ModerateClass III antiarrhythmics (Vaughan Williams)×Non-steroidal anti-inflammatory drugs (NSAIDs)
Updated · Methodology
Mechanism
No direct pharmacokinetic interaction. Additive bleeding risk in patients on concurrent warfarin or amiodarone (the latter enhances anticoagulation via CYP2C9 inhibition).
Symptoms
Epigastric pain, heartburn, black or tarry stools, gum bleeding, bruising. Higher risk in older patients and prior peptic ulcer disease.
Management
For short diclofenac courses (3–7 days), no specific adjustment needed. For long-term needs, consider paracetamol up to 2 g/day, topical NSAIDs, or physiotherapy. Avoid NSAIDs on a warfarin-amiodarone regimen.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Amiodarone hydrochloride tablet (Dr. Reddy's Labratories Inc.) – Prescribing Information (2018)– ; DailyMed setid 95cef33b-c0e6-b17c-7cbb-f5c066872705
- AEMPS: Ficha técnica: Diclofenaco (nº registro 62161), sección 4.5 (2025)– AEMPS, CIMA, nº registro 62161, revisión 08/2025, sección 4.5