Withdrawal of oral Diclofenac

By January 2012 the Trust will have completed the process of transition to oral ibuprofen and oral naproxen as the Non-Steroidal Anti-inflammatory Drugs (NSAIDs) of first choice. Further details are available on Trustnet. The EMEA (European Medicines Agency) is doing a safety review of NSAIDs for the same reasons we were making this transition. We expect:
  • Non-NSAID pain relief should be used whenever appropriate.
  • Where oral NSAID pain relief is indicated:
    • The Trust will move to oral ibuprofen as its oral NSAID of first choice for acute analgesia
    • The Trust continues to recommend oral naproxen as its oral NSAID of first choice for chronic analgesia and it should be used where possible when acute oral NSAID analgesia is considered necessary in patients on low dose aspirin
    • Oral diclofenac can no longer be recommended in any indication where the above are realistic alternatives. It will be withdrawn as a stock item (including TTAs) from all areas
    • Diclofenac will remain available in its rectal, injection and as oral diclofenac dispersible tablets and SR 100mg formulations in areas where these are presently used. 

Details are in a briefing document  and background information of evidence base for NSAID use in secondary care.