scholar 

  • McCarthy JT, Torres VE, Romero JC, Wochos DN, Velosa JA. Acute intrinsic renal failure induced by indomethacin. Mayo Clinic Proceedings 57: 289–296, 1982

    PubMed  CAS  Google Scholar 

  • McMahon MF, Cash HC. An open assessment of the efficacy and tolerability of diclofenac sodium (Voltarol®) in patients with rheumatic disease and a comparative study of diclofenac sodium (Voltarol®) with indomethacin in patients with osteoarthritis and rheumatoid arthritis. Rheumatology and Rehabilitation (Suppl. 2): 81–88, 1979

  • Mehrez H. Double-blind comparison of diclofenac sodium vs piroxicam in the treatment of spondylarthrosis. Abstract no. FP.10. Journal of the Medical Association of Thailand 67: 3, 1985

    Google Scholar 

  • Menassé R, Hedwall PR, Kraetz J, Pesicin C, Riesterer L, et-al. Pharmacological properties of diclofenac sodium and its metabolites. Scandinavian Journal of Rheumatology (Suppl. 22): 5–16, 1978

    Google Scholar 

  • Meyers OL, Quantock OP, Joubert PG, Louw DFP, Marais DF, et al. A multicentre trial of Voltaren in the treatment of rheumatoid arthritis. South African Medical Journal 48: 2013–2017, 1974

    PubMed  CAS  Google Scholar 

  • Michalevicz R, Seligsohn U. Clinical bleeding due to diclofenac (Voltaren). Arthritis and Rheumatism 25: 599, 1982

    PubMed  CAS  Google Scholar 

  • Michot F, Ajdacic K, Glaus L. A double-blind clinical trial to determine if an interaction exists between diclofenac sodium and the oral anticoagulant acenocoumarol (nicomaline). Journal of International Medical Research 3: 153, 1975

    PubMed  CAS  Google Scholar 

  • Miehlke K. Results of clinical trials with diclofenac in the treatment of rheumatic diseases. In Wagenhauser (Ed.) Chronic forms of polyarthritis, p. 320, Hans Huber, Berne, 1976

    Google Scholar 

  • Montanaro D, Punzi L, Piccoli A, Pellizzaro E, Baggio B, et al. Effects of diclofenac on renin-angiotensin-aldosterone system in normotensive subjects: comparison with indomethacin. Current Therapeutic Research 28: 253–259, 1980

    CAS  Google Scholar 

  • Morimoto K, Iwamoto Y, Katashima T, Takeeda T, Nakamoto Y, et al. Absorption and bioavailability of diclofenac after rectal administration of diclofenac-Na gel preparation in rat and man. Pharmaceutical Research 4: 166–170, 1985

    Google Scholar 

  • Morris BAP, Remtulla SS. Erythema multiforme major following use of diclofenac. Canadian Medical Association Journal 133: 665, 1985

    PubMed  CAS  Google Scholar 

  • Mörsdorf K, Wolf G. Zur Wirkungspotenz neuerer Antiphlogistika. Arzneimittel-Forschung 27: 531, 1977

    PubMed  Google Scholar 

  • Müller FO, Hundt HKL, Müller DG. Pharmacokinetic and pharmacodynamic implications of long-term administration of non-steroidal anti-inflammatory agents. International Journal of Clinical Pharmacology 15: 397–402, 1977

    Google Scholar 

  • Mutru O, Penttilä M, Pesonen J, Salmela P, Suhonen O, et al. Diclofenac sodium (Voltaren) and indomethacin in the ambulatory treatment of rheumatoid arthritis: a double-blind multicentre study. Scandinavian Journal of Rheumatology (Suppl. 22): 51–56, 1978

  • Nahir AM, Scharf Y. A comparative study of diclofenac and sulindac in ankylosing spondylitis. Rheumatology and Rehabilitation 19: 193–198, 1980

    Google Scholar 

  • Nasution AR. A comparative trial of diclofenac sodium and flufenamic acid in adult patients with extra-articular rheumatism. Indonesian Medical and Pharmaceutical Journal 2: 25–27, 1976

    Google Scholar 

  • Naveh D. Treatment of renal colic with intramuscular injection of diclofenac sodium. Harefuah 102: 375–376, 1982

    PubMed  CAS  Google Scholar 

  • Naveh D, Bernheim J, Gelfond M, Rathaus M. Relief of pain in renal colic by intramuscular diclofenac sodium (Voltaren). Abstract no. PS.214. Journal of the Medical Association of Thailand 67: 63, 1984

    Google Scholar 

  • Needs CJ, Brooks PM. Antirheumatic medication during lactation. British Journal of Rheumatology 24: 291–297, 1985

    PubMed  CAS  Google Scholar 

  • Netter P, Lambert H, Larcan A, Godbillon J, Gosset G. Diclofenac sodium-chlormezanone poisoning. European Journal of Clinical Pharmacology 26: 535–536, 1984

    PubMed  CAS  Google Scholar 

  • Noguchi Y, Ishiko J, Ohtsuki I. Comparative pharmacological profiles of piroxicam, indomethacin, phenylbutazone, diclofenac, ibuprofen, and mefenamic acid. Royal Society of Medicine International Congress and Symposium Series 67: 61–67, 1984

    Google Scholar 

  • Nuutinen LS, Wuolijoki E, Pentikaïnen IT. Diclofenac and oxycodone in treatment of postoperative pain: a double-blind trial. Acta Anaesthesiologica Scandinavica 30: 620–624, 1986

    PubMed  CAS  Google Scholar 

  • O’Brien WM. Adverse reactions to nonsteroidal anti-inflammatory drugs: diclofenac compared with other nonsteroidal anti-inflammatory drugs. American Journal of Medicine 80 (Suppl. 4B): 70–80, 1986

    PubMed  Google Scholar 

  • Oliw E, Lundén I, Anggård E. Invivoinhibition of prostaglandin synthesis in rabbit kidney by non-steroidal anti-inflammatory drugs. Acta Pharmacologica et Toxicologica 42: 179–184, 1978

    PubMed  CAS  Google Scholar 

  • Osnes M, Larsen S, Eidsaunet W, Thorn E. Effect of diclofenac and naproxen on gastroduodenal mucosa. Clinical Pharmacology and Therapeutics 26: 399–405, 1979

    PubMed  CAS  Google Scholar 

  • Österman K. piroxicam versus slow-release diclofenac in osteoarthritis. Royal Society of Medicine International Congress and Symposium Series 67: 13–17, 1984

    Google Scholar 

  • Parapia L, Cox JA. Spontaneous platelet aggregation after diclofenac treatment. Abstract. British Medical Journal 288: 368, 1984

    Google Scholar 

  • Paret Masana A, Guarga Rojas A, Urrutia de Diego A, Sabriá Leal M. Hepatitis aguda y diclofenac sódico. Revista Clinica Española 179: 476, 1986

    PubMed  CAS  Google Scholar 

  • Perianin A, Gougerot-Pocidalo M-E, Giroud J-P, Hakim J. Diclofenac sodium, a negative chemokinetic factor for neutrophil locomotion. Biochemical Pharmacology 34: 3433–3438, 1985

    PubMed  CAS  Google Scholar 

  • Pesenti A, Riboni A, Basilico E, Grossi E. Antipyretic therapy in ICU patients: evaluation of low dose diclofenac sodium. Intensive Care Medicine 12: 370–373, 1986

    PubMed  CAS  Google Scholar 

  • Peters P, Cooper C, Maiorana K, Graeme ML. The effect of topically applied agents on ultraviolet erythema in guinea pigs. Agents and Actions 7: 545–553, 1977

    PubMed  CAS  Google Scholar 

  • Philip PJ, Lema LEK, Carneiro PMR. A comparison of diclofenac sodium (Voltaren) and pethidine as post-operative analgesics in major elective surgical procedures. East African Medical Journal 62: 666–671, 1985

    PubMed  CAS  Google Scholar 

  • Pietschmann H, Silberbauer KF, Ring F, Sinzinger H. Diclofenac and thrombocyte aggregation. Wiener Medizinische Wochenschrift 24: 747, 1977

    Google Scholar 

  • Pinheiro GC, Gouveia OS, Morerra Filho JMC, Rodrigues JA, et al. Clinical trial in osteoarthritis comparing Voltaren (GP 45840) with indomethacin. Folha Medica 71: 341–346, 1975

    Google Scholar 

  • Poggioni M, Borghi C, Maresca V. Migraine attack treatment with diclofenac sodium. Cephalalgia 5 (Suppl. 3): 144–145, 1985

    Google Scholar 

  • Polman HA, Augusteijn R. The use of diclofenac sodium (Voltaren®) suppositories as an antipyretic in children with fever due to acute infections: a double-blind, between-patient, placebo-controlled study. Journal of International Medical Research 9: 343–348, 1981

    PubMed  CAS  Google Scholar 

  • Pradalier A, Dry J. Hémicranie paroxystique chronique: traitement par indométacine et diclofénac. Thérapie 39: 185–188, 1984

    PubMed  CAS  Google Scholar 

  • Quilez C, Pérez-Mateo M, Hernández P, Rubio I. Utilidad de un antiinflamatorio no esteroides diclofenac sódico, en el tratamiento del cólico nefrítico: estudio comparativo con un espasmolítico y un analgésico opiáceo. Medicina Clínica 82: 754–755, 1984

    PubMed  CAS  Google Scholar 

  • Rainsford KD. The comparative gastric ulcerogenic activities of non-steroid anti-inflammatory drugs. Agents and Actions 7: 573–577, 1977

    PubMed  CAS  Google Scholar 

  • Rainsford KD, Willis C. Relationship of gastric mucosal damage induced in pigs by antiinflammatory drugs to their effects on prostaglandin production. Digestive Diseases and Sciences 27: 624–635, 1982

    PubMed  CAS  Google Scholar 

  • Rau R, Georgiopoulos G, Neumann P, Gross D. Die Beeinflussung des Digoxinblutspiegels durch Antirheumatika. Aktuelle Rheumatologie 5: 349–358, 1980

    Google Scholar 

  • Reimann IW, Frölich JC. Effects of diclofenac on lithium kinetics. Clinical Pharmacology and Therapeutics 30: 348–352, 1981

    PubMed  CAS  Google Scholar 

  • Reiner M, Cereghetti S, Haeusermann M, Monti T. Antipyretic activity of nimesulide suppositories: double blind versus diclofenac and placebo. International Journal of Clinical Pharmacology, Therapy and Toxicology 23: 673–677, 1985

    CAS  Google Scholar 

  • Reinicke C, Hippius M, Stiller K-J, Wächter B, Steiner A, et al. Diclofenac-Natrium (Voltaren®) hat kiven Einfluss auf die hepatische Demethylierung von Aminopyrin bei Patienten mit rheumatischen Erkrankungen. Aktuelle Rheumatologie 8: 10–13, 1983

    Google Scholar 

  • Renaud S, Lecompte F. Thrombosis prevention by coagulation and platelet aggregation inhibitors in hyperlipemic rats. Thrombosis et Diathesis Haemorrhagica 24: 577–586, 1970

    PubMed  CAS  Google Scholar 

  • Rheinberger K. Short-term efficacy and tolerance of diclofenac sodium/Voltaren as compared with sulindac and placebo in osteoarthritis. Verhandlungen der Deutschen Gesellschaft für Rheumatologie 7: 329–331, 1981

    Google Scholar 

  • Rheinberger K. Wirksamkeit und Verträglichkeit von Voltaren und Indometacin bei Patienten mit ankylosierender Spondylitis. Therapiewoche 26: 2916–2920, 1976

    Google Scholar 

  • Riess W, Schmid K, Botta L, Kobayashi K, Moppert J, et al. Die perkutane Resorption von Diclofenac. Arzneimittel-Forschung 36: 1092–1096, 1986

    PubMed  CAS  Google Scholar 

  • Riess W, Stierlin H, Degen P, Faigle JW, Gérardin A, et al. Pharmacokinetics and metabolism of the anti-inflammatory agent Voltaren. Scandinavian Journal of Rheumatology (Suppl. 22): 17–29, 1978

    Google Scholar 

  • Riess W, Stierlin H, Faigle JW, Geiger UP, Gérardin A, et al. Kinetik und Biotransformation von Diclofenac in Tier und Mensch. Therapiewoche 26: 2891, 1976

    CAS  Google Scholar 

  • Riihiluoma P, Wuolÿoki E, Pulkkinen MO. Treatment of primary dysmenorrhea with diclofenac sodium. European Journal of Gynecology and Reproductive Biology 12: 189–194, 1981

    CAS  Google Scholar 

  • Rimailho A, Riou B, Richard C, Auzepy P. Fulminant necrotizing fasciitis and nonsteroidal anti-inflammatory drugs. Journal of Infectious Diseases 155: 143–146, 1987

    PubMed  CAS  Google Scholar 

  • Rivet JP, Richard A. Le Voltarene, anti-inflammatoire de rheumatologie: bilan clinique a propos de 10352 observations recueillies par 2623 omnipraticiens en France. Gazette Médicale 84: 3547–3554, 1977

    Google Scholar 

  • Robles Gil J. Diflunisal vs diclofenac en artritis reumatoide activa. Investigatión Médica International 9 (Suppl. 2): 39–44, 1982

    Google Scholar 

  • Robles Gil J, Martínez Lavín M. Estudio de la eficacia y tolerancia de tres fármacos antiinflamatorios no esteroides. Investigatión Médica International 10: 342–349, 1983

    Google Scholar 

  • Rohde J, Schwegler F, Standel W. Zur Behandlung der chronischen Polyarthritis: offene Paralleluntersuchung der nichtsteroidalen Antirheumatika Piroxicam und Diclofenac. Deutsche Medizinische Wochenschrift 105: 1614–1617, 1980

    PubMed  CAS  Google Scholar 

  • Romanowicz A. Tiaprofenic acid in the treatment of osteoarthritis of the knee. Presented at the 3rd International Seminar on the Treatment of Rheumatic Diseases, Israel, Nov 13–20, 1983

  • Ronen S, Rozenman Y, Zylbermann R, Berson D. Treatment of ocular inflammation with diclofenac sodium: double-blind trial following cataract surgery. Annals of Ophthalmology 17: 577–581, 1985

    PubMed  CAS  Google Scholar 

  • Rorarius M, Miralies J, Baer GA, Palomäki E. Diclofenac versus indomethacin given as intravenous infusions: their effect on haemodynamics and bleeding time, and side effects in healthy subjects. Annals of Clinical Research 17: 306–309, 1985

    PubMed  CAS  Google Scholar 

  • Rosa G, Savarese A. The use of diclofenac sodium, Voltaren, in orthopaedics: comparison with indomethacin. Gazzetta Medica Italiana 136: 331–337, 1977

    Google Scholar 

  • Rosak C, Schöffling K. Über den Einfluss von Diclofenac auf die Glucostoleranz von Diabetikern. Medizinische Welt 28: 1845–1846, 1977

    PubMed  CAS  Google Scholar 

  • Rossi E. Avaliacao clinica do diclofenaco sodico de liberacao gradativa no tratamento da artrite reumatoide. Archivos Brasi-leiros de Médicina 60: 521–526, 1986

    Google Scholar 

  • Rossi E, Ferraccioli GF, Cavalieri F, Menta R, Dall’Aglio PP, et al. Diclofenac-associated acute renal failure. Nephron 40: 491–493, 1985

    PubMed  CAS  Google Scholar 

  • Rossi FA, Balladore GB, Baroni L. A short-term comparison between diclofenac sodium (D) and sulindac (S) in osteoarthrosis of the elderly. Presented at the 9th European Congress of Rheumatology, Wiesbaden, Sep 2–8, 1979

  • Rossi FA, Baroni L. A double-blind comparison between diclofenac sodium and ibuprofen in osteoarthritis. Journal of International Medical Research 3: 267–274, 1975

    Google Scholar 

  • Rücker K, Ciccolunghi SN. Multizentrische Prüfung von Diclofenac Na bei degenerativen und werchteilrheumatischen Erkrankungen in Vergleich zu einem Standardantirheumaticum. Therapiewoche 26: 88–91, 1976

    Google Scholar 

  • Sacerdote P, Monza G, Mantegazza P, Panerai AE. Diclofenac and pirprofen modify pituitary and hypothalamic beta-endorphin concentrations. Pharmacological Research Communications 17: 679–684, 1985

    PubMed  CAS  Google Scholar 

  • Sacks S. Diclofenac sodium in rheumatoid arthritis and osteoarthritis. South African Medical Journal 48: 213–215, 1974

    PubMed  CAS  Google Scholar 

  • Sallmann AR. The history of diclofenac. American Journal of Medicine 80 (Suppl. 4B): 29–33, 1986

    PubMed  CAS  Google Scholar 

  • Salvarani C, Iori I, Rossi F, Macchioni P, Filippi G. Hypersensitivity to diclofenac with acute hepatitis, immune-haemolytic anaemia, thrombocytopaenia and renal involvement. Italian Journal of Gastroenterology 16: 54–58, 1984

    Google Scholar 

  • Sami Khalifa M, Sharkawi MA. Treatment of pain owing to acute ureteral obstruction with prostaglandin-synthetase inhibitor: a prospective randomized study. Journal of Urology 136: 393–395, 1986

    Google Scholar 

  • Samprisi-Aprile F. Tiaprofenic acid: a brief review of its analgesic and anti-inflammatory action and a double-blind, controlled study in osteoarthritis of the knee compared with diclofenac sodium. In Bianchi and Colombo (Eds) New trends in osteoarthritis, part II, pp. 14–19, Karger, Basel, 1983

    Google Scholar 

  • Schapira D, Bassan L, Nahir AM, Scharf Y. Diclofenac-induced hepatotoxicity. Postgraduate Medical Journal 62: 63–65, 1986

    PubMed  CAS  Google Scholar 

  • Scharf Y, Nahir M, Schapira D, Lorber M. A comparative study of naproxen with diclofenac sodium in osteoarthritis of the knees. Rheumatology and Rehabilitation 21: 167–170, 1982

    PubMed  CAS  Google Scholar 

  • Schillinger F, Montagnac R, Milcent T. Glomérulonéphrite extramembraneuse réversible secondaire à un traitement par diclofénac. Semaine des Hôpitaux 63: 1831–1832, 1987

    Google Scholar 

  • Schlumpf U. Der Einfluss von Diclofenac-Natrium auf den Stoffwechsel von Diabetikern unter qualitativer Diät mit und ohne Tolbutamid. Schweizerische Medizinische Wochenschrift 108: 28–34, 1978

    PubMed  CAS  Google Scholar 

  • Scholer DW, Ku EC, Boettcher I, Schweizer A. Pharmacology of diclofenac sodium. American Journal of Medicine 80 (Suppl. 4B): 34–38, 1986

    PubMed  CAS  Google Scholar 

  • Schubiger BI, Ciccolunghi SN, Tanner K. Once daily dose treatment with a non-steroidal antirheumatic drug (Diclofenac) in osteoarthrosis. Journal of International Medical Research 8: 167–173, 1980

    PubMed  CAS  Google Scholar 

  • Schultis K. Results of short term treatment with ‘Voltaren’ as compared with indomethacin and placebo in non-articular rheumatism. In Wagenhaeuser (Ed.) Voltaren, a new non-steroid antirheumatic agent, pp. 60–61, Hans Huber Publishers, Bern, 1976

    Google Scholar 

  • Schumacher A, Faust-Tinnefeldt G, Geissler HE, Mutschier E, Zimmer M. Untersuchungen potentieller Interaktionen von Diclofenac-Natrium (Voltaren®) mit den Basistherapeutika Gold, D-Penicillamin, Chloroquin, Azathioprin und mit Prednisolon. Aktuelle Rheumatologie 8: 79–83, 1983a

    Google Scholar 

  • Schumacher A, Faust-Tinnefeldt G, Geissler H, Zimmer M, Mutschier E. Voltaren in co-medication. In Kass (Ed.) Voltaren — new findings, pp. 31–38, Hans Huber Publishers, Bern, 1982

    Google Scholar 

  • Schumacher A, Geissler HE, Mutschier E, Osterburg M. Untersuchungen potentieller Interaktionen von Diclofenac-Natrium (Voltaren®) mit Antibiotika. Zeitschrift für Rheumatologie 42: 25–27, 1983b

    PubMed  CAS  Google Scholar 

  • Scott SJ, Bussey A, et al. Renal papillary necrosis associated with diclofenac sodium. Abstract. British Medical Journal 292: 1050, 1986

    Google Scholar 

  • Seda H, Cardozo PC. Efficacy and tolerability of diclofenac sodium vs ibuprofen in osteoarthritis. Folha Medica 72: 633–636, 1976

    Google Scholar 

  • Seppälä E, Nissilä M, Isomäki H, Nuotio P, Nykänen E, et al. Comparison of the effects of different anti-inflammatory drugs on synovial fluid prostanoid concentrations in patients with rheumatoid arthritis. Clinical Rheumatology 4: 315–320, 1985

    PubMed  Google Scholar 

  • Serfaty D, Henrion R, Levrier M, Nahmanovici C. Dysménorrhées primaires: étude comparative croisée du piroxicam (Feldène®) contre l’acide méfenamique (Ponstyl®) on le diclofénac (Voltarène®). Fertility and Sterility 13: 1111–1118, 1985

    Google Scholar 

  • Serra Peralba A. A clinical trial of a new antirheumatic agent: diclofenac sodium. Medicina Clinica 67: 418–423, 1976

    Google Scholar 

  • Shiba R, Morishita M, Takada K, Kawakatsu K. Clinical evaluation of a new anti-phlogistic and analgesic agent: comparative study between sodium-O-(2,6-dichloroanilino) phenylacetate (GP 45840) and indomethacin by double-blind method. Prospect of Dental Field 40: 334–342, 1972

    Google Scholar 

  • Shiokawa Y, Takatori M, Sakuma A. Multi-centre trial of Voltaren (GP-45’840) on rheumatoid arthritis by double-blind technique. Journal of the Japanese Rheumatology Association 12: 271–282, 1972

    CAS  Google Scholar 

  • Siegmeth W, Placheta P. Long-term study comparing diclofenac (Voltaren) with naproxen (Proxen) in arthrosis. Schweizerische Medizinische Wochenschrift 108: 349–353, 1978

    PubMed  CAS  Google Scholar 

  • Siegmeth W, Sieberer W. A comparison of the short-term effects of ibuprofen and diclofenac in spondylosis. Journal of International Medical Research 6: 369–374, 1978

    PubMed  CAS  Google Scholar 

  • Singh RR, Malaviya AN, Pardey JN, Guleria JS. Fatal interaction between methotrexate and naproxen. Lancet 1: 1390, 1986

    PubMed  CAS  Google Scholar 

  • Sioufi A, Schoeller J-P, Schwarzberg C, et al. Presence of diclofenac in plasma and in synovial fluid in various rheumatic disorders. Gazette Médicale 91: 88–89, 1984

    Google Scholar 

  • Sioufi A, Stierlin H, Schweizer A, et al. Recent findings concerning clinically relevant pharmacokinetics of diclofenac sodium. In Kass (Ed.) Voltaren — new findings, pp. 19–30, Hans Huber Publishers, Bern, 1982

    Google Scholar 

  • Siraux P. Diclofenac (Voltaren®) for the treatment of osteoarthrosis: a double-blind comparison with naproxen. Journal of International Medical Research 5: 169–174, 1977

    PubMed  CAS  Google Scholar 

  • Solomon L, Abrams G. Voltaren in the treatment of rheumatoid arthritis. South African Medical Journal 48: 949, 1974

    PubMed  CAS  Google Scholar 

  • Stacher G, Steinringer H, Schneider S, Mittelbach G, Winklehner S, et al. Experimental pain induced by electrical and thermal stimulation of the skin in healthy man: sensitivity to 75 and 150mg diclofenac sodium in comparison with 60mg codeine and placebo. British Journal of Clinical Pharmacology 21: 35–43, 1986

    PubMed  CAS  Google Scholar 

  • Stegink AJ. Diclofenac-Na (Voltaren) in the treatment of osteoarthrosis of the spine: a long term (6 months) comparative trial versus indomethacin. Tijdschrift voor Geneesmiddelenonderzoek 5: 41–45, 1977

    Google Scholar 

  • Stierlin H, Faigle JW. Biotransformation of diclofenac sodium (Voltaren®) in animals and man. II. Quantitative determination of the unchanged drug and principal phenolic metabolites, in urine and bile. Xenobiotica 9: 611–622, 1979

    PubMed  CAS  Google Scholar 

  • Stierlin H, Faigle JW, Colombi A. Pharmacokinetics of diclofenac sodium (Voltaren) and metabolites in patients with impaired renal function. Scandinavian Journal of Rheumatology (Suppl. 22): 30–35, 1978

    Google Scholar 

  • Stierlin H, Faigle JW, Sallmann A, Küng W, Richter WJ, et al. Biotransformation of diclofenac sodium (Voltaren®) in animals and in man. I. Isolation and identification of principal metabolites. Xenobiotica 9: 601–610, 1979

    PubMed  CAS  Google Scholar 

  • Szczeklik A, Gryglewski RJ, Czerniawska-Mysik G, Pieton R. Asthmatic attacks induced in aspirin-sensitive patients by diclofenac and naproxen. British Medical Journal 2: 231–232, 1977

    PubMed  CAS  Google Scholar 

  • Takashima T, Kado Y, Ono T. Anti-inflammatory effects of GP 45,840. Clinical Reports 6: 50–57, 1972

    Google Scholar 

  • Tannenbaum H, Esdaile J, Topp JR, Prat A, Rostogi RB, et al. A double-blind, multicenter, controlled study on diclofenac (Voltaren®) and naproxen in patients with rheumatoid arthritis (R.A.). Current Therapeutic Research 35: 357–362, 1984

    Google Scholar 

  • Taylor RJ, Salata JJ. Inhibition of prostaglandin synthetase by tolmetin (Tolectin, McN-2559), a new non-steroidal anti-inflammatory agent. Biochemical Pharmacology 25: 2479, 1976

    PubMed  CAS  Google Scholar 

  • Terhaag B, Le Petit G, Richter K, Rogner M. Zur Berziehung von in-vitro- und in-vivo-Untersuchungen beim Menschen am Beispiel von Diclofenac-Suppositorien. Pharmazie 40: 784–786, 1985

    PubMed  CAS  Google Scholar 

  • Thyss A, Milano G, Kubar J, Namer M, Schneider M. Clinical and pharmacokinetic evidence of a life-threatening interaction between methotrexate and ketoprofen. Lancet 1: 256–258,1986

    PubMed  CAS  Google Scholar 

  • Tigerstedt I, Jarhunen L, Tammisto T. Efficacy of diclofenac in a single prophylactic dose in postoperative pain. Annals of Clinical Research 19: 18–22, 1987

    PubMed  CAS  Google Scholar 

  • Tiitinen S, Nissilä M, Ruutsalo HM, Isomäki H. Effect of non-steroidal anti-inflammatory drugs on the renal excretion of uric acid. Clinical Rheumatology 2: 233–236, 1983

    PubMed  CAS  Google Scholar 

  • Timbal Y, Berutti A, Barnaud P. Intéret du Voltaréne dans la crise de colique néphrétique. Gazette Médicale 88: 5557–5558, 1982

    Google Scholar 

  • Tonachella R, Curcio CG, Grossi E. Diclofenac sodium in cancer pain: a double-blind within-patients comparison with pentazocine. Current Therapeutic Research 37: 1130–1132, 1985

    Google Scholar 

  • Torralba TP. A short-term between patient comparison of diclofenac sodium and acetylsalicylic acid in osteoarthritis of the knee and hip. Philippine Journal of Internal Medicine 14: 77–82, 1976

    Google Scholar 

  • Treadwell BLJ, Tweed JM. Diclofenac in rheumatoid disease. New Zealand Medical Journal 89: 43–45, 1979

    PubMed  CAS  Google Scholar 

  • Tsurumi K, Hiramatsu Y, Nozaki M, Hayashi M, Shibuya T, et al. Effects of GP 45/840 on acute experimental inflammations. Folia Pharmacologica Japonica 69: 299–318, 1973a

    PubMed  CAS  Google Scholar 

  • Tsurumi K, Hiramatsu Y, Yamaguchi A, Hayashi M, Shibuya T, et al. Effects of GP-45,840 on subchronic experimental inflammations. Folia Pharmacologica Japonica 69: 319–334, 1973b

    PubMed  CAS  Google Scholar 

  • Tyutyulkova N, Gorantcheva Y, Lisitchkov T. Effect of diclofenac sodium (Feloran) on platelet aggregation. Methods and Findings in Experimental and Clinical Pharmacology 6: 21–25, 1984

    PubMed  CAS  Google Scholar 

  • Ulloa JE, Mar M. Estudio clinico comparativo de piroxicam vs diclofenac ‘retard’ en gonartrosis. atInvestigatión Médica Interacional 10: 417–421, 1983

  • Ulrych I. Ziv Frage der Dosiering von nichtsteroidhaltigen neureren antiphlogistisch-analgetisch wirkenden Práparatei. Praxis 68: 1292–1293, 1979

    PubMed  CAS  Google Scholar 

  • Uthgenannt H. Comparative studies on blood loss in the faeces during treatment with Voltaren, naproxen, and acetylsalicylic acid over a period of several weeks. In Wagenhauser (Ed.) Voltaren a new, non-steroid antirheumatic agent (diclofenac), Hans Haber Publishers, Bon, 1976

    Google Scholar 

  • Uthgenannt H. Gastrointestinale Blutansschiedung unter der Einnahine von Feprazon, Naproxen, Diclofenac. Medizinische Welt 28: 989–992, 1977

    PubMed  CAS  Google Scholar 

  • Uthgenannt H, Letzel H. Gastrointestinal blood loss in volunteers following fenclofenac and idiclofenac. British Journal of Clinical Practice 35: 229–232, 1981

    PubMed  CAS  Google Scholar 

  • Valtonen EJ. A comparative short-term trial with Voltaren (diclofenac sodium) and naproxen in soft tissue rheumatism. Scandinavian Journal of Rheumatology (Suppl. 22): 69–73, 1978

    Google Scholar 

  • Vandenburg MJ, Currie WJC, Mann SG, Diggins JB. Differential effects of two nonsteroidal anti-inflammatory drugs on the plasma urea of elderly patients with osteoarthritis. British Journal of Clinical Practice 38: 403–406, 1984

    PubMed  CAS  Google Scholar 

  • Van Heerden JJ. Diclophenac sodium, oxyphenbutazone and placebo in sports injuries of the knee. South African Medical Journal 52: 396–399, 1977

    PubMed  Google Scholar 

  • Vecchini L, Grossi E. Ionization with diclofenac sodium in rheumatic disorders: a double-blind placebo-controlled trial. Journal of International Medical Research 12: 346–350, 1984

    PubMed  CAS  Google Scholar 

  • Vetter G. A comparison of naproxen and diclofenac sodium in the treatment of osteoarthritis in elderly patients. British Journal of Clinical Practice 39: 276–281, 1985

    PubMed  CAS  Google Scholar 

  • Vignoni A, Fierro A, Morescnini G, Cau M, Agostino A, et al. Diclofenac sodium in ureteral colic: a double-blind comparison with placebo. Journal of International Medical Research 11: 303–307, 1983

    PubMed  CAS  Google Scholar 

  • Vogt KH. Vergleichende Multicenter-Prüfung von Diclofenac Na und Ketoprofen bei Weichteilrheumatismus. Therapiewoche 26: 2975–2978, 1976

    Google Scholar 

  • Wacquez M, Tyberghein JM. Diclofenac suppositoires 100mg pour le traitement de la dysmenorrhee primaire. Acta Therapeutica 8: 379–384, 1982

    Google Scholar 

  • Wafin F, Valindas E, Wuolijoki E. Comparison of diclofenac and indomethacin suppositories in rheumatoid arthritis. Clinical Rheumatology 3: 67–70, 1984

    PubMed  CAS  Google Scholar 

  • Wagenhauser FJ, Narozna H. Treatment of osteoarthritis with a new non-steroidal antirheumatic drug Voltaren. Therapiewoche 26: 2947–2957, 1976

    Google Scholar 

  • Wagner J, Sulc M. Binding of diclofenac-Na (Voltaren) to serum proteins of different species and interactions with other drugs in protein binding. Aktuelle Rheumatologie 4: 153, 1979

    Google Scholar 

  • Ward JR. Efficacy of diclofenac in osteoarthritis: experience in the United States. American Journal of Medicine 80 (Suppl. 4B): 53–57, 1986

    PubMed  CAS  Google Scholar 

  • Ward MC, Kirwan JR, Norris P, Murray N. Paracetamol and diclofenac in the painful shoulder syndrome. British Journal of Rheumatology 25: 412–420, 1986

    PubMed  CAS  Google Scholar 

  • Watanabe S, Akasaka Y. Clinical efficacy of GP-45,840 on lumbago and spondylosis deformans. Medical Consultation and New Remedies 9: 933–939, 1972

    Google Scholar 

  • Weisman MH. Double-blind randomized trial of diclofenac sodium versus placebo in patients with rheumatoid arthritis. Clinical Therapeutics 8: 427–438, 1986

    PubMed  CAS  Google Scholar 

  • Wietfeld K, Rübsamen B, Rechziegler H, Bernard I. Therapie mit Acemetacin und Diclofenac bei Patienten mit degenerativen Gelenkerkrankungen. Medizinische Welt 37: 1073–1076, 1986

    Google Scholar 

  • Willis JV, Jack DB, Kendall MJ, John VA. The influence of food on the absorption of diclofenac as determined by the urinary excretion of the unchanged drug and its major metabolites during chronic administration. European Journal of Clinical Pharmacology 19: 39–44, 1981b

    PubMed  CAS  Google Scholar 

  • Willis JV, Kendall MJ. Pharmacokinetic studies on diclofenac sodium in young and old volunteers. Scandinavian Journal of Rheumatology (Suppl. 22): 36–41, 1978

  • Willis JV, Kendall MJ, Flinn RM, Thornhill DP, Welling PG. The pharmacokinetics of diclofenac sodium following intravenous and oral administration. European Journal of Clinical Pharmacology 16: 405–410, 1979

    PubMed  CAS  Google Scholar 

  • Willis JV, Kendall MJ, Jack DB. A study of the effect of aspirin on the pharmacokinetics of oral and intravenous diclofenac sodium. European Journal of Clinical Pharmacology 18: 415–418, 1980

    PubMed  CAS  Google Scholar 

  • Willis JV, Kendall MJ, Jack DB. The influence of food on the absorption of diclofenac after single and multiple oral doses. European Journal of Clinical Pharmacology 19: 33–37, 1981a

    PubMed  CAS  Google Scholar 

  • Willkens RF. Worldwide clinical safety experience with diclofenac. Seminars in Arthritis and Rheumatism 15 (Suppl. 1): 105–110, 1985

    PubMed  CAS  Google Scholar 

  • Wolters J, Van Breda Vriesman PJC. Minimal change nephropathy and interstitial nephritis associated with diclofenac. Netherlands Journal of Medicine 28: 311–314, 1985

    PubMed  CAS  Google Scholar 

  • Wuolijoki E, Oikarinen VJ, Ylipaavalniemi P, Hampf G, Tolvanen M. Effective postoperative pain control by preoperative injection with diclofenac. European Journal of Clinical Pharmacology 32: 249–252, 1987

    PubMed  CAS  Google Scholar 

  • Yasunaga K. Effects of N-(2,6-dichlorophenyl)-o-amino-phenylacetic acid (GP 45,840) upon platelets, blood coagulation and fibrinolytic activity. Naika Hokan 19: 301–306, 1972

    CAS  Google Scholar 

  • Zandstra DF, Stoutenbeek CP, Alexander JP. Antipyretic therapy with diclofenac sodium. Intensive Care Medicine 9: 21–23, 1983

    PubMed  CAS  Google Scholar 

  • Ziel R, Krupp P. The significance of inhibition of prostaglandin synthesis in the selection of non-steroidal anti-inflammatory agents. International Journal of Clinical Pharmacology 12: 186–191, 1975

    CAS  Google Scholar 

  • Zimmerer J, Tittor W, Degen P. Rheuma-Therapie bei Leberkranken. Fortschritter der Medizin 100: 683–688, 1982

    Google Scholar 

  • Zuckner J. International experience with diclofenac in rheumatoid arthritis. American Journal of Medicine 80 (Suppl. 4B): 39–42, 1986

    PubMed  CAS  Google Scholar 

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    Peter A. Todd & Eugene M. Sorkin

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  1. Peter A. Todd
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Various sections of the manuscript reviewed by: H. Berry, King’s College Hospital, London, England; R. Day, St Vincent’s Hospital, Sydney, Australia; R.R. Grigor, Department of Rheumatology, Auckland Hospital, Auckland, New Zealand; F.D. Hart, Harley Street, London, England; E.C. Huskisson, Department of Rheumatology, St Bartholomew’s Hospital Medical College, London, England; M. A. Khan, Case Western Reserve University, Cleveland Metropolitan General Hospital, Cleveland, Ohio, USA; J.G. Kral, St Lukes-Roosevelt Hospital Center, New York, New York, USA; S. Lundstam, Department of Surgery, Östra Hospital, University of Göteborg, Göteborg, Sweden; W.M. O’Brien, University of Virginia School of Medicine, Charlottesville, Virginia, USA; S.R. Roth, St Luke’s Hospital Medical Center, Phoenix, Arizona, USA; K. Tsurumi, Department of Pharmacology, Gifu University School of Medicine, Gifu, Japan; J.A. Vale, West Midlands Poisons Unit, Birmingham, England; J.R. Ward, Division of Rheumatology, University of Utah School of Medicine, Salt Lake City, Utah, USA; R.F. Willkens, Harborview Medical Center, Seattle, Washington, USA; H. Yamamoto, Department of Pharmacology, Wakayama Medical College, Wakayama, Japan.

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Todd, P.A., Sorkin, E.M. Diclofenac Sodium. Drugs 35, 244–285 (1988). https://doi.org/10.2165/00003495-198835030-00004

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Keywords

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