Patient Medication Information: uses, side effects, how to take - Sandoz-Diclofenac (Sandoz Canada, 50 mg, 100 mg)
What is Sandoz-Diclofenac and Sandoz-Diclofenac SR used for?
to treat patients 16 years and older with symptoms of arthritis disorders such as:
- Osteoarthritis, including osteoarthritis of the hip
- Rheumatoid arthritis
How does Sandoz-Diclofenac and Sandoz-Diclofenac SR work?
- Sandoz-Diclofenac and Sandoz-Diclofenac SR(diclofenac sodium) belong to a group of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). They can reduce the chemicals produced by your body which cause pain and swelling.
- Sandoz-Diclofenac or Sandoz-Diclofenac SR only treats the symptoms and relieves pain as long as you take it. Sandoz-Diclofenac and Sandoz-Diclofenac SR do NOT cure your illness or stop it from getting worse.
Serious Warnings and Precautions
Heart and blood vessel problems:
Stomach and intestine (gastrointestinal) problems:
Talk to your healthcare professional about any medical conditions you have and drugs you are taking. Pregnancy:
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What are the ingredients in Sandoz-Diclofenac and Sandoz-Diclofenac SR?
Medicinal ingredient: Diclofenac sodium
Non-medicinal ingredients:
- Sandoz-Diclofenac: semi-synthetic glycerides.
- Sandoz-Diclofenac SR: black ink, carnauba wax, cellulose compounds, cetyl alcohol, colloidal silicon dioxide, hypromellose, magnesium stearate, polysorbate 80, povidone, red iron oxide, sucrose, talc, titanium dioxide.
Sandoz-Diclofenac and Sandoz-Diclofenac SR comes in the following dosage forms:
Sandoz-Diclofenac: Suppositories, 50 mg
Sandoz-Diclofenac SR: Slow-release tablets, 100 mg
Do not use Sandoz-Diclofenac and Sandoz-Diclofenac SR if you:
- Are planning to have or have recently had heart bypass surgery.
- Have severe, uncontrolled heart failure.
- Have bleeding in the brain or other bleeding disorders.
- Are pregnant and in a later stage of pregnancy (from 28 weeks or later).
- Are breastfeeding (or planning to breastfeed).
- Are allergic to diclofenac sodium or any of the ingredients in this medicine or the container.
- Have a history of asthma, hives, growths in your nose, sinus swelling or symptoms of an allergic reaction after taking acetylsalicylic acid (ASA) or other NSAIDs.
- Have active stomach or intestine ulcers.
- Have active bleeding from the stomach or gut.
- Have inflammatory bowel disease (Crohn’s Disease or Ulcerative Colitis).
- Have liver disease (active or severe).
- Have kidney disease (severe or worsening).
- Have high potassium in the blood.
- Are under 16 years of age.
- Have an inflamed rectum or anus, and have a recent history of rectal or anal bleeding (for Sandoz-Diclofenac suppositories).
To help avoid side effects and ensure proper use, talk to your health professional before you take Sandoz-Diclofenac and Sandoz-Diclofenac SR. Talk about any health conditions or problems you may have, including if you:
- Have high blood pressure, high cholesterol or diabetes
- Have or had heart attacks, chest pain, heart disease, stroke or heart failure
- Have poor blood flow to your extremities (like your hands and feet)
- Smoke or used to smoke
- Drink a lot of alcohol
- Have a stomach infection
- Have recently had stomach or intestine tract surgery
- Have liver or kidney disease, urine problems or are dehydrated
- Have a history of ulcer or bleeding from the stomach or gut (small or large intestine)
- Previous bleeding in the brain
- Have other bleeding or blood problems
- Have asthma or other lung problems
- Have immune system problems
- Family history of allergy to NSAIDs, such as acetylsalicylic acid (ASA) or other NSAIDs
- Are on a low-salt diet
- Are pregnant, planning on becoming or become pregnant while taking Sandoz-Diclofenac or Sandoz-Diclofenac SR
Other Warnings: Serious Side Effects: Sandoz-Diclofenac and Sandoz-Diclofenac SR can cause serious side effects, including:
Blood and bleeding problems:
- Sandoz-Diclofenac and Sandoz-Diclofenac SR can cause blood problems, bleeding and prolonged bleeding.
Taking Sandoz-Diclofenac and Sandoz-Diclofenac SR with the following drugs can increase the risk of bleeding:
- anticoagulants (prevents blood clots), corticosteroids (anti-inflammatory) or antidepressants like selective serotonin reuptake inhibitors (SSRIs).
Serious skin reactions: In rare cases, serious, life-threatening allergic and skin reactions have been reported with some NSAIDs, such as Sandoz-Diclofenac or Sandoz-Diclofenac SR. These skin problems most often happen during the first month of treatment. Tell your healthcare professional immediately if you notice any changes in your skin both during and after treatment.
Sandoz-Diclofenac and Sandoz-Diclofenac SRmight cause you to become more sensitive to sunlight or UV light. Sunlight or sunlamps may cause sunburn, skin blisters, skin rash, redness, itching or discolouration, or vision changes. If you have a reaction from the sun or UV light, talk to your healthcare professional.
Check-ups and testing: You will have regular visits with your healthcare professional during treatment with Sandoz-Diclofenac and Sandoz-Diclofenac SR to monitor your health. They will:
- Check your blood pressure.
- Check your eyes. Sandoz-Diclofenac and Sandoz-Diclofenac SR can cause blurred or reduced vision.
- Do blood and urine tests to check your liver, kidney and blood health.
Surgery: Tell any doctor, dentist, pharmacist or healthcare professional that you see, that you are taking this medicine. This is especially important if you are planning to have heart surgery.
Driving and Using Machines: Sandoz-Diclofenac and Sandoz-Diclofenac SR may cause eye or nervous system problems. This includes tiredness, trouble sleeping, blurred vision, spinning or dizziness (vertigo), hearing problems or depression. Be careful about driving or doing activities that require you to be alert. If you become drowsy, dizzy or light-headed after taking Sandoz-Diclofenac and Sandoz-Diclofenac SR, do NOT drive or operate machinery.
Fertility in Women: Sandoz-Diclofenac and Sandoz-Diclofenac SR may affect your fertility. This means that it may be difficult for you to have a child. If you have trouble having a child, you might need to stop taking Sandoz-Diclofenac and Sandoz-Diclofenac SR. Talk to your healthcare professional if you have questions about this.
Adults (65 years or older): Side effects like gastrointestinal problems may happen more often. Your healthcare professional might have you start with a lower dose of Sandoz-Diclofenac and Sandoz-Diclofenac SR. They will monitor your health during and after treatment.
Tell your health professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
The following may interact with Sandoz-Diclofenac or Sandoz-Diclofenac SR:
- Acetaminophen, used to treat fever and pain
Acetylsalicylic Acid (ASA) or other NSAIDs, used to treat pain, fever and inflammation, like:
- e.g. ASA, celecoxib, diclofenac, diclofenac potassium, ibuprofen, indomethacin, ketorolac, meloxicam, naproxen
- Alcohol
- Antacids, used to treat symptoms of excess stomach acid
- Blood pressure medications like enalapril, lisinopril, perindopril, Ramipril, candesartan, irbesartan, losartan, valsartan, metoprolol
- Corticosteroids (including glucocorticoids, such as prednisone, used as an anti-inflammatory
- Digoxin, used to treat heart disorders
- Phenytoin, used to treat seizures
- Trimethoprim, used to treat urinary tract infections
- Voriconazole, used to treat fungal infections
- Lithium, used as a mood stabilizer
- Medicines used as blood thinners or to prevent blood clots, like warfarin, ASA, clopidogrel
- Medicines used to lower the risk of organ rejection, like tacrolimus and cyclosporine
- Medicines used to treat bacteria infections (antibiotics) like rifampin, quinolone
- Medicines used to treat gout like sulfinpyrazone, probenecid
- Medicines used to lower extra fluid levels (diuretics) like furosemide, hydrochlorothiazide
- Medicines used to treat depression (antidepressants) like citalopram, fluoxetine, paroxetine, sertraline
- Methotrexate, used to treat some kinds of cancer
- Medicines used to treat diabetes, like metformin or other oral hypoglycemics
How to take Sandoz-Diclofenac or Sandoz-Diclofenac SR:
Sandoz-Diclofenac and Sandoz-Diclofenac SR:
- Take Sandoz-Diclofenac or Sandoz-Diclofenac SR as directed by your healthcare professional. They should recommend the lowest dose possible for your treatment for the shortest time needed.
- This medication has been prescribed specifically for you. Do NOT give it to anyone else. It may harm them, even if their symptoms seem to be similar to yours.
- It is best to take your dose at the same time each day.
Take Sandoz-Diclofenac or Sandoz-Diclofenac SR tablets with food.
- You should remain standing or sitting upright (do not lie down) for about 15-30 minutes after taking the Sandoz-Diclofenac or Sandoz-Diclofenac SR.
- If you will be using Sandoz-Diclofenac or Sandoz-Diclofenac SR for more than 7 days, see your health care provider regularly. They will check if it is working for you and if it is causing you any unwanted effects.
Sandoz-Diclofenac:
- Sandoz-Diclofenac suppositories are wrapped in a plastic film. Make sure that the plastic wrapping is fully removed before inserting the suppository into the rectum.
- It is best to take the suppositories after emptying your bowels
- Do not take suppositories by mouth.
Sandoz-Diclofenac SR:
- Sandoz-Diclofenac SR: Swallow tablet whole with water at mealtime. Do NOT chew or divide the tablet.
Usual dose:
Sandoz-Diclofenac and Sandoz-Diclofenac SR:
Patients 16 years of age and older:
- Your healthcare professional will decide on the best dosage for you based on your condition.
Your healthcare professional may lower your dose, stop your treatment for a period of time or recommend that you stop treatment completely. This may happen if you:
- experience serious side effects, or
- your disease gets worse.
Overdose:
| If you think you, or a person you are caring for, have taken too much Sandoz-Diclofenac or Sandoz-Diclofenac SR, contact a healthcare professional, hospital emergency department, or regional poison control centre immediately, even if there are no symptoms. |
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Missed Dose:
- If you miss a dose of Sandoz-Diclofenac or Sandoz-Diclofenac SR, take the dose as soon as possible.
- Do not take a bigger dose to make up for the missed dose.
What are possible side effects from using Sandoz-Diclofenac and Sandoz-Diclofenac SR?
These are not all the possible side effects you may have when taking Sandoz-Diclofenac or Sandoz-Diclofenac SR. If you experience any side effects not listed here, tell your healthcare professional.
- Nausea, vomiting, diarrhea, constipation, stomach upset/abdominal pain, heartburn, indigestion, feeling gassy
- Headache, dizziness, light-headedness
- Feeling of burning/prickliness/numbing
- Confusion, hard to concentrate or think, short-term memory loss, nervousness
Bruises
- Skin rash, itchy skin
- Taste disorder, thirst, dry mouth
- Muscle pain
- Mouth sores
- Hair loss
- Increased sweating
- Problems with your period (women)
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| COMMON | |||
| Gastrointestinal (GI) problems (bleeding, blockage, holes, ulcers or inflammation in your GI tract): blood in vomit, black tarry or bloody stool, dizziness, stomach pain, bloating, loss of appetite, weight loss, nausea, vomiting, constipation or diarrhea, chills or fever, inflamed tongue, rectal itching or bleeding | ✓ | ||
| Vertigo (a sense of severe spinning dizziness, light headedness) | ✓ | ||
| UNCOMMON | |||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| Anaphylaxis/hypersensitivity (severe allergic reactions): sudden wheeziness and chest pain or tightness; or swelling of eyelids, face, lips, tongue or throat, swelling or anaphylactic reaction/shock, chills, fever, muscle aches or pains, or other flu-like symptoms, low blood pressure | ✓ | ||
| Congestive heart failure (heart does not pump blood as well as it should): shortness of breath, fatigue and weakness, swelling in ankles, legs and feet, cough, fluid retention, lack of appetite, nausea, rapid or irregular heartbeat, reduced ability to exercise | ✓ | ||
| Cystitis (bladder infection): increased need to urinate, pain in the pelvis or lower back, frequent urination during the night, cloudy urine that may contain blood, burning or pain urinating | ✓ | ||
| Liver problems (including hepatitis, liver failure): yellowing of your skin and eyes (jaundice), right upper stomach area pain or swelling, nausea or vomiting, unusual dark urine, unusual tiredness | ✓ | ||
| Lung problems, asthma: increased shortness of breath, wheezing, difficulty breathing, cough and chest tightness, irregular heartbeat | ✓ | ||
| Myocardial infarction (heart attack): pressure or squeezing pain between the shoulder blades, in the chest, jaw, left arm or upper | ✓ | ||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| abdomen, shortness of breath, dizziness, fatigue, light-headedness, clammy skin, sweating, indigestion, feeling faint and possible irregular heartbeat | |||
| Stroke (bleeding or blood clot in the brain): sudden numbness, weakness or tingling of the face, arm, or leg, particularly on one side of the body, sudden headache, blurry vision, difficulty swallowing or speaking, or lethargy, dizziness, fainting, vomiting, trouble understanding, trouble with walking and loss of balance | ✓ | ||
| RARE | |||
| Hypertension (high blood pressure): fatigue, dizziness or fainting, chest pain | ✓ | ||
| Kidney disorder/problems (including kidney failure): nausea, vomiting, fever, swelling of extremities, fatigue, thirst, dry skin, irritability, dark urine, increased or decreased urine output, blood in the urine, rash, weight gain (from retaining fluid), loss of appetite, mental status changes (drowsiness, confusion, coma) | ✓ | ||
| Serious Skin Reactions: fever, severe rash, swollen lymph glands, flu-like feeling, blisters and peeling skin that may start in and around the mouth, nose, eyes and genitals and spread to other areas of the body, swelling of face and/or legs, yellow skin or eyes, shortness of breath, dry cough, chest pain or | ✓ | ||
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
|---|---|---|---|
| Only if severe | In all cases | ||
| discomfort, feeling thirsty, urinating less often, less urine or dark urine, hives, red or dry itchy skin, purple or red spots on skin | |||
| VERY RARE | |||
| Abnormal thoughts and behaviour, including depression: irritability, difficulty sleeping or sleeping too much, changes in appetite or weight, reduced sex drive and thoughts of death or suicide, disorientated | ✓ | ||
| Aseptic meningitis (inflammation of the protective lining of the brain that is not caused by infection): Headaches, stiff neck, nausea and vomiting, fever or clouding of consciousness | ✓ | ||
| Blood problems (low white and/or red blood cell or platelet count): feeling tired or weak, pale skin, bruising or bleeding for longer than usual if you hurt yourself, fever, chills | ✓ | ||
| Tinnitus (hearing problems): includes ringing, buzzing, clicking or hissing in ears, loss of hearing | ✓ | ||
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
Reporting Side Effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice. |
Storage:
Sandoz-Diclofenac: Store suppositories between 15°C-30°C. Protect from heat.
Sandoz-Diclofenac SR: Store tablets between 15°C-30°C. Protect tablets from heat and humidity.
Do NOT keep expired medicine or medicine no longer needed. Return to your healthcare professional.
Keep out of reach and sight of children.
If you want more information about Sandoz-Diclofenac and Sandoz-Diclofenac SR:
- Talk to your healthcare professional
- Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website: (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html; the manufacturer’s website www.sandoz.ca, or by calling 1-800-361-3062