Adverse reactions to nonsteroidal anti-inflammatory drugs diclofenac compared with other nonsteroidal anti-inflammatory drugs

Abstract The most common adverse effects of nonsteroidal anti-inflammatory drugs are gastritis, peptic ulceration, and depression of renal function, all of which result primarily from prostaglandin inhibition. The types of side effects observed with diclofenac are similar to those of other nonsteroidal anti-inflammatory drugs and are unavoidable given that the drugs are prostaglandin inhibitors. However, the incidences of such side effects may be lower with diclofenac than with some of the other nonsteroidal anti-inflammatory drugs. Worldwide experience with diclofenac exceeds 7.6 million patient-years, which should provide estimates of the frequency of very rare adverse reactions. The latter include blood dyscrasias, erythema multiforme, hepatitis, and others, such as aseptic meningitis, anaphylaxis, and urticaria. Moreover, some nonsteroidal anti-inflammatory drugs appear to have unique side-effect profiles. Examples include a higher incidence of ulceration and erythema multiforme with piroxicam, and acute pancreatitis, in rare instances, with sulindac. From a careful survey of the world's accumulated literature and reports to CIBA-GEIGY, diclofenac does not appear to have any unusual adverse reactions.