Diclofenac ophthalmic (patient information)

# Why this medication is prescribed
Diclofenac ophthalmic is used to treat eye pain, redness, and swelling in patients who are recovering from cataract surgery (procedure to treat clouding of the lens in the eye). Diclofenac ophthalmic is also used to temporarily relieve eye pain and sensitivity to light in patients who are recovering from corneal refractive surgery (surgery to improve vision). Diclofenac is in a class of medications called nonsteroidal anti-inflammatory medications. It works by stopping the production of certain natural substances that cause pain and swelling.

# How this medication should be used
Diclofenac ophthalmic comes as a solution (liquid) to instill in the eyes. When diclofenac ophthalmic is used by patients recovering from cataract surgery, it is usually instilled 4 times a day beginning 24 hours after surgery and continuing for 2 weeks after surgery. When diclofenac ophthalmic is used by patients undergoing corneal refractive surgery, it is usually instilled one hour before the surgery, 15 minutes after the surgery, and then four times a day for up to 3 days. Use diclofenac eye drops at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use diclofenac eye drops exactly as directed. Do not use more or less of them or use them more often than prescribed by your doctor.
To use the eye drops, follow these steps:
- Use a mirror or have someone else put the drops in your eye.
- Wash your hands thoroughly with soap and water.
- Shake the container well.
- Remove the protective cap. Make sure that the end of the dropper is not chipped or cracked.
- Avoid touching the dropper tip against your eye or anything else.
- Lie down or tilt your head back and look upward.
- Hold the bottle between your thumb and index finger and place the dropper tip as near as possible to your eyelid without touching it.
- Brace the remaining fingers of that hand against your cheek or nose.
- Use the index finger of your other hand to gently press the skin just beneath the lower eyelid, then pull the lower eyelid down to form a pocket.
- Drop the prescribed number of drops into the pocket made by the lower lid and the eye.
- Close your eye gently.
- Replace and tighten the cap right away. Do not rinse it off.
- Wipe off any excess liquid from your cheek with a clean tissue. Wash your hands again.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before using diclofenac eye drops:
- tell your doctor and pharmacist if you are allergic to diclofenac; aspirin or other NSAIDs such as nepafenac (Nevanac), ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or tolmetin (Tolectin); any other medications, or any of the ingredients in diclofenac eye drops. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin and other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); and corticosteroid eye drops such as dexamethasone (Maxidex), fluorometholone (FML), hydrocortisone (in Cortisporin), loteprednol (Alrex, Lotemax), medrysone (HMS), prednisolone (Pred Mild), and rimexolone (Vexol). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had diabetes, rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), dry eye disease or any eye problem other than cataracts, or any condition that causes you to bleed easily.
- tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while using diclofenac eye drops, call your doctor.
- tell your doctor if you wear soft contact lenses. Your doctor may tell you that you should not wear your contact lenses during your treatment with diclofenac eye drops.

# Special dietary instructions
Unless your doctor tells you otherwise, continue your normal diet.

# What to do if you forget a dose
Instill the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill extra eye drops to make up for a missed dose.

# Side effects

## Minor side effects
Diclofenac eye drops may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- burning or stinging in your eye just after you instill the drops
- itchy eyes
- stomach pain
- upset stomach
- vomiting
- difficulty falling asleep or staying asleep
- headache
- dizziness
- fever
- chills
- runny nose

## Severe side effects
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
- swelling of the eyes or face
- red or bloody eyes
- eye pain
- feeling that something is in the eye
- sensitivity to light
- blurred or decreased vision
- teary eyes
- eye discharge or crusting
Diclofenac eye drops may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
If someone swallows diclofenac eye drops, call your local poison control center at 1-800-222-1222. Give the victim plenty of liquids to drink. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Other information
Keep all appointments with your doctor.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Voltaren