Avoid giving diclofenac injection to a patient who drinks heavily or has suspected alcohol-related liver disease unless a clinician has assessed them.

Why:

For a one-time emergency dose, it is not automatically contraindicated solely because of alcohol use, but avoid or use only with medical supervision if there is active intoxication, heavy chronic use, jaundice, ascites, hematemesis/melena, known cirrhosis, abnormal LFTs, renal impairment, or bleeding risk. The official labeling lists alcohol use and advanced liver disease/coagulopathy as GI-bleeding risk factors, as described in DailyMed diclofenac safety information.

Consider non-NSAID pain options based on the cause and liver status. Do not combine diclofenac with alcohol, ibuprofen, naproxen, aspirin, anticoagulants, or steroids without clinician advice.

Diclofenac tablets should generally be avoided in a heavy alcohol user, especially with known or suspected liver disease.

Oral diclofenac has the same key risks as injection:

Do not use it without medical advice if there is cirrhosis, jaundice, vomiting blood, black stools, prior ulcer/GI bleed, kidney disease, blood thinners, or ongoing heavy drinking.

If prescribed, use only the lowest dose for the shortest duration, take after food, and avoid alcohol and other NSAIDs such as ibuprofen or naproxen. Seek urgent care for black stools, vomiting blood, severe abdominal pain, yellow eyes/skin, reduced urine, or fainting.