title: Lower gastrointestinal bleeding associated with diclofenac topical patch in a patient with colonic mass and on antiplatelet therapy for atrial fibrillation.
abstract: Topical formulations of diclofenac, a nonsteroidal anti-inflammatory drug commonly prescribed to treat musculoskeletal complaints such as osteoarthritis, low back pain, and myofascial pain, are available in the form of a solution, gel, and patch. The topical application of diclofenac results in substantially lower systemic exposure to diclofenac compared with oral diclofenac, resulting in a more favorable side effect profile. To the authors' knowledge, this is the first case report of a lower gastrointestinal bleed associated with diclofenac topical patch use in a 77 yr-old-woman with a history of colonic mass and atrial fibrillation on antiplatelet therapy.
authors.affiliation: From the Emory University School of Medicine, Department of Physical Medicine and Rehabilitation, Atlanta, Georgia.
authors.forename: Jacob
authors.initials: J
authors.lastname: Lee
authors.forename: David T
authors.initials: DT
authors.lastname: Burke
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D000077144:Clopidogrel; D003110:Colonic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D003113:Colonoscopy / Q000379:methods; D004008:Diclofenac / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009209:Myofascial Pain Syndromes / Q000175:diagnosis / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D057968:Transdermal Patch / Q000009:adverse effects
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors; D004008:Diclofenac; D000077144:Clopidogrel; D013988:Ticlopidine