Distil ← Back to home
Medication · nsaid

Supplements and Diclofenac sodium.

Every documented pair, every citation. Below: 6 documented pairs grouped by mechanism.

Diclofenac sodium, sold under the brand names Voltarol, Voltaren, is a non-steroidal anti-inflammatory drug (NSAID): it inhibits cyclooxygenase enzymes, with documented gastrointestinal and renal long-term risks.

Diclofenac sodium is an NSAID, a non-steroidal anti-inflammatory drug. The class inhibits cyclooxygenase enzymes (COX-1 and COX-2 depending on selectivity), reducing pain and inflammation driven by prostaglandins. It also reduces the protective gastric and renal prostaglandin signalling that drives the side effect profile. Use at high doses or sustained over time carries gastric ulceration risk (mitigated when a PPI is given alongside), reduced antihypertensive effect of ACE inhibitors and ARBs, additive renal stress in CKD3+, and additive antiplatelet effect with aspirin or clopidogrel. The supplement surface divides into two patterns. Compounds that target the same pathway (curcumin, boswellia, omega-3 EPA at higher doses) overlap mechanism with NSAIDs in the COX cascade. Additive effects are real but rarely problematic at OTC doses. Ginkgo, garlic extract, and fish oil at high doses add to bleeding risk when stacked with NSAIDs, especially around dental work or surgery.

Below are the 6 documented pairs we have explicitly assessed against Diclofenac sodium in the Distil database: 6 amber. The pairs cluster around 4 mechanisms: Absorption interference, Additive hyperkalaemia (raised potassium), Additive antiplatelet effect, and Reduced renal lithium clearance. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.

Documented interactions

Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.

Absorption interference

Amber Does Hibiscus Extract interact with ?

A small human study found that drinking a hibiscus beverage alongside diclofenac changed how much of the drug appeared in the urine, which suggests hibiscus may slightly affect how diclofenac is handled by the body. The effect is not well characterised and may be minor, but if you take both regularly it is worth separating them by a couple of hours and mentioning it to your GP or pharmacist.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

PMID 17094172 · BNF: Diclofenac

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Additive hyperkalaemia (raised potassium)

Amber Does Potassium interact with ?

Anti-inflammatory painkillers like diclofenac can make the kidneys hold on to a little more potassium. On their own the effect is usually small, but added to a potassium supplement, and especially if your kidneys are not working at full strength or you take a blood-pressure medicine that also raises potassium, it can nudge your potassium higher. If you take diclofenac regularly, mention any potassium supplement to your GP or pharmacist.

Evidence: Supported by human study data.

PMID 25047526 · PMID 1739077 · PMID 26935365 · BNF: Diclofenac

Additive antiplatelet effect

Amber Does Garlic Extract interact with ?

High-dose garlic extract has its own mild antiplatelet effect on top of diclofenac's. For occasional pain relief at standard doses, this is rarely a problem. For chronic NSAID use or pre-surgery, the combined effect can mean more bleeding and bruising.

Evidence: Limited human data, based on case reports and a known mechanism.

PMID 32478963 · PMID 29196903 · BNF: Diclofenac

Amber Does Ginkgo Biloba interact with ?

Both ginkgo and diclofenac can slow blood clotting. Used together for short periods at standard doses, the combined effect is usually mild. Used at high doses for long periods, the combined effect can mean more bleeding and bruising. Stop ginkgo at least two weeks before any planned surgery.

Evidence: Limited human data, based on case reports and a known mechanism.

PMID 22530457 · PMID 32478963 · PMID 29196903 · BNF: Diclofenac

Amber Does Omega-3 EPA interact with ?

High-dose omega-3 has a mild antiplatelet effect that adds to diclofenac's. At typical supplement doses and short-course NSAID use, the combined effect is usually mild. At high doses or for chronic NSAID use, the additive bleeding tendency is worth knowing about.

Evidence: Limited human data, based on case reports and a known mechanism.

PMID 21621252 · PMID 29196903 · BNF: Diclofenac

Reduced renal lithium clearance

Amber Does Lithium Orotate interact with ?

Anti-inflammatory painkillers such as diclofenac can make the kidneys hold on to lithium, which raises the lithium level in the blood. With prescription lithium this is a recognised caution. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take regular anti-inflammatories, check with your pharmacist or GP before using a lithium supplement.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

Loading database stats…

No affiliates. No commission. We earn nothing on what you buy.

For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP or pharmacist, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
Add every supplement you take. Type a name and click each match to add it, as many as you like.
Add all your medications, brand or generic. Type and click each match to add it.
Anything we should know? (optional)
Pick any that apply. We adjust the findings where context changes the answer.
Add all the supplements and medications you take, then check them together in one go.
Not sure where to start? Try one:
How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology
The full report

A full supplement review, built around you, not a generic stack.

The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.

  • what your diet already covers, so you are not adding a capsule for something food is already handling
  • which evidence-graded compounds are worth considering for your goals, and which were considered but left out
  • what to keep, change or stop from what you already take, plus the order to introduce anything new
  • how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment

The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.

£49 introductory price for early customers. Standard price £79.

Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.