Also known as Diclofenac Acid, Diclofenaco, Diclofenacum, ISV-205

A nonsteroidal benzeneacetic acid derivative with anti-inflammatory activity. As a nonsteroidal anti-inflammatory drug (NSAID), diclofenac binds and chelates both isoforms of cyclooxygenase (COX-1 and-2), thereby blocking the conversion of arachidonic acid to pro-inflammatory-proprostaglandins. This agent also may inhibit COX-2-mediated tumor angiogenesis. When inhibiting COX-2, diclofenac may be effective in relieving pain and inflammation; when inhibiting COX-1, it may produce unacceptable gastrointestinal side effects. This agent may be more active against COX-2 than several other carboxylic acid-containing NSAIDs. (NCI04)

Originator: NCI Thesaurus | Source: The website of the National Cancer Institute (http://www.cancer.gov)

Can I take Diclofenac while breastfeeding?

Data on excretion of diclofenac into milk are poor, but the drug has a short half-life and little glucuronide metabolite formation. Most reviewers consider diclofenac to be acceptable during breastfeeding.[1][2][3][4] Other agents having more published information may be preferred, especially while nursing a newborn or preterm infant.

Drug levels

No original data on the excretion of diclofenac into milk are available. Data are limited to those reported in review articles in which no study details are reported.

Diclofenac was undetectable (<100 mcg/L) in the breastmilk over a 6-hour period after a 50 mg intramuscular injection in 6 women.[5][6] Six mothers were given oral diclofenac 100 mg daily orally for one week postpartum. The drug was undetectable(<10 mcg/L) in milk of any of 59 samples of milk collected (collection times unspecified).[6] A woman treated with 150 mg daily of diclofenac had a breastmilk diclofenac level of 100 mcg/L, equivalent to about 0.03 mg/kg daily for the infant.[7]

Effects in breastfed infants

No original data on the excretion of diclofenac into milk are available. Data are limited to those reported in review articles in which no study details are reported.

Diclofenac was undetectable (<100 mcg/L) in the breastmilk over a 6-hour period after a 50 mg intramuscular injection in 6 women.[5][6] Six mothers were given oral diclofenac 100 mg daily orally for one week postpartum. The drug was undetectable(<10 mcg/L) in milk of any of 59 samples of milk collected (collection times unspecified).[6] A woman treated with 150 mg daily of diclofenac had a breastmilk diclofenac level of 100 mcg/L, equivalent to about 0.03 mg/kg daily for the infant.[7]

Possible effects on lactation

Relevant published information was not found as of the revision date.

Alternate drugs to consider

Acetaminophen, Flurbiprofen, Ibuprofen, Indomethacin, Naproxen, Piroxicam

References

1. Brooks PM, Needs CJ. Antirheumatic drugs in pregnancy and lactation. Baillieres Clin Rheumatol. 1990;4:157-71. PMID: 2282661

2. Ostensen ME. Safety of non-steroidal anti-inflammatory drugs during pregnancy and lactation. Inflammopharmacology. 1996;4:31-41.

3. Spigset O, Hagg S. Analgesics and breast-feeding: safety considerations. Paediatr Drugs. 2000;2(3):223-38. PMID: 10937472

4. Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy and lactation. Arch Intern Med. 2000;160:610-9. PMID: 10724046

5. Fowler PD. Voltarol: diclofenac sodium. Clin Rheum Dis. 1979;5:427-64.

6. Sioufi A, Stierlin H, Schweizer A et al. Recent findings concerning clinically relevant pharmacokinetics of diclofenac sodium. In: Kass E. Voltaren new findings. Bern: Hans Huber Publishers, 1982:19-30.

7. Todd PA, Sorkin EM. Diclofenac sodium. A reappraisal of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. Drugs. 1988;35:244-85. PMID: 8638785

8. Hirose M, Hara Y, Hosokawa T et al. The effect of postoperative analgesia with continuous epidural bupivacaine after cesarean section on the amount of breast feeding and infant weight gain. Anesth Analg. 1996;82:1166-9. PMID: 8638785

9. De Cerqueira AM, De Azevedo JO, Guimaraes MB, Afradique MC. Urticaria in a newborn. J Am Acad Dermatol. 2009;60:Abstract 148.

Last Revision Date

20160204

Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Source: LactMed – National Library of Medicine (NLM)

3D Model of the Diclofenac molecule

MolView – data visualization platform