Recommended Dosage of Voltaren (Diclofenac) Tablets
The recommended dosage of Voltaren (diclofenac) tablets is 50-200 mg daily in divided doses, with the specific dose depending on the condition being treated and using the lowest effective dose for the shortest duration possible to minimize cardiovascular and gastrointestinal risks. 1
Dosage by Indication
Pain or Primary Dysmenorrhea: 50 mg three times a day (150 mg total daily). In some patients, an initial dose of 100 mg followed by 50 mg doses may provide better relief 1
Osteoarthritis: 100-150 mg daily in divided doses, typically 50 mg two or three times a day 1, 2
Rheumatoid Arthritis: 150-200 mg daily in divided doses, typically 50 mg three or four times a day 1, 2
Ankylosing Spondylitis: 100-150 mg daily in divided doses 2
Administration Guidelines
- Take with meals to reduce gastrointestinal side effects 2
- Use the lowest effective dose for the shortest duration consistent with treatment goals 1
- Different formulations of diclofenac (sodium enteric-coated tablets, sodium extended-release tablets, potassium immediate-release tablets) are not necessarily bioequivalent even at the same milligram strength 1
Important Safety Considerations
Cardiovascular Risk: NSAIDs including diclofenac may increase risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke 3
Gastrointestinal Risk: Diclofenac can cause serious gastrointestinal adverse events including inflammation, bleeding, ulceration, and perforation 3
Risk Factors: Patients with cardiovascular disease, risk factors for cardiovascular disease, or elderly patients are at greater risk for adverse events 3
Contraindication: Diclofenac is contraindicated for treatment of perioperative pain in coronary artery bypass graft (CABG) surgery 3
Special Populations
Elderly: Careful monitoring is recommended, though specific dosage adjustments may not be required based on age alone 4
Renal Impairment: No specific dosage adjustments are recommended for mild to moderate renal impairment, but caution is advised 4
Hepatic Impairment: Caution is advised, though specific dosage adjustments may not be required for mild to moderate hepatic impairment 4
Clinical Efficacy Considerations
Diclofenac has demonstrated comparable efficacy to other NSAIDs including aspirin, indomethacin, naproxen, and ibuprofen in clinical trials for various rheumatological conditions 2, 5
In some comparative studies, diclofenac showed superior tolerability compared to indomethacin, with fewer central nervous system and gastrointestinal adverse effects 6
When compared with naproxen in osteoarthritis, diclofenac provided greater relief of pain and stiffness and improved range of joint movement in some studies 7