The systemic concentration of diclofenac is lower after topical administration, compared to oral formulations. With reference to experience from treatment with NSAIDs with systemic uptake, the following is recommended:

As the cardiovascular risks of diclofenac may increase with dose and duration of exposure, the shortest duration possible and the lowest effective daily dose should be used. The patient's need for symptomatic relief and response to therapy should be re-evaluated periodically.NSAIDs, including diclofenac, may be associated with increased risk of gastro-intestinal anastomotic leak. Close medical surveillance and caution are recommended when using diclofenac after gastro-intestinal surgery. Quinolone antibacterials: Convulsions may occur due to an interaction between quinolones and NSAIDs. This may occur in patients with or without a previous history of epilepsy or convulsions. Therefore, caution should be exercised when considering the use of a quinolone in patients who are already receiving an NSAID. The active substance is diclofenac diethylammonium. Each gram of gel contains 23.2 mg of diethylammonium diclofenac. Children (aged 1-12 years) with juvenile chronic arthritis: 1-3mg/kg per day divided into 2 or 3 doses (12.5mg and 25mg suppositories only). Close medical surveillance and caution should be exercised in patients with ulcerative colitis, or with Crohn's disease as these conditions may be exacerbated (see section 4.8 Undesirable effects).

If you experience any of the following signs of allergy, STOP using this medicine and tell a doctor or pharmacist immediately:Cardiac glycosides: Concomitant use of cardiac glycosides and NSAIDs in patients may exacerbate cardiac failure, reduce GFR and increase plasma glycoside levels. Some possibility of gastro-intestinal bleeding in those with a significant history of this condition has been reported in isolated cases. Use a finger, thumb, side of your hand or even edge of a table against the underside of the cap lid to open the flip-top cap easily. Patients should remain alert for the signs and symptoms of serious arteriothrombotic events (e.g. chest pain, shortness of breath, weakness, slurring of speech), which can occur without warnings. Patients should be instructed to see a physician immediately in case of such an event.