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Diclofenac sodium overdose

Voltaren overdose

Diclofenac sodium is a type of nonsteroidal anti-inflammatory drug (NSAID). It is used to relieve pain, swelling, and inflammation. Diclofenac sodium overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

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Poisonous Ingredient

Diclofenac sodium can be harmful in large amounts.

Where Found

Diclofenac sodium is a prescription medicine. It is sold under these brand names:

• Voltaren
• Arthrotec
• Solaraze

Other medicines may also contain diclofenac sodium.

Symptoms

Below are symptoms of a diclofenac sodium overdose in different parts of the body.

AIRWAYS AND LUNGS

• Wheezing or trouble breathing, especially in those who have asthma or lung conditions

EYES AND EARS

• Blurred vision
• Ringing in the ears

BLADDER AND KIDNEYS

• Little or no urine output

STOMACH AND INTESTINES

• Diarrhea
• Nausea (common)
• Possible bleeding in the stomach and intestines
• Stomach pain
• Vomiting (common, sometimes with blood)

HEART AND BLOOD

• Chest pain
• High or low blood pressure
• Increased heart rate
• Edema (swelling in the body or legs)

NERVOUS SYSTEM

• Agitation
• Confusion
• Coma (decreased level of consciousness and lack of responsiveness), in a very severe overdose
• Seizures, in a very severe overdose
• Dizziness (common)
• Drowsiness (common)
• Blurred vision (common)
• Delirium (person is not making sense)
• Movement problems
• Numbness and tingling
• Unsteadiness
• Headache

SKIN

• Rash

Home Care

Seek medical help right away. Do not make the person throw up unless poison control or a health care provider tells you to.

Before Calling Emergency

Have this information ready:

• Person's age, weight, and condition
• Name of the product (ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed
• If the medicine was prescribed for the person

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Take the container to the hospital with you, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• Electrocardiogram (ECG)
• Endoscopy -- camera placed down the throat to check for burns in the esophagus and stomach

Treatment may include:

• Fluids through a vein (by IV)
• Medicine to treat stomach pain, inflammation and bleeding, or breathing problems
• Activated charcoal
• Laxative
• Tube through the mouth into the stomach if vomiting contains blood
• Breathing support, including a tube through the mouth and connected to a breathing machine (ventilator)

Outlook (Prognosis)

How well someone does depends on how much diclofenac sodium was swallowed and how quickly treatment is received. The faster the medical help is received, the better the chance for recovery.

A mild overdose of this medicine does not usually cause serious problems. There may be some stomach pain and vomiting (possibly with blood).

However, a large amount of internal bleeding is possible, and a blood transfusion may be needed. Endoscopy may be needed to stop the internal bleeding.

In rare cases, there can be ringing in the ears and a bad headache. But these symptoms will likely pass as well.

If kidney damage is severe, dialysis (kidney machine) may be needed until kidney function returns. In some cases, the damage is permanent.

A large overdose can be very harmful to children and adults. Death may occur.

References

Aronson JK. Non-steroidal anti-inflammatory drugs (NSAIDs). In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:236-272.

Chitturi S, Teoh NC, Farrell GC. Liver disease caused by drugs. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 88.

Hatten BW. Aspirin and nonsteroidal agents. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 139.

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Review Date: 11/2/2023  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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