Tell your doctor or pharmacist if you are taking or have recently taken any other medicines, and about any medicines you plan to take. It is especially important to tell your doctor or pharmacist if you are taking the following medicines:

• lithium or antidepressants (medicines to treat depression);
• digoxin (a medicine to treat heart problems);
• angiotensin converting enzyme inhibitors or beta-blockers (medicines used to treat high blood pressure or heart failure);
• methotrexate (a medicine used to treat certain types of cancer or arthritis);
• drugs for the treatment of diabetes mellitus, except insulin;
• diuretics (drugs that increase the amount of urine you pass);
• drugs that reduce blood clotting (anticoagulants and antiplatelet drugs);
• other anti-inflammatory or analgesic drugs such as acetylsalicylic acid or ibuprofen;
• corticosteroids (medicines to treat inflammation);
• cyclosporine and tacrolimus (medicines used in people after organ transplants);
• trimethoprim (a medicine used to prevent and treat urinary tract infections);
• antibacterial quinolones (medicines to treat infections);
• sulfinpyrazone (a medicine to treat gout) or voriconazole (a medicine to treat fungal infections);
• phenytoin (a medicine to treat epilepsy);
• colestipol or cholestyramine (medicines used to lower cholesterol).

Side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. If you get any side effects, talk to your doctor or pharmacist, including any possible side effects not listed in this leaflet. Some side effects can be serious Some side effects are uncommon, especially when used at high doses (150 mg daily) and over a long period of time. This frequency is expected to be lower with short term use at low doses (up to 75 mg / day).

Uncommon – may affect 1 to 10 in 1,000 people using this medicine:

• palpitations, sudden and pressing pain in the chest (signs of a heart attack or heart attack);
• shortness of breath, difficulty breathing when lying down, swelling of the feet or legs (signs of heart failure).

Occasionally, rarely or very rarely, side effects can be serious.

If you notice any of the following side effects, stop taking this medicine and contact your doctor immediately:

• Mild painful cramps and tenderness of the abdomen, beginning soon after starting Voltaren Express and followed by rectal bleeding or bloody diarrhea, generally within 24 hours of the onset of abdominal pain (frequency not known – cannot be estimated from the available data) ).
• severe stomach pain, blood in the stools, tarry stools, bloody vomiting, bloody diarrhea;
• allergic reactions including difficulty breathing or swallowing, swelling of the face, lips, tongue or throat, often accompanied by a skin rash, collapse;
• sudden difficulty in breathing and tightness of the chest with wheezing or coughing (signs of asthma);
• sudden difficulty in breathing and a feeling of heaviness in the chest with wheezing or coughing (signs of pneumonia);
• sudden and sharp headache, neck stiffness, difficulty speaking, seizures
• reddening of the skin with blisters, peeling of the skin, purple skin lesions, blistering of the mucosa in the mouth or eyes, skin inflammation with peeling skin;
• swelling of the arms, hands, legs and feet;
• any changes in the appearance or amount of urine, proteinuria, haematuria;
• yellowing of the skin or eyes (signs of liver damage and / or liver failure), increase in liver enzymes;
• bleeding, bruising, high fever or prolonged sore throat, frequent infections;
• increased skin sensitivity to the sun. Taking medications like diclofenac may be associated with a slightly increased risk of heart attack or stroke. The risk is increased when high doses are used for long periods. Other side effects

The side effects that may occur are usually mild. Some side effects have been seen with higher doses of diclofenac, the active ingredient of Voltaren Express Forte, when used over a long period of time. If you notice them, contact your doctor or pharmacist.

Common (occurs in less than 1 in 10 people using the medicine):

• stomach pain, diarrhea, nausea, gas, vomiting, indigestion, decreased appetite;
• headache, dizziness;
• rash.

Rare (occurs in less than 1 in 1,000 people using the drug):

• somnolence;
• itchy rash.

Very rare (affects less than 1 in 10,000 people using the medicine): –

• low amount of white blood cells, low amount of red blood cells;
• constipation, inflammation of the oral mucosa, swollen red sore tongue, taste disturbance, upper abdominal cramps;
• tingling or numbness in the hands or feet, tremors;
• itching and redness of the skin, hair loss;
• blurred vision, ringing in the ears, hearing impairment;
• mood changes, difficulty falling asleep, feeling confused.