The risk may be higher for people who use NSAIDs for a long time, are 60 years of age or older, have poor health, smoke, or drink alcohol while using topical diclofenac. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. NSAIDs such as topical diclofenac (Pennsaid, Voltaren) may cause swelling, ulcers, bleeding, or holes in the stomach or intestine. If you will be undergoing a coronary artery bypass graft (CABG a type of heart surgery), you should not use topical diclofenac (Pennsaid, Voltaren) right before or right after the surgery. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of your body, or slurred speech. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke if you smoke and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Do not use an NSAID such as topical diclofenac if you have recently had a heart attack, unless directed to do so by your doctor. This risk may be higher for people who use NSAIDs for a long time. These events may happen without warning and may cause death. People who use nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as topical diclofenac (Pennsaid, Voltaren) may have a higher risk of having a heart attack or a stroke than people who do not use these medications.
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