Voltaren Ophthalmic, (diclofenac ophthalmic) dosing, indications, interactions, adverse effects, and more

Sections

Sections diclofenac ophthalmic
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosing Strength

ophthalmic solution

0.1%

Dosing Strength

ophthalmic solution

0.1%

Cataract Surgery

1 gtt in affected eye(s) four times daily for 2 weeks, beginning 24 hours post-surgery

Corneal Refractive Surgery

1-2 gtt in affected eye(s) within 1 hour pre-op & 15 minutes post-op; continue 1-2 gtt four times daily for 3 days

Safety & efficacy not established

Frequency Not Defined

Mild ocular stinging, irritation

May slow corneal wound healing

Lacrimation

Increased IOP

Keratitis

Dizziness

Insomnia

Pain

Fever

Chills

Nausea/vomiting

Abdominal pain

Corneal deposits

Corneal edema

Conjunctivitis

Irritation

Eyelid swelling

Corneal perforation

Corneal thinning

Contraindications

Hypersensitivity to ASA, NSAIDs, or components of the formulation

Cautions

Contains sodium sulfite which may cause allergic reactions in susceptible individuals NSAIDs may slow or delay healing

Potential for cross-sensitivity to other NSAIDs or aspirin

Interferes with platelet aggregation and may increase bleeding of ocular tissues; use caution in patients with predisposition to bleeding

Corneal effects, including keratitis, reported

Remove contact lenses before application, may reinsert 10 minutes after instilling drops

Corneal adverse reactions may occur in patients with keratitis after continued use that may result in loss of vision; discontinue use in patients with evidence of corneal epithelial damage

Use caution in patients with diabetes (may be at risk of corneal adverse effects that may result in loss of vision)

Use caution in patients with complicated ocular surgeries, corneal denervation, repeat ocular surface disease, or corneal epithelial defects

Use caution in patients with rheumatoid arthritis

Pregnancy & Lactation

Pregnancy Category: C

Lactation: Excretion in milk significantly lower than systemic acministration of diclofenac; possibly compatible

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Mechanism of Action Nonsteroidal anti-inflammatory agent; inhibits COX-1 and COX-2, which results in decreased formation of prostaglandin precursors

Pharmacokinetics

Absorption: Negligible

BRAND	FORM.	UNIT PRICE	PILL IMAGE
diclofenac sodium topical -	1.5 % drops
diclofenac sodium topical -	1 % gel
diclofenac sodium topical -	20 mg/gram /actuation(2 %) solution
diclofenac sodium topical -	1.5 % drops
diclofenac sodium topical -	1 % gel
diclofenac sodium topical -	3 % gel
diclofenac sodium topical -	1.5 % drops
diclofenac sodium topical -	3 % gel
diclofenac sodium topical -	20 mg/gram /actuation(2 %) solution
diclofenac sodium topical -	3 % gel
diclofenac sodium topical -	1 % gel
diclofenac sodium topical -	1.5 % drops
diclofenac sodium topical -	3 % gel
diclofenac sodium topical -	1.5 % drops
diclofenac sodium topical -	1 % gel
diclofenac sodium topical -	1 % gel
diclofenac sodium topical -	1 % gel
diclofenac sodium topical -	3 % gel
diclofenac sodium topical -	1.5 % drops
diclofenac ophthalmic (eye) -	0.1 % drops
diclofenac ophthalmic (eye) -	0.1 % drops
diclofenac ophthalmic (eye) -	0.1 % drops
diclofenac ophthalmic (eye) -	0.1 % drops
diclofenac ophthalmic (eye) -	0.1 % drops
diclofenac oral -	75 mg tablet
diclofenac oral -	50 mg tablet
diclofenac oral -	25 mg tablet
diclofenac oral -	75 mg tablet
diclofenac oral -	50 mg tablet
diclofenac oral -	50 mg tablet
diclofenac oral -	75 mg tablet
diclofenac oral -	50 mg tablet
diclofenac oral -	50 mg tablet
diclofenac oral -	25 mg tablet
diclofenac oral -	75 mg tablet
diclofenac oral -	100 mg tablet
diclofenac oral -	100 mg tablet
diclofenac oral -	25 mg tablet
diclofenac oral -	100 mg tablet
diclofenac oral -	100 mg tablet
diclofenac oral -	50 mg tablet
diclofenac oral -	50 mg tablet
diclofenac oral -	75 mg tablet
Pennsaid topical -	20 mg/gram /actuation(2 %) solution

Patient Handout

Select a drug:

DICLOFENAC - OPHTHALMIC

(dye-KLOE-fen-ak)

COMMON BRAND NAME(S): Voltaren

USES: This medication is used to treat swelling (inflammation) of the eye after cataract surgery. It is also used after another type of eye surgery (corneal refractive surgery) to temporarily relieve pain and sensitivity of the eye to light. Diclofenac belongs to a class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs).

HOW TO USE: Apply this medication to the affected eye as directed by your doctor. The dosage and duration of treatment is based on your medical condition and response to treatment.Do not wear contact lenses while you are using this medicine unless your doctor approves of it. Sterilize contact lenses according to the manufacturer's directions, and check with your doctor before you begin using them again.To apply eye drops, wash your hands first. To avoid contamination, do not touch the dropper tip or let it touch your eye or any other surface.Tilt your head back, look upward, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place 1 drop into the pouch. Look downward and gently close your eyes for 1 to 2 minutes. Place one finger at the corner of your eye (near the nose) and apply gentle pressure. This will prevent the medication from draining out. Try not to blink and do not rub your eye. Repeat these steps if your dose is for more than 1 drop.Do not rinse the dropper. Replace the dropper cap after each use. If you are using the single dose units, discard the unit and any remaining solution after one use.If you are using another kind of eye medication (for example, other drops or ointments), wait at least 5 to 10 minutes before applying other medications. Use eye drops before eye ointments to allow the drops to enter the eye.This medication is intended for short-term use only. Do not use this medication more often or for longer than prescribed because doing so may increase your risk of serious side effects.Do not use this product if it becomes contaminated (for example, drops turn cloudy or a dark color). Use of contaminated eye medication can cause infection, serious damage to the eye, and loss of vision. Contact your doctor or pharmacist for more information.Tell your doctor if your symptoms last or if they get worse.

SIDE EFFECTS: Stinging/burning of the eyes for 1 to 2 minutes and temporary blurred vision may occur when you apply this medication. Watery eyes may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: eye pain, decreased vision, bleeding in the eye (increased redness in the eye).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using diclofenac, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients (such as polyoxyethylated castor oil found in some brands), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), growths in the nose (nasal polyps), bleeding or clotting problems, other eye problems (such as cornea problems, dry eye syndrome, past eye surgeries), diabetes, rheumatoid arthritis.After you apply this drug, your vision may become temporarily blurred. Do not drive, use machinery, or do any activity that requires clear vision until you can do it safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: corticosteroids (such as prednisone).This medication may increase the risk of bleeding when used with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen or naproxen). These drugs are similar to diclofenac and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another eye condition unless told to do so by your doctor. A different medication may be necessary in that case.

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Store at room temperature according to the product package instructions for your brand, or ask your pharmacist. Do not store in the bathroom. Keep the bottle tightly closed when not in use. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier	Description
1	This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2	This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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