Overview
Diclofenac is a potent, prescription-strength nonsteroidal anti-inflammatory drug (NSAID) primarily utilized for the management of moderate to severe pain and significant inflammatory conditions. It is particularly indicated for musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute injury-related inflammation.

Mechanism of Action
Its mechanism of action involves the robust non-selective inhibition of both COX-1 and COX-2 enzymes. By blocking these enzymes, diclofenac drastically reduces the production of prostaglandins at the site of inflammation, thereby effectively alleviating pain, swelling, and joint stiffness.

Dosage and Administration
The typical adult oral dosage ranges from 50 mg to 100 mg daily, usually divided into two or three doses. The maximum daily limit is generally 150 mg. Due to its potency and potential for gastrointestinal irritation, it is imperative to take diclofenac with or immediately after food.

Side Effects
Due to its potency, diclofenac carries a notably higher risk of adverse gastrointestinal events, including severe bleeding, ulceration, and perforation, compared to milder NSAIDs. Furthermore, systemic use of diclofenac is associated with an elevated risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke.

Contraindications
It is strictly contraindicated in patients with a history of ischemic heart disease, stroke, congestive heart failure, or active gastrointestinal bleeding/ulcers. It should also not be used by patients who experience asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.

Pregnancy and Lactation
Use of diclofenac during the third trimester of pregnancy is strictly contraindicated due to the risk of premature closure of the fetal ductus arteriosus. It should be used with extreme caution during the first and second trimesters and during lactation, only if the potential benefit justifies the risk.