Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) widely prescribed to manage pain, inflammation, and stiffness associated with conditions like arthritis. Taking a dose significantly higher than recommended, either accidentally or intentionally, can lead to diclofenac toxicity, which constitutes a serious medical emergency. An overdose rapidly overwhelms the body’s ability to process the medication, leading to acute organ dysfunction and severe systemic effects. Immediate recognition of symptoms and swift medical intervention are necessary to prevent lasting harm.
Identifying the Signs of Overdose
Symptoms of diclofenac overdose range from mild discomfort to severe, life-threatening complications, often depending on the total amount ingested. Gastrointestinal distress is a common initial sign, presenting as severe nausea, vomiting, abdominal pain, and sometimes diarrhea. Diclofenac can cause irritation and potential bleeding in the stomach and intestines, which may manifest as vomiting blood or passing black, tarry stools.
Central nervous system (CNS) effects are also frequent, typically including dizziness, drowsiness, and confusion. A person may experience tinnitus, a persistent ringing or buzzing sound in the ears, or a pronounced headache. In severe cases, CNS effects can escalate to agitation, delirium, seizures, or a decreased level of consciousness leading to coma.
The drug’s impact on the kidneys is signaled by a noticeable reduction in the frequency and volume of urination, reflecting early renal toxicity. It is important to note that symptoms may not appear immediately after ingestion, and patients can initially seem well, only to develop delayed and severe complications hours later. Cardiovascular effects may also occur, including fluctuations in blood pressure, an increased heart rate, or fluid retention causing swelling.
Emergency Response and Immediate Actions
A suspected diclofenac overdose requires immediate, directed action to ensure the best possible outcome. The first step is to call your local emergency number or the national Poison Help hotline immediately. Do not wait for symptoms to worsen or attempt to diagnose the severity of the situation yourself.
While waiting for emergency services, remain calm and keep the affected person quiet and comfortable. Do not attempt to induce vomiting unless a medical professional explicitly directs you to do so, as this can cause further injury. Gather crucial information to share with responders, including the person’s age, weight, pre-existing conditions, the exact product taken, dose strength, estimated amount ingested, and the precise time of ingestion. Keep the medication container available for responders to inspect.
Monitor the person’s breathing, consciousness, and responsiveness until medical help arrives. If the individual becomes unconscious, has a seizure, or stops breathing, immediately follow the instructions provided by the emergency operator.
Medical Management and Organ Damage
Upon arrival at a medical facility, the primary goal of treatment is supportive care, focusing on stabilizing the patient’s vital signs and preventing further absorption of the drug. Gastrointestinal decontamination often involves administering activated charcoal to bind diclofenac in the digestive tract, limiting its entry into the bloodstream. Intravenous fluids are commonly given to maintain hydration and support kidney function.
Diclofenac overdose carries a significant risk of damage to the kidneys and liver. The drug inhibits the production of prostaglandins, which play a protective role in maintaining adequate blood flow to the kidneys. This inhibition can lead to renal vasoconstriction, causing acute kidney injury, which may be severe enough to require temporary dialysis until kidney function recovers.
Liver damage (hepatotoxicity) is another serious concern, as diclofenac is frequently associated with liver injury among NSAIDs. The drug’s metabolism produces reactive compounds that cause cellular damage and death within liver cells. Medical teams continuously monitor the patient’s kidney and liver function through blood and urine tests.
The prognosis for recovery depends heavily on the amount of drug consumed, the time elapsed before treatment, and the patient’s underlying health status. While many patients with an acute overdose recover fully with supportive care, massive ingestions can result in multisystem organ failure and potentially permanent damage.