Who should not use cataflam? Understanding the Contraindications

October 9, 2025 •

4 min read

According to the FDA, Cataflam, like other NSAIDs, carries a boxed warning about increased risk of serious cardiovascular and gastrointestinal side effects. Therefore, certain individuals with pre-existing conditions are at a significantly higher risk and should not use cataflam, while others must proceed with extreme caution.

Quick Summary

A detailed review of the major contraindications and health risks associated with Cataflam (diclofenac potassium), including conditions affecting the heart, stomach, kidneys, and pregnancy. The article provides essential information for determining who should avoid this NSAID for their safety.

Key Points

Cardiovascular Risks: Do not use Cataflam before or after heart bypass surgery (CABG) due to an increased risk of heart attack and stroke.
Gastrointestinal Bleeding: Avoid Cataflam if you have a history of stomach ulcers, active GI bleeding, or are at high risk for GI complications.
Pregnancy Concerns: Do not take Cataflam after 30 weeks of gestation, as it can harm the unborn baby's heart.
Kidney and Liver Disease: Severe liver or kidney impairment is a contraindication, and those with existing conditions need close monitoring.
Aspirin-Sensitive Asthma: Individuals with aspirin-sensitive asthma should not use Cataflam due to the risk of life-threatening allergic reactions.
Bleeding Disorders: Caution is necessary for those with bleeding problems or who are taking blood thinners.
Elderly Population: Older adults have a higher risk of adverse effects and should be carefully monitored when taking Cataflam.
Multi-Drug Interactions: Certain medications like ACE inhibitors, blood thinners, and other NSAIDs can increase the risks associated with Cataflam.

Cataflam (diclofenac potassium) is a powerful nonsteroidal anti-inflammatory drug (NSAID) used to treat pain, swelling, and inflammation. While effective for many, its potent nature means it is not safe for everyone. The drug has significant contraindications and warnings, particularly concerning cardiovascular health, gastrointestinal integrity, and fetal development. Anyone considering taking Cataflam must consult with a healthcare professional to assess their individual risk factors and determine if a different, safer treatment option is available.

Cardiovascular Risks and Contraindications

Cataflam carries a critical warning about the potential for serious and even fatal cardiovascular thrombotic events like heart attack and stroke, which can happen early in treatment and with increased risk at higher doses or longer use.

Patients who should avoid Cataflam based on heart health:

Coronary Artery Bypass Graft (CABG) Surgery: Cataflam is contraindicated immediately before or after CABG surgery due to a significantly increased risk of heart attack and stroke.
Known Cardiovascular Disease: Individuals with existing heart conditions such as heart attack, stroke, or congestive heart failure (NYHA class II-IV) should not take Cataflam as it elevates their already higher risk.
High Blood Pressure: Cataflam can cause new or worsen existing hypertension and can interfere with blood pressure medications.
Fluid Retention: Patients with fluid retention or heart failure should be cautious as Cataflam can cause fluid retention and edema.

Gastrointestinal Dangers

Cataflam and other NSAIDs can lead to serious and potentially fatal gastrointestinal issues like bleeding, ulceration, and perforation.

Individuals at risk for GI complications:

Active Ulcers or GI Bleeding: Cataflam is contraindicated for individuals with active peptic ulcers or a history of GI bleeding or perforation from NSAID use.
Increased Risk Factors: The risk of GI bleeding is heightened in older adults, those with a history of peptic ulcers, long-term NSAID users, and those taking certain other medications like corticosteroids or anticoagulants. Smoking and alcohol also increase risk.
Crohn's Disease or Ulcerative Colitis: These conditions increase the likelihood of complications from NSAID use.

Pregnancy, Fertility, and Breastfeeding

Cataflam use during pregnancy poses risks to the fetus.

Third Trimester: Cataflam is contraindicated from 30 weeks of gestation due to the risk of premature closure of the fetal ductus arteriosus.
20-30 Weeks Gestation: Use should be limited to the lowest dose for the shortest time, as it may cause fetal kidney issues and low amniotic fluid.
Female Fertility: Cataflam might temporarily delay ovulation and is not advised for women trying to conceive.
Breastfeeding: Diclofenac is found in breast milk in small amounts; healthcare providers should assess the potential risk to the infant.

Liver and Kidney Impairment

Cataflam is processed by the liver and eliminated by the kidneys, making it risky for those with liver or kidney disease.

Severe Impairment: Cataflam should not be used by patients with severe hepatic or renal impairment.
Existing Dysfunction: Caution is needed for those with less severe liver or kidney issues, potentially requiring lower doses and regular monitoring.
Signs of Toxicity: Watch for signs of liver damage (nausea, fatigue, jaundice) or kidney problems (swelling, changes in urination).

Other Important Contraindications

Several other conditions require avoiding or using Cataflam with extreme caution.

Aspirin-Sensitive Asthma: Patients with asthma, hives, or allergic reactions to aspirin or other NSAIDs should not use Cataflam due to the risk of severe, potentially fatal, allergic reactions.
Bleeding Disorders: Cataflam can affect platelet function, so those with active bleeding or bleeding disorders should avoid it. Close monitoring is needed for patients on blood thinners.
Severe Allergic Reactions: A history of a serious allergic reaction to diclofenac or its components is a contraindication.
Elderly Patients: Older adults face a higher risk of serious cardiovascular, GI, and kidney side effects. They should start with the lowest dose for the shortest duration and be monitored closely.

Comparison of Cataflam Risks with Other NSAIDs


Feature	Cataflam (Diclofenac)	Ibuprofen	Naproxen
Cardiovascular Risk	Elevated risk of heart attack and stroke, especially with long-term or high-dose use. Often considered a higher risk than ibuprofen.	Elevated risk, but potentially lower than diclofenac.	Elevated risk, similar to other NSAIDs.
Gastrointestinal Risk	Increased risk of serious GI bleeding, ulceration, and perforation, especially with cofactors.	Risk of GI bleeding and ulcers, though generally considered to have a slightly more favorable GI profile than diclofenac.	Risk of GI bleeding and ulcers, generally similar profile to ibuprofen.
Speed of Absorption	Immediate-release formulations (like Cataflam) offer rapid absorption for acute pain relief.	Typically rapid absorption for fast pain relief.	Slower absorption, leading to a longer duration of action.
Prescription Status	Generally requires a prescription due to its potency and side effect profile.	Available over-the-counter (OTC) at lower doses.	Available OTC at lower doses.
Safety in Pregnancy	Avoided after 30 weeks; restricted between 20-30 weeks.	Avoided after 30 weeks; restricted between 20-30 weeks.	Avoided after 30 weeks; restricted between 20-30 weeks.

Conclusion

Cataflam is an effective NSAID for pain and inflammation but carries significant risks, especially for those with heart, GI, or kidney conditions. It is also not advised during pregnancy, particularly later stages, or for those with aspirin-sensitive asthma. Due to these concerns, Cataflam should only be used under medical supervision at the lowest effective dose for the shortest time. A thorough medical evaluation is essential before use. For those with contraindications, alternative treatments should be discussed with a healthcare provider. Detailed prescribing information is available from the FDA.(https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020142s027lbl.pdf)

Frequently Asked Questions

No, individuals with known cardiovascular disease, congestive heart failure, or a history of heart attack or stroke should generally avoid Cataflam due to an increased risk of serious cardiovascular events.

No, Cataflam should be avoided in pregnant women from 30 weeks onward due to the risk of harming the fetus's heart. Use between 20 and 30 weeks should be limited and monitored by a doctor, while use in the first and second trimesters is also not without risk.

You should not use Cataflam if you have a history of peptic ulcers or gastrointestinal bleeding. Cataflam increases the risk of serious and potentially fatal GI bleeding, ulceration, and perforation.

Yes, Cataflam can cause or worsen liver and kidney problems, especially in those with pre-existing conditions. It is not recommended for patients with severe liver or kidney impairment, and regular monitoring is advised for those with less severe issues.

Elderly patients, individuals with cardiovascular or GI disease, and those on certain other medications like blood thinners are at a higher risk for serious side effects from Cataflam.

You should not use Cataflam if you have aspirin-sensitive asthma, as it can trigger severe, potentially fatal bronchospasm. Use in any patient with pre-existing asthma requires caution.

Taking Cataflam shortly before or after coronary artery bypass graft (CABG) surgery is contraindicated due to an increased risk of heart attack and stroke.