NSAIDS AND OPIOIDS - DICLOFENAC

N An isolated report describes grand mal seizures in a patient given diclofenac and
pentazocine. Diclofenac did not alter morphine pharmacokinetics in one study. However, in another, diclofenac slightly increased respiratory depression despite a reduction in morphine use, possibly because of persistent levels of an active metabolite of morphine.
These interactions are not established and they seem unlikely to be of general significance, but be alert to the possibility of increased sedation, or, with pentazocine, use with caution in patients who are known to be seizure-prone.
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