What medication should you not take with Voltaren?

October 8, 2025 •

4 min read

Each year in the United States, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is linked to about 100,000 hospitalizations [1.9.1, 1.9.2]. Understanding what medication you should not take with Voltaren, a potent NSAID, is crucial for avoiding serious health risks.

Quick Summary

A crucial overview of medicines that interact with Voltaren (diclofenac). Details the significant risks of combining it with other NSAIDs, blood thinners, antidepressants, and certain blood pressure drugs.

Key Points

Other NSAIDs: Combining Voltaren with ibuprofen or naproxen greatly increases the risk of stomach bleeding and kidney damage and should be avoided [1.4.4, 1.4.5].
Blood Thinners: Taking Voltaren with anticoagulants like warfarin or apixaban can lead to a dangerously high risk of severe bleeding [1.3.1, 1.3.3].
Blood Pressure Meds: Voltaren can reduce the effectiveness of ACE inhibitors, ARBs, and diuretics, potentially raising blood pressure and harming the kidneys [1.5.2, 1.5.3].
Antidepressants (SSRIs/SNRIs): Concurrent use with medications like fluoxetine or sertraline increases the risk of gastrointestinal bleeding [1.6.1, 1.6.2].
Methotrexate & Lithium: Voltaren can cause toxic levels of methotrexate and lithium to build up in the body, leading to severe side effects [1.7.2, 1.7.5].
Corticosteroids: Using Voltaren with steroids like prednisone significantly raises the risk of stomach ulcers and bleeding [1.8.1, 1.8.2].
Always Disclose: Inform your doctor about all medications, including over-the-counter drugs and supplements, before starting Voltaren to prevent harmful interactions [1.2.3, 1.4.1].

Understanding Voltaren (Diclofenac) and Its Risks

Voltaren, with the active ingredient diclofenac, is a nonsteroidal anti-inflammatory drug (NSAID) commonly prescribed to treat pain and inflammation from conditions like osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis [1.2.1, 1.2.6]. It works by inhibiting cyclooxygenase (COX) enzymes, which reduces the production of prostaglandins—substances in the body that cause pain and inflammation. While effective, Voltaren carries a risk of significant drug interactions that can lead to severe health complications, including gastrointestinal bleeding, kidney problems, and cardiovascular events [1.2.3, 1.4.2]. It is vital to manage its use carefully and in full consultation with a healthcare provider.

Major Drug Classes That Interact with Voltaren

Combining Voltaren with certain other medications can either increase the risk of dangerous side effects or reduce the effectiveness of one or both drugs. Below are the primary classes of medications to be aware of.

Other NSAIDs (e.g., Ibuprofen, Naproxen)

This is one of the most critical interactions. Since diclofenac is itself an NSAID, taking it with other NSAIDs like ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or aspirin is generally not recommended [1.4.3, 1.4.4]. Doing so does not provide additional pain relief but significantly elevates the risk of serious side effects, including stomach ulcers, gastrointestinal bleeding, and kidney damage [1.4.5, 1.4.6]. Many over-the-counter cold and flu remedies contain NSAIDs, so it is essential to read all medication labels carefully [1.4.3].

Anticoagulants and Antiplatelets (Blood Thinners)

This category includes medications like warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), and clopidogrel (Plavix) [1.2.1, 1.3.1]. Voltaren has its own antiplatelet effects and can cause bleeding [1.2.3]. When combined with blood thinners, the risk of serious and potentially fatal bleeding is greatly increased [1.3.1, 1.3.3]. Patients should seek immediate medical attention if they experience unusual bruising, black or tarry stools, or vomit that looks like coffee grounds [1.3.2]. Even topical Voltaren gel can interact with oral blood thinners [1.3.4].

Blood Pressure Medications

Voltaren can interfere with medications used to control high blood pressure, making them less effective and increasing cardiovascular risk [1.5.1, 1.5.2]. Key interactions include:

ACE Inhibitors and ARBs: Drugs like lisinopril (Zestril) and losartan (Cozaar) can become less effective when taken with Voltaren. This combination also heightens the risk of kidney damage, particularly in older adults or those who are dehydrated [1.2.1, 1.5.2, 1.5.3].
Diuretics ("Water Pills"): Medications such as furosemide (Lasix) and hydrochlorothiazide can have their blood pressure-lowering effects diminished by Voltaren. The combination also increases the strain on the kidneys [1.2.1, 1.5.2].
Beta-Blockers: Metoprolol (Lopressor) and propranolol may also be less effective at controlling blood pressure when used with Voltaren [1.2.1, 1.5.2].

Certain Antidepressants (SSRIs and SNRIs)

Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro), as well as Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like duloxetine (Cymbalta), can increase the risk of bleeding when taken with Voltaren [1.2.1, 1.6.1]. The combined use potentiates the risk of gastrointestinal bleeding and ulcers [1.6.1, 1.6.2]. A healthcare provider may need to monitor patients on this combination more closely or suggest medication to protect the stomach [1.4.5].

Corticosteroids

Oral corticosteroids like prednisone, when taken with Voltaren, significantly increase the risk of developing stomach ulcers and gastrointestinal bleeding [1.8.1, 1.8.2]. This combination should generally be avoided if possible. If they must be used together, a doctor might add a stomach-protecting medication [1.8.1, 1.8.4].

Other Significant Interactions

Methotrexate: Used for cancer and autoimmune diseases, methotrexate levels can become toxic when taken with Voltaren, as diclofenac can reduce its clearance from the body. This can lead to severe side effects, including bone marrow suppression and kidney damage [1.7.1, 1.7.2, 1.7.4].
Lithium: Voltaren can increase lithium levels in the blood, leading to lithium toxicity. Symptoms include confusion, vomiting, muscle weakness, and seizures [1.2.3, 1.7.5].
Cyclosporine: This immunosuppressant, often used after organ transplants, can have its risk of kidney damage amplified when combined with Voltaren [1.2.1, 1.7.3].
Digoxin: Used for heart conditions, digoxin levels can be increased by Voltaren, raising the risk of toxicity, which can manifest as heart palpitations and fainting [1.2.3].

Comparison Table: Key Voltaren (Diclofenac) Interactions


Interacting Drug Class	Example Medications	Potential Risk/Effect
Other NSAIDs	Ibuprofen (Advil), Naproxen (Aleve), Aspirin	Increased risk of GI bleeding, ulcers, and kidney damage [1.2.1, 1.4.4].
Anticoagulants/Antiplatelets	Warfarin (Coumadin), Apixaban (Eliquis), Clopidogrel (Plavix)	Significantly increased risk of serious or fatal bleeding [1.3.1, 1.3.3].
Blood Pressure Meds (ACEi/ARBs/Diuretics)	Lisinopril (Zestril), Losartan (Cozaar), Furosemide (Lasix)	Reduced effectiveness of blood pressure control and increased risk of kidney damage [1.2.1, 1.5.2].
SSRIs/SNRIs	Fluoxetine (Prozac), Sertraline (Zoloft), Duloxetine (Cymbalta)	Increased risk of gastrointestinal bleeding [1.6.1, 1.6.4].
Corticosteroids	Prednisone, Dexamethasone	Heightened risk of stomach ulcers and GI bleeding [1.8.1, 1.8.2].
Methotrexate	Trexall, Otrexup	Increased methotrexate levels, leading to severe toxicity [1.7.2, 1.7.4].
Lithium	Lithobid	Increased lithium levels, leading to toxicity [1.7.5].

Conclusion: Prioritizing Safety Through Communication

Voltaren (diclofenac) is a powerful medication for managing pain and inflammation, but its potential for serious drug interactions cannot be overlooked. The most dangerous combinations involve other NSAIDs, blood thinners, and certain blood pressure medications. To ensure safety, it is imperative to provide your doctor and pharmacist with a complete list of all medications you take, including over-the-counter drugs, herbal products, and supplements [1.2.3, 1.4.1]. Never start or stop taking a medication with Voltaren without first consulting your healthcare provider. Being informed and proactive is the best defense against adverse drug events.

For more detailed information on diclofenac, you can visit the U.S. National Library of Medicine's MedlinePlus page.

Frequently Asked Questions

Yes, it is generally considered safe to take Tylenol (acetaminophen) with Voltaren because they work in different ways and are not known to interact. However, you should consult your healthcare provider, especially if you have liver problems [1.4.5, 1.4.6].

Combining Voltaren with even low-dose aspirin is generally not recommended as it increases the risk of gastrointestinal bleeding [1.2.6]. Regular use of Voltaren might also make aspirin less effective for heart protection. You should take aspirin at least 2 hours before Voltaren if your doctor approves it [1.4.5].

Taking ibuprofen and Voltaren (diclofenac) together is not recommended. Both are NSAIDs, and combining them significantly increases your risk of serious side effects like stomach ulcers, intestinal bleeding, and kidney damage, without offering more pain relief [1.4.4, 1.4.6].

It is recommended to avoid or limit alcohol consumption while taking Voltaren. Mixing alcohol with an NSAID like diclofenac increases the risk of serious gastrointestinal problems, including stomach bleeding and ulcers [1.2.1, 1.3.5].

You should avoid taking multiple NSAIDs concurrently. If you need to switch medications, consult your healthcare provider for guidance on the appropriate timing to minimize the risk of side effects [1.4.3, 1.4.6].

While topical forms of diclofenac, like Voltaren gel, result in lower systemic absorption, they can still interact with other medications, especially oral blood thinners like warfarin [1.3.4]. The risk is lower than with oral Voltaren, but you should still inform your doctor of all medications you use [1.4.5].

Signs of a serious interaction can include severe stomach pain, black or bloody stools, vomit that looks like coffee grounds, unexplained weight gain, shortness of breath, chest pain, weakness, or slurred speech. If you experience any of these, seek immediate medical help [1.2.6, 1.8.5].