Dicofen Special Precautions

Use is restricted to adults. The minimal effective dose should be administered.
In the following circumstances, particularly careful medical supervision is required: Patients with gastrointestinal symptoms, history of duodenal ulcer, ulcerative colitis or Crohn's disease, haematological or coagulation disorders; elderly patients; major post-surgical procedures; patients with hepatic or renal impairment or arterial hypertension and/or heart failure.
It is recommended to monitor diuresis and kidney function in patients with cardiac failure in cirrhotic or renally-insufficient patients, and in patients receiving diuretics; to monitor haematological, hepatic and renal function during prolonged treatment. Discontinue treatment in case of persistent abnormalities; to exercise particular caution in patients with hepatic porphyria.
The following category of patients should take diclofenac only if emergency facilities are available: Patients who have reacted to previous administration of NSAIDs or any other prostaglandin synthesis inhibitors or analgesics with hypersensitivity reactions eg, asthma attacks, skin reactions or acute allergic rhinitis.
Effects on the Ability to Drive or Operate Machinery: Slight dizziness or other CNS disorders may occur.
Use in pregnancy: No malformation associated with diclofenac therapy in man has been reported. Nevertheless, it is recommended not to prescribe diclofenac during the first 3 months of pregnancy because of a possible teratogenic risk.
Any NSAID intake is absolutely contraindicated in the 3rd trimester of pregnancy.
Use in lactation: Diclofenac should not be prescribed in breastfeeding women.
Use in pregnancy and lactation should be restricted to situations where the potential benefit to the mother justifies the potential risk to the foetus or breastfed infant.
Dosage adjustment is not necessary in the elderly.