Voveran SR

Voveran SR contains diclofenac sodium, a non-steroidal anti-inflammatory drug that reduces the production of prostaglandins, the chemicals that fuel pain, stiffness and swelling in joints and soft tissues. The SR in the name stands for slow release: each 100 mg tablet lets the drug out gradually, so one tablet covers the day. UK prolonged-release diclofenac 100 mg is used in rheumatoid arthritis, osteoarthritis, ankylosing spondylitis and painful musculoskeletal conditions. It eases symptoms, and it leaves the underlying joint disease where it was.

Only the 100 mg tablet is stocked. Packs hold 30, 60, 90, 120, 180 or 360 tablets, which is a lot of NSAID to keep in the house, so store the blisters in a dry cupboard well away from children. The tablets are imported, and Voveran is not the name of any UK-licensed product. For the same ingredient and strength, British prescribers have several licensed prolonged-release products to turn to, from a number of manufacturers.

Voveran SR is a 100 mg prolonged-release tablet, taken once a day, swallowed whole with water, with or after food, and never crushed or chewed because that would defeat the slow-release design. The SmPC asks for the smallest effective dose over the shortest possible time, which matters more with diclofenac than with many other painkillers. If someone needs more than 100 mg in a day, the total should stay at or below 150 mg, usually topped up with an ordinary 25 or 50 mg diclofenac tablet. Frail or underweight people are watched especially closely, and the medicine is not intended for children.

Voveran SR is not for people with a stomach or duodenal ulcer, a past bleed or perforation linked to NSAIDs, heart failure of NYHA class II to IV, established ischaemic heart disease, peripheral arterial disease, cerebrovascular disease, or severe liver or kidney failure. It should never follow an episode of asthma, hives or a runny nose brought on by aspirin or another NSAID. It must not be taken in the final three months of pregnancy. Taken at high dose for long periods, diclofenac slightly raises the risk of heart attack and stroke, and like other NSAIDs it may make it harder for a woman to conceive.

Lithium, digoxin and methotrexate can all rise to higher levels when Voveran SR is added, and ciclosporin and tacrolimus put the kidneys at greater risk. Diuretics and blood pressure tablets may work less well. Warfarin and other anticoagulants, steroid tablets, SSRI antidepressants and aspirin make gut bleeding more likely. Phenytoin levels need watching. Voriconazole raises the amount of diclofenac in the body, and quinolone antibiotics bring a small extra risk of seizures. A pharmacist can check your whole list in a few minutes.

Indigestion, stomach pain, nausea, headache, dizziness, a raised liver enzyme result and a rash are the more frequent reactions. Black or tarry stools, blood in vomit, yellowing of the skin or eyes, chest pain, breathlessness or weakness on one side of the body need immediate help from 999 or A&E. Do not add another NSAID, such as over-the-counter ibuprofen or aspirin tablets, on top of this one. The decision to use Voveran SR, and for how long, rests with your doctor.