Side effects of diclofenac in pregnancy

Key takeaways

• Diclofenac is a widely used non-steroidal anti-inflammatory medication (NSAID) for the healing of mild and intermediate pain and swelling. It is particularly useful for relieving inflammatory symptoms in people with arthritis.
• Studies have indicated that diclofenac may not be safe for pregnant people and their fetuses, especially those that are up to 30 weeks pregnant.
• Taking diclofenac during pregnancy can cause side effects such as persistent pulmonary hypertension (PPHN) and sudden closure of the ductus arteriosus—a blood vessel that directs blood away from the lungs in fetuses.
• If you have taken diclofenac and notice any adverse effects, the best thing to do is to see a gynecologist or obstetrician for safe and effective treatment.

Being pregnant usually comes with a mixture of joy and skepticism, which usually drives expectant mothers to embrace certain healthy lifestyles.

Being pregnant also comes with a series of precautionary measures. These measures don't end with eating healthy and doing light exercises; they also involve the discontinuation of certain medications that may hinder the success of your baby's delivery or affect their health. One such drug you should avoid is diclofenac.

What is diclofenac?

Diclofenac is a medication used for treating and relieving pain, discomfort, and swelling, which are typically signs of inflammation. It's classified as a member of the non-steroidal anti-inflammatory drugs (NSAIDs).

Diclofenac is commonly used as a therapy for relieving pain and complications in the bones, muscles, and joints. Doctors typically use it to treat people with arthritis.

Diclofenac comes in different forms, like tablets, capsules, gel, solutions, plasters, delayed-release suppositories, tablets, or capsules.

Can a pregnant person take diclofenac?

Diclofenac is not an ideal medication for pregnant people. Doctors typically don’t prescribe it for people who are pregnant because it poses a risk of complications for the pregnant person and their unborn baby. So, you shouldn't take it during pregnancy.

Paracetamol is usually the medication doctors prescribe for pregnant people who are experiencing pain. But if your doctor prescribes diclofenac for you, they most likely have considered different factors, such as your condition, general state of health, and pregnancy stage, and may have determined that it’s beneficial for you. 

In all, it is best to ask your doctor questions to understand why they are prescribing certain medications to you. It is okay to want to understand the treatment approach they recommend for you. You may also want to get a second opinion from a qualified medical doctor if you are not satisfied with the response you received.

Side effects of diclofenac in pregnancy

Despite being a pain reliever, diclofenac can pose a threat to you and your unborn baby. This goes to say that diclofenac can go from being a pain relief medication to causing mild or severe complications in pregnant people.

Some of the side effects of taking diclofenac during pregnancy include:

1. Low amount of amniotic fluid

Amniotic fluid is a shielding liquid contained in the amniotic sac of a pregnant person. The amniotic sac serves as a safe space for the developing baby (fetus). The amniotic fluid, commonly referred to as woman's water, helps in the exchange of nutrients between you and your unborn baby (fetus).

If there's less amniotic fluid, it might affect the development of your baby's lungs, digestive system, bones, or muscles. It might also lead to the squeezing of the umbilical cord, which may reduce the amount of nutrients transferred to your unborn baby.

2. Sudden closure of the ductus arteriosus

The ductus arteriosus is a blood vessel that forms while the fetus is still growing. It connects the pulmonary artery and the aorta in a fetus. It directs blood away from the fetus's lungs to other parts of its body.

The ductus arteriosus is necessary for developing babies because they can’t use their lungs while in the womb. Instead, they get the oxygen they need directly from their mother's placenta.

Using diclofenac may trigger the sudden closure of the ductus arteriosus, especially during the formative stage of the fetus. This may cause pulmonary hypertension or death of the fetus.

3. Persistent pulmonary hypertension in the newborn (PPHN)

PPHN This is a respiratory condition that makes it hard for the newborn baby's lungs to cope after birth. In a few cases, this condition has been linked to the sudden closure of the ductus arteriosus.

There hasn't been concrete evidence linking this condition to non-steroidal anti-inflammatory drugs or diclofenac in particular. Also, there is a need for researchers to carry out an extensive study to determine the extent to which they relate.

Uses of diclofenac: Why do doctors prescribe it?

Being a potent and popular drug used to combat mild to average degrees of pain in the body, diclofenac is a common medication that doctors prescribe to their patients who are experiencing pain, swelling, and osteoarthritis-induced stiffness. 

Uses of diclofenac include:

• treating ankylosing spondylitis, which is caused by the inflammation of the spine
• Relieving painful menstrual cramps
• Treating migraines in adult patients (basically for the treatment and not prevention of migraine)
• Treating toothaches
• Treating sprained and strained muscles and ligaments.
• Treating gout, a medical condition that causes sudden severe pain in different joints in the body

Diclofenac works by relieving pain and inflammation-causing hormones in the body.

What to do if you take diclofenac and realize that you are pregnant

Available scientific evidence has indicated that diclofenac is not ideal for pregnant people. But if you find that you are pregnant and have been on diclofenac treatment, do not panic.

Start by quitting diclofenac and other NSAIDs you are taking. Then, visit a qualified doctor who will examine you and also recommend the best and safest alternative therapy for you.

Other common side effects of diclofenac

Just like every other medicine, diclofenac can trigger several side effects, even in non-pregnant people. But not everyone will experience these side effects.

Consider seeing a doctor or pharmacist if you notice any of the side effects mentioned below:

• Nausea
• Vomiting and diarrhea 
• Constant feeling of fatigue 
• Headaches
• Stomach aches
• Appetite loss
• Rashes on the body

If you are using the diclofenac gels or plasters, there is little or no chance of you experiencing these adverse effects. This is because a limited amount is entering the body.

However, using diclofenac gels or plasters may cause skin irritation, especially if you do not apply them properly.

Severe side effects of diclofenac

In rare cases, diclofenac may cause severe side effects. Make sure you see a doctor if you notice any of these:

• Severe stomach aches, puking, diarrhea, and heartburn—these might be symptoms of an ulcer.
• Blackish poop and traces of blood when you vomit—these might be symptoms of bleeding inside the stomach or gut.
• Itchy skin irritations and swollen skin—these might be indications of edema or hives.
• Difficulty in breathing, weakness, and swelling of the legs or ankles—these may be indications of heart failure.

Special precautions to observe when you are taking diclofenac

See that you do the following things before taking a diclofenac prescription from the doctor or pharmacist:

• Make sure that you let the doctor know about your previous allergies to diclofenac or other non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin.
• Notify your doctor about your pre-existing health conditions. Health conditions like ulcers, liver disease, kidney problems, high or low blood pressure, and heart diseases can pose a threat to you if you are taking diclofenac.
• Diclofenac can trigger a harsh response in the stomach, so try to eat enough and drink some milk too.
• If you are on diclofenac therapy, it is best to avoid taking alcohol for the time being.
• Talk to your doctor about other medications you've been taking before, as some medications are not compatible with diclofenac (i.e., they may interact with it) 
• Look out for adverse effects and report any abnormal changes to your doctor.
• Make sure the packaged diclofenac drugs are properly stored in an environment free of moisture, direct sunlight, and heat.

Wrap up

Diclofenac is not ideal for you if you are pregnant, as this medication is linked to some adverse effects that can affect a pregnant person and their unborn baby.

Every pregnant person may not experience the side effects of diclofenac.  But it’s best to take precautions, and one way to do that is to ensure you don’t take this medication without your doctor's prescription. Also, if you are pregnant and experiencing pain and discomfort, it is advisable to speak with your doctor for proper examinations and treatment.