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Diclofenac for Gout - The Downside


The sense of urgency created by gout attacks rarely fails to garner the attention it seeks. Well, who will want to suffer from the burning pain and fiery inflammation for a long time! At least, not me and most likely not you. Because of this, the faster the medicine the better it is for gout sufferers. The second criteria of medication will be the effectiveness. Who will want a fast medicine that does nothing?
This article aims to explain the use of diclofenac for gout. What is the proper dosage? Does it really work in treating gout? Find out more in this article.
Diclofenac is Effective for Headache. But how about for gout?
Diclofenac is very effective when it comes to eliminating headache and migraine. How about gout? As we know gout is something far different from those conditions.
Actually, compared to other NSAIDs, diclofenac performs quite OK for gout. It is much slower, but it does less side effects.
So, what happens inside your body when you take diclofenac for gout? Let us zoom in millions of times to find out what really happens.
Diclofenac Mechanism of Action
To relieve pain and inflammation, diclofenac relies on disrupting pain and inflammation signals. Swallowing diclofenac is like swallowing a signal jammer!
The disrupted pain and inflammation signals are not just there to give you agony. They are actually warning calls sent to your alarm system, the nociceptors! Nociceptors then send signals to your brain and voila! Pain sets in and the gouty joint inflames. Take note that the signals sent by the nociceptors does not always send signals. This depends on the strength of the pain signal sent. Nociceptors have individual thresholds for pain signals. That means the nociceptor can tolerate up to a particular strength of signal. If the pain signal breaches this threshold, BOOM! The tragic chapter we call “gout attack” begins.
When cells die (such as when neutrophils die from a futile attempt to engulf the uric acid crystal), they release a substance called arachidonic acid. This is then converted by cyclooxygenase enzymes into prostaglandins, the pain signals! Then, prostaglandins will do a myriad of thins such as raise body temperature, cause inflammation and lower the pain threshold! *Coughs* Gout attack!
This is where the heroic (is it?) diclofenac comes in. Take diclofenac for gout and it will disrupt cyclooxygenase (cox) enzymes so the arachidonic acid will mostly remain untouched – they are not converted into prostaglandins! Hence, no pain occurs, no inflammation irritates you and no gout attack to ruin your day (or week). The best part is, diclofenac mostly inhibits only the cyclooxygenase cox2 and not cox1. In human language, this means that diclofenac causes relatively lower cases of gastrointestinal bleeding and ulceration compared to other NSAIDs.
Does all these benefits tempt you to take diclofenac for gout? Think twice! Read on and find out the cons of diclofenac.

The Downside of Diclofenac
The downside of diclofenac, when compared to other NSAIDs, is the fact that it has a relatively slower action. This is because it uses sodium salt base instead of potassium salt. This also means that it can induce undesired reactions to people who can not tolerate sodium.  Added to this is the fact that it CAN still cause ulceration and gastrointestinal bleeding.
Diclofenac can also cause depression, anxiety, irritability, nightmares, and psychotic reactions! Not to mention that it can cause Steven-Johnson Syndrome and Toxic Epidermal Necrolysis, two severe reactions that will cause the skin to peel-off. In worst cases, they cause organs to undergo necrosis (your own cells devouring each other!). This skin reactions are also side effects of allopurinol so if you have been taking diclofenac along allopurinol, that is twice the risk for you.
Taking risks is not that worth it, especially because it does not lower uric acid at all. Yes, diclofenac can temporarily relieve your pain, but sooner or later gout will come back to haunt you. As long as you do not address the hyperuricemia and acidosis problem properly, gout will be there lurking in the big toe, knees or whatever joint it is. Be wary as it can catch you off-guard.

Suggested Read: NSAIDs for Gout - Diclofenac vs Ibuprofen


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