Diclofenac sodium is a non-steroidal anti-inflammatory drug, otherwise known as an NSAID. These types of drugs block prostaglandins, which are produced by the body and cause inflammation, pain and sometimes fever. NSAIDs reduce prostaglandins in the body, therefore minimizing inflammation, pain and fever. Prostaglandins do have important functions, such as protecting the lining of the stomach from acid and supporting the body's blood clotting function. Therefore, taking NSAIDs can have negative effects, such as ulcers and bleeding. For pregnant women, there are added risks.
Use
NSAIDs can be used to treat headaches, arthritis, sports injuries and menstrual pain. Aspirin, used to inhibit blood clotting and to prevent strokes and heart attacks, is an NSAID. The NSAID diclofenac sodium is used primarily to treat the symptoms of rheumatoid arthritis, which include inflammation, swelling, stiffness and joint pain. Cataflam and Voltaren are two brand names of diclofenac sodium. The latter is used for long-term treatment, while the former is used for immediate relief of pain.
Pregnancy & Birth
A 2001 study, which combined population-based observation with case-controlled research, looked at whether the use of NSAIDs caused adverse outcomes during pregnancy. The study concluded that the use of NSAIDs, such as diclofenac sodium, was not specifically associated with birth defects, preterm delivery or low birth weight. However, the study did conclude that there was an association between NSAIDs and spontaneous abortions, or miscarriages.
Fetal Risk
Diclofenac sodium taken by pregnant women has been proven to cross into the placenta. Risk to the fetus can include suppression of fetal renal function, as well as premature closure of the ductus arteriosus--the vessel that connects the lungs with the heart--and pulmonary hypertension. Use of diclofenac sodium in the third trimester nearing delivery increases these risks.
A 1998 report showed that a woman who took diclofenac sodium for two weeks at the 34th week of her pregnancy developed premature closure of the ductus arteriosus in the fetus. The mother took the drug for back pain and to treat carpal tunnel syndrome. At 41 weeks, the fetus's heart was enlarged and showing signs of early cardiac failure, causing doctors to perform an emergency C-section. The baby was successfully resuscitated.
Breastfeeding
No reports have been found studying the use of diclofenac sodium while breast feeding. According to the manufacturer, the drug is present in the milk of nursing mothers, but the manufacturer does not cite how much is actually present. Some drug reviewers have stated that the drug is safe for use during breast feeding. The American Academy of Pediatrics approves the use of an NSAID similar to diclofenac sodium during nursing.
Side Effects
Patients who take diclofenac sodium--whether pregnant or not--will need to have frequent doctor checkups because of the possibility of ulcers and internal bleeding that can occur. Other side effects include cramps, abdominal swelling, anemia, constipation, diarrhea, dizziness, fluid retention, gas, headaches, heartburn, indigestion, itching, nausea, rashes, ringing in the ears and vomiting. To deal with some of the side effects, doctors recommend that patients take the drug with food, milk or an antacid. It is also recommended to take the drug with a glass of water and to avoid lying down afterward. These steps will help relieve the irritation that diclofenac sodium can cause to the digestive tract.
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