CONCURRENT USED WITH ACE INHIBITORS, CYCLOSPORIN, TACROLIMUS, OR DIURETICS THE RISK OF NEPHROTOXICITY MAY BE INCREASED. THE ACE INHIBITORS AND POTASSIUM-SPARING DIURETICS MAY PRODUCE HYPERKALAEMIA. QUINOLONES MAY PRODUCE CONVULSIONS. DICLOFENAC MAY ENHANCE THE EFFECTS OF PHENYTOIN AND SULPHONYLUREA. THE THEORETICAL RISK CAN OCCUR WHEN ASPIRIN USED WITH IT. WITH CONCURRENTLY ADMINISTRATION OF CORTICOSTERIOIDS, ALCOHOL, AND BISPHOSPHONATES OR OXPENTIFYLLINE THERE MAY BE RISK OF G.I. BLEEDING OR ULCERATION.
CONCOMITANT ADMINISTRATION OF DICLOFENAC AND ASPIRIN IS NOT
RECOMMENDED BECAUSE DICLOFENAC IS DISPLACED FROM ITS BINDING SITES.
WHILE STUDIES HAVE NOT SHOWN DICLOFENAC TO INTERACT WITH
ANTICOAGULANTS OF THE WARFARIN TYPE, CAUTION SHOULD BE EXERCISED, NONETHELESS. DICLOFENAC, LIKE OTHER NSAIDS, MAY AFFECT
RENAL PROSTAGLANDINS AND INCREASE THE TOXICITY OF CERTAIN DRUGS. INGESTION OF DICLOFENAC MAY INCREASE SERUM CONCENTRATIONS OF DIGOXIN AND METHOTREXATE AND INCREASE CYCLOSPORINE'S NEPHROTOXICITY. DICLOFENAC DECREASES LITHIUM RENAL CLEARANCE AND INCREASES LITHIUM PLASMA LEVELS.
THERE ARE RARE REPORTS, HOWEVER, FROM MARKETING EXPERIENCES OF CHANGES IN EFFECTS OF INSULIN OR ORAL HYPOGLYCEMIC AGENTS IN THE PRESENCE OF DICLOFENAC THAT NECESSITATED CHANGES IN THE DOSES OF SUCH AGENTS. BOTH HYPO- AND HYPERGLYCEMIC EFFECTS HAVE BEEN REPORTED. DICLOFENAC AND OTHER NSAIDS CAN INHIBIT THE ACTIVITY OF DIURETICS.