Transdermal diclofenac, a nonsteroidal anti-inflammatory drug (NSAID) delivered via patch, can trigger serious allergic and systemic reactions. These include severe skin conditions like Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), as well as multiorgan hypersensitivity (DRESS syndrome). Beyond allergic responses, it may elevate cardiovascular risks (heart attack, stroke), cause gastrointestinal bleeding, and impair liver/kidney function. The risks escalate with prolonged use, age, or preexisting conditions. Immediate medical attention is critical for symptoms like rash with fever, facial swelling, or difficulty breathing.
Key Points Explained:
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Severe Allergic Reactions
- DRESS Syndrome: A systemic hypersensitivity reaction involving eosinophilia (high white blood cell count) and organ inflammation, particularly affecting the liver, kidneys, and heart. Symptoms include fever, rash, and swollen lymph nodes.
- Anaphylaxis: Rare but life-threatening, presenting with hives, throat swelling, and hypotension.
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Severe Skin Reactions
- Stevens-Johnson Syndrome (SJS) & Toxic Epidermal Necrolysis (TEN): Painful blistering and skin peeling, often preceded by flu-like symptoms. These conditions require emergency care.
- Link to Diclofenac Transdermal Patch for absorption-related risks.
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Cardiovascular Risks
- Increased risk of heart attack or stroke, even in short-term use. NSAIDs like diclofenac may elevate blood pressure and cause fluid retention, worsening heart failure.
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Gastrointestinal Damage
- Ulcers, bleeding, or perforations in the stomach/intesines, sometimes fatal. Risk factors include age >65, alcohol use, or concurrent corticosteroids.
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Organ Toxicity
- Liver Damage: Jaundice, fatigue, or abdominal pain signal potential hepatitis.
- Kidney Impairment: Reduced urine output or swelling in legs due to fluid retention.
- Hyperkalemia: High potassium levels can disrupt heart rhythm.
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Risk Factors
- Long-term use, smoking, or comorbidities (e.g., diabetes) amplify risks.
Why does this matter? These reactions underscore the need for vigilance with NSAID patches, especially in vulnerable populations. Always monitor for early signs like unexplained rashes or breathing difficulties.
Summary Table:
| Reaction Type | Symptoms | Emergency Signs |
|---|---|---|
| Severe Allergic | DRESS syndrome (fever, rash, organ inflammation), anaphylaxis (throat swelling) | Facial swelling, difficulty breathing, hypotension |
| Skin Reactions | SJS/TEN (blistering, skin peeling), rash with fever | Widespread rash, flu-like symptoms |
| Cardiovascular | Heart attack, stroke, high blood pressure | Chest pain, sudden weakness, slurred speech |
| Gastrointestinal | Bleeding, ulcers, perforations | Black/tarry stools, severe abdominal pain |
| Organ Toxicity | Liver damage (jaundice), kidney failure (swelling), hyperkalemia | Fatigue, reduced urine output, irregular heartbeat |
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