From november 1988 to june 1991 the fda received 180 cases of diclofenac -induced adverse hepatic injury of which 79 were female, 71 were elderly patients above the age of 60 , and 77 of the patients had osteoarthritis.
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All eight NSAIDs are available on prescriptionwhile diclofenacnaproxen and ibuprofen are also available in lower dose over-the-counterOTCforms that can be obtained without a prescriptionPiroxicam is also available as an OTC topical medicine
Consider advising patients who have risk factors for cardiovascular disease of the increased risks of using NSAIDsincluding OTC productsand educating them regarding the signs and symptoms of serious cardiovascular toxicityInstruct them to seek medical attention immediately if they experience any.
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caroline hi ,i also have ra, i am currently taking 20 mgs of methotrexate along with sulfasalazine, diclofenac, and sleeping tablets.