Details of Drug

Drug General Information (ID: D0478)
Drug Name	Diclofenac (topical)
Drug Type	Small molecule
Drug Synonymous	Diclofenac (sodium matrix patch, pain) Click to Show/Hide
Disease Class	FA00-FA05: Osteoarthritis
Therapeutic Class	Nsaids/Analgesics
Structure
Structure	3D Structure		2D Structure
Formula	C14H11Cl2NO2
InChI	1S/C14H11Cl2NO2/c15-10-5-3-6-11(16)14(10)17-12-7-2-1-4-9(12)8-13(18)19/h1-7,17H,8H2,(H,18,19)
InChIKey	DCOPUUMXTXDBNB-UHFFFAOYSA-N
Canonical SMILES	C1=CC=C(C(=C1)CC(=O)O)NC2=C(C=CC=C2Cl)Cl
External Link
	Pubchem ID	3033
	CAS Number	15307-86-5
	CHEBI ID	47381
	TTD ID	D0TG1H
	VARIDT ID	DR00681

Drug-Drug Interaction Network
Sunburst Graph		Legend Information AM005 Affected excretion pathways AM006 Pharmacodynamic additive effects BM032 Decreased renal excretion (Unspecific) BM050 Increased risk of bleeding BM055 Increased risk of hepatotoxicity BM072 Increased risk of nephrotoxicity
Relation Graph

Full list of drugs interacting with Diclofenac (topical)
Affected excretion pathways
	Decreased renal excretion (Unspecific)					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0940		Lithium carbonate	CLi2O3	11125	Major		Inter Info	[6], [7], [8]
Pharmacodynamic additive effects
	Increased risk of bleeding					Drug Num: 64
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0005		Abciximab	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0047		Alteplase	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0084		Anagrelide	C10H7Cl2N3O	135409400	Moderate		Inter Info	[12], [13], [14]
D0088		Anistreplase	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0102		Ardeparin	C26H42N2O37S5	772	Moderate		Inter Info	[12], [13], [14]
D0104		Argatroban	C23H36N6O5S	92722	Moderate		Inter Info	[12], [13], [14]
D0189		Bivalirudin	C98H138N24O33	16129704	Moderate		Inter Info	[12], [13], [14]
D0008		Acalabrutinib	C26H23N7O2	71226662	Moderate		Inter Info	[12], [13], [14]
D0017		Acetylsalicylic acid	C9H8O4	2244	Moderate		Inter Info	[12], [13], [14]
D0087		Anisindione	C16H12O3	2197	Moderate		Inter Info	[12], [13], [14]
D0092		Antithrombin Alfa	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0093		Antithrombin III human	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0096		Apixaban	C25H25N5O4	10182969	Moderate		Inter Info	[12], [13], [14]
D0129		Avapritinib	C26H27FN10	118023034	Moderate		Inter Info	[12], [13], [14]
D0176		Betrixaban	C23H22ClN5O3	10275777	Moderate		Inter Info	[12], [13], [14]
D0230		Cabozantinib	C28H24FN3O5	25102847	Moderate		Inter Info	[12], [13], [14]
D0247		Cangrelor	C17H25Cl2F3N5O12P3S2	9854012	Moderate		Inter Info	[12], [13], [14]
D0250		Caplacizumab	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0336		Cilostazol	C20H27N5O2	2754	Moderate		Inter Info	[12], [13], [14]
D0364		Clopidogrel	C16H16ClNO2S	60606	Moderate		Inter Info	[12], [13], [14]
D0414		Dalteparin	C26H42N2O37S5	772	Moderate		Inter Info	[12], [13], [14]
D0415		Danaparoid	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0428		Dasatinib	C22H26ClN7O2S	3062316	Moderate		Inter Info	[12], [13], [14]
D0435		Defibrotide	C20H21N4O6P	135565962	Moderate		Inter Info	[12], [13], [14]
D0447		Desirudin	C287H440N80O110S6	16129703	Moderate		Inter Info	[12], [13], [14]
D0506		Dipyridamole	C24H40N8O4	3108	Moderate		Inter Info	[12], [13], [14]
D0574		Enoxaparin	C26H42N2O37S5	772	Moderate		Inter Info	[12], [13], [14]
D0586		Epoprostenol	C20H32O5	5282411	Moderate		Inter Info	[12], [13], [14]
D0753		Heparin	C26H42N2O37S5	772	Moderate		Inter Info	[12], [13], [14]
D0785		Ibrutinib	C25H24N6O2	24821094	Moderate		Inter Info	[12], [13], [14]
D0792		Iloprost	C22H32O4	5311181	Moderate		Inter Info	[12], [13], [14]
D0805		Inotersen	C230H318N69O121P19S19	121492004	Moderate		Inter Info	[12], [13], [14]
D1221		Panobinostat	C21H23N3O2	6918837	Moderate		Inter Info	[12], [13], [14]
D1251		Pentoxifylline	C13H18N4O3	4740	Moderate		Inter Info	[29], [30]
D1305		Plicamycin	C52H76O24	163659	Moderate		Inter Info	[12], [13], [14]
D1313		Ponatinib	C29H27F3N6O	24826799	Moderate		Inter Info	[12], [13], [14]
D1328		Prasugrel	C20H20FNO3S	6918456	Moderate		Inter Info	[12], [13], [14]
D1380		Ramucirumab	NA	NA	Moderate		Inter Info	[12], [13], [14]
D1387		Regorafenib	C21H15ClF4N4O3	11167602	Moderate		Inter Info	[12], [13], [14]
D1417		Rivaroxaban	C19H18ClN3O5S	9875401	Moderate		Inter Info	[12], [13], [14]
D1434		Ruxolitinib	C17H18N6	25126798	Moderate		Inter Info	[12], [13], [14]
D1518		Sulfinpyrazone	C23H20N2O3S	5342	Moderate		Inter Info	[12], [13], [14]
D1538		Tazemetostat	C34H44N4O4	66558664	Moderate		Inter Info	[12], [13], [14]
D1579		Ticagrelor	C23H28F2N6O4S	9871419	Moderate		Inter Info	[12], [13], [14]
D1588		Tinzaparin	C26H42N2O37S5	772	Moderate		Inter Info	[12], [13], [14]
D1593		Tirofiban	C22H36N2O5S	60947	Moderate		Inter Info	[12], [13], [14]
D1623		Trastuzumab emtansine	NA	NA	Moderate		Inter Info	[12], [13], [14]
D1705		Vorapaxar	C29H33FN2O4	10077130	Moderate		Inter Info	[12], [13], [14]
D1711		Warfarin	C19H16O4	54678486	Moderate		Inter Info	[12], [13], [14]
D1718		Zanubrutinib	C27H29N5O3	135565884	Moderate		Inter Info	[12], [13], [14]
D0481		Dicoumarol	C19H12O6	54676038	Moderate		Inter Info	[12], [13], [14]
D0537		Drotrecogin alfa	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0588		Eptifibatide	C35H49N11O9S2	448812	Moderate		Inter Info	[12], [13], [14]
D0690		Fondaparinux	C31H53N3O49S8	5282448	Moderate		Inter Info	[12], [13], [14]
D0784		Ibritumomab tiuxetan	NA	NA	Moderate		Inter Info	[12], [13], [14]
D0904		Lepirudin	C287H440N80O111S6	118856773	Moderate		Inter Info	[12], [13], [14]
D1395		Reteplase	NA	NA	Moderate		Inter Info	[12], [13], [14]
D1506		Streptokinase	C11H19NO2	9815560	Moderate		Inter Info	[12], [13], [14]
D1550		Tenecteplase	NA	NA	Moderate		Inter Info	[12], [13], [14]
D1581		Ticlopidine	C14H14ClNS	5472	Moderate		Inter Info	[12], [13], [14]
D1613		Tositumomab	NA	NA	Moderate		Inter Info	[12], [13], [14]
D1614		Tositumomab (I-131)	NA	NA	Moderate		Inter Info	[12], [13], [14]
D1625		Treprostinil	C23H34O5	6918140	Moderate		Inter Info	[12], [13], [14]
D1669		Urokinase	NA	NA	Moderate		Inter Info	[12], [13], [14]
	Increased risk of hepatotoxicity					Drug Num: 42
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0900		Leflunomide	C12H9F3N2O2	3899	Major		Inter Info	[3], [4], [5]
D0944		Lomitapide	C39H37F6N3O2	9853053	Major		Inter Info	[9]
D1073		Mipomersen	C230H324N67O122P19S19	118984467	Major		Inter Info	[10]
D1258		Pexidartinib	C20H15ClF3N5	25151352	Major		Inter Info	[11]
D1556		Teriflunomide	C12H9F3N2O2	54684141	Major		Inter Info	[3], [4], [5]
D0114		Asparaginase Escherichia coli	NA	NA	Moderate		Inter Info	[15], [16], [17]
D0298		Celecoxib	C17H14F3N3O2S	2662	Moderate		Inter Info	[18]
D0113		Asparaginase Erwinia chrysanthemi	NA	NA	Moderate		Inter Info	[15], [16], [17]
D0149		Bedaquiline	C32H31BrN2O2	5388906	Moderate		Inter Info	[19], [20]
D0199		Brentuximab vedotin	NA	NA	Moderate		Inter Info	[21]
D0210		Bromfenac	C15H12BrNO3	60726	Moderate		Inter Info	[18]
D0232		Calaspargase pegol	NA	NA	Moderate		Inter Info	[15], [16], [17]
D0248		Cannabidiol	C21H30O2	644019	Moderate		Inter Info	[22], [23]
D0489		Diflunisal	C13H8F2O3	3059	Moderate		Inter Info	[18]
D0624		Etodolac	C17H21NO3	3308	Moderate		Inter Info	[18]
D0680		Flurbiprofen	C15H13FO2	3394	Moderate		Inter Info	[18]
D0786		Ibuprofen	C13H18O2	3672	Moderate		Inter Info	[18]
D0789		Idelalisib	C22H18FN7O	11625818	Moderate		Inter Info	[19], [24]
D0881		Ketoprofen	C16H14O3	3825	Moderate		Inter Info	[18]
D0988		Meclofenamic acid	C14H11Cl2NO2	4037	Moderate		Inter Info	[18]
D0991		Mefenamic acid	C15H15NO2	4044	Moderate		Inter Info	[18]
D0995		Meloxicam	C14H13N3O4S2	54677470	Moderate		Inter Info	[18]
D1106		Naltrexone	C20H23NO4	5360515	Moderate		Inter Info	[25]
D1109		Naproxen	C14H14O3	156391	Moderate		Inter Info	[18]
D1196		Oxaprozin	C18H15NO3	4614	Moderate		Inter Info	[18]
D1239		Peginterferon beta-1a	NA	NA	Moderate		Inter Info	[26], [27], [28]
D1274		Phenylbutazone	C19H20N2O2	4781	Moderate		Inter Info	[18]
D1389		Remdesivir	C27H35N6O8P	121304016	Moderate		Inter Info	[31], [32], [33]
D1520		Sulindac	C20H17FO3S	1548887	Moderate		Inter Info	[18]
D1615		Trabectedin	C39H43N3O11S	108150	Moderate		Inter Info	[22], [34]
D0645		Fenoprofen	C15H14O3	3342	Moderate		Inter Info	[18]
D0800		Indomethacin	C19H16ClNO4	3715	Moderate		Inter Info	[18]
D0826		Interferon beta-1a	NA	NA	Moderate		Inter Info	[26], [27], [28]
D0827		Interferon beta-1b	NA	NA	Moderate		Inter Info	[26], [27], [28]
D0882		Ketorolac	C15H13NO3	3826	Moderate		Inter Info	[18]
D1025		Methotrexate	C20H22N8O5	126941	Moderate		Inter Info	[22], [35], [36]
D1234		Pegaspargase	C14H19NO	436058	Moderate		Inter Info	[15], [16], [17]
D1300		Piroxicam	C15H13N3O4S	54676228	Moderate		Inter Info	[18]
D1421		Rofecoxib	C17H14O4S	5090	Moderate		Inter Info	[18]
D1589		Tioguanine	C5H5N5S	2723601	Moderate		Inter Info	[5], [37]
D1606		Tolmetin	C15H15NO3	5509	Moderate		Inter Info	[18]
D1674		Valdecoxib	C16H14N2O3S	119607	Moderate		Inter Info	[18]
	Increased risk of nephrotoxicity					Drug Num: 1
Drug ID		Drug Name	Formula	Pubchem ID	Severity Level		Interaction Detail	REF
D0432		Deferasirox	C21H15N3O4	214348	Major		Inter Info	[1], [2]

References
1	Product Information. Exjade (deferasirox). Novartis Pharmaceuticals, East Hanover, NJ.
2	Rafat C, Fakhouri F, Ribeil JA, Delarue R, Le Quintrec M "Fanconi Syndrome Due to Deferasirox." Am J Kidney Dis (2009):. [PMID: 19493602]
3	EMEA "EMEA public statement on leflunomide (ARAVA) - severe and serious hepatic reactions.".
4	Product Information. Arava (leflunomide). Hoechst Marion-Roussel Inc, Kansas City, MO.
5	Product Information. Aubagio (teriflunomide). Genzyme Corporation, Cambridge, MA.
6	Ragheb M, Ban TA, Buchanan D, Frolich JC "Interaction of indomethacin and ibuprofen with lithium in manic patients under a steady-state lithium level." J Clin Psychiatry 41 (1980): 397-8.[PMID: 7440513]
7	Khan IH "Lithium and non-steroidal anti-inflammatory drugs." Br Med J 302 (1991): 1537-8.[PMID: 1855032]
8	Monji A, Maekawa T, Miura T, et al. "Interactions between lithium and non-steroidal antiinflammatory drugs." Clin Neuropharmacol 25 (2002): 241-2.[PMID: 12410052]
9	Product Information. Juxtapid (lomitapide). Aegerion Pharmaceuticals Inc, Cambridge, MA.
10	Product Information. Kynamro (mipomersen). Genzyme Corporation, Cambridge, MA.
11	Product Information. Turalio (pexidartinib). Daiichi Sankyo, Inc., Parsippany, NJ.
12	Product Information. Acular (ketorolac). Allergan Inc, Irvine, CA.
13	Product Information. Nevanac (nepafenac ophthalmic). Alcon Laboratories Inc, Fort Worth, TX.
14	Product Information. Xibrom (bromfenac ophthalmic). ISTA Pharmaceuticals, Irvine, CA.
15	Bodmer M, Sulz M, Stadlmann S, Droll A, Terracciano L, Krahenbuhl S "Fatal liver failure in an adult patient with acute lymphoblastic leukemia following treatment with L-asparaginase." Digestion 74 (2006): epub. [PMID: 16988508]
16	Cerner Multum, Inc. "Australian Product Information.".
17	Product Information. Oncaspar (pegaspargase). Rhone-Poulenc Rorer, Collegeville, PA.
18	Product Information. Solaraze (diclofenac topical). Doak Dermatologics Division, Fairfield, NJ.
19	Product Information. Hivid (zalcitabine). Roche Laboratories, Nutley, NJ.
20	Product Information. Sirturo (bedaquiline). Janssen Pharmaceuticals, Titusville, NJ.
21	Product Information. Adcetris (brentuximab vedotin). Seattle Genetics Inc, Bothell, WA.
22	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
23	Product Information. Epidiolex (cannabidiol). Greenwich Biosciences Inc, Carlsbad, CA.
24	Product Information. Zydelig (idelalisib). Gilead Sciences, Foster City, CA.
25	Product Information. ReVia (naltrexone). DuPont Pharmaceuticals, Wilmington, DE.
26	Product Information. Betaseron (interferon beta-1b). Berlex, Richmond, CA.
27	Product Information. Plegridy (peginterferon beta-1a). Biogen Idec Inc, Cambridge, MA.
28	Product Information. Rebif (interferon beta-1a). Serono Laboratories Inc, Norwell, MA.
29	Canadian Pharmacists Association.
30	Product Information. Trental (pentoxifylline). Hoechst Marion-Roussel Inc, Kansas City, MO.
31	European Medicines Agency "Summary on compassionate use. Remdesivir Gilead.".
32	Gilead Sciences, Inc "About Remdesivir.".
33	US Food and Drug Administration "Fact sheet for health care providers emergency use authorization (EUA) of remdesivir (GS-5734TM)".
34	Product Information. Yondelis (trabectedin). Janssen Pharmaceuticals, Titusville, NJ.
35	Nesher G, Mates M, Zevin S "Effect of caffeine consumption on efficacy of methotrexate in rheumatoid arthritis." Arthritis Rheum 48 (2003): 571-572. [PMID: 12571869]
36	Product Information. Methotrexate (methotrexate). Lederle Laboratories, Wayne, NJ.
37	Product Information. Tabloid (thioguanine). Prasco Laboratories, Cincinnati, OH.

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