Thursday, 15 January 2015

On diclofenac tablets? What should you do?

As of today, you can no longer buy diclofenac tablets (for pain and inflammation) over the counter from a pharmacy. The Medicines and Healthcare Products Regulatory Agency (MHRA) has made this decision based on the fact that diclofenac carries a 'small' risk of serious cardiac side effects, especially if taken in high doses or for the long-term treatment of chronic pain. Pharmacists are being told to take any diclofenac tablets off their shelves and return any stock.

What is diclofenac?
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID), in the same class of medicines as ibuprofen. It combats pain and inflammation and has commonly been used for arthritis symptoms.

Why is the availability of diclofenac tablets changing?
In 2013, the MHRA warned that diclofenac tablets shouldn't be taken by people with an underlying heart condition or a history of a heart attack or stroke. This evidence has now been looked at by the Commission on Human Medicines, which concluded that the side effects can't be ruled out, even when the medicine is taken for a short time or at a lower dose. Therefore, diclofenac tablets are being reclassified as a prescription-only medicine (POM).

What about diclofenac gels?
Diclofenac topical gel is still available to buy over the counter as Voltarol Pain-eze, Voltarol Emulgel and Voltarol 12-hour Emulgel. You rub these gently into your skin for local pain relief. The gels are suitable for rheumatic or muscular pain, sprains, strains and bruises (e.g. due to sports injuries). To buy certain Voltarol gel products over the counter, you need to have a discussion with the pharmacist first, as these are pharmacy-only (P) medicines.

What should you do?
Firstly don't panic!

If you have been prescribed diclofenac by your GP, continue taking your medicines as instructed, as your GP will have already assessed your medical history and individual risks. If you are concerned, speak to your GP at your next visit.

If you have bought diclofenac tablets over the counter, stop taking them and speak to your pharmacist about suitable alternatives. If you want to continue taking diclofenac tablets, you will need to make an appointment with your GP, who can assess the risks and will prescribe diclofenac if it's appropriate for you.

What else is available from your pharmacy?
There are many pain relief options available over the counter.
These include:
  • Ibuprofen and/or paracetamol tablets or capsules: you can buy these painkillers separately or take them together in one product (Nuromol).
  • Topical analgesic gels, containing either diclofenac or ibuprofen in various strengths.
  • Hot and cold treatments (in the form of patches, rubs and sprays).
  • Non-drug treatments (e.g. those using acupressure, electromagnetic pulse therapy, TENS etc.)
Before buying any pain relief products, always check with the pharmacist that these are suitable for you - disclose whether you have any underlying medical conditions or take any other medicines. Even non-drug treatments aren't suitable for everyone.

Before using a product, read the instructions carefully, checking how to use it safely and the correct dosage. If your pain is severe or persistent, you should always get it checked out by your GP.

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