Diclofenaco Use During Pregnancy

Introduction to Diclofenaco Safety

The European League Against Rheumatism (EULAR) 2025 data confirms that early exposure to nonsteroidal anti-inflammatory drugs (NSAIDs), including diclofenaco, shows no evidence of increased risk of spontaneous abortion or teratogenicity 1
NSAIDs, including diclofenaco, may interfere with ovulation by causing luteinized unruptured follicle syndrome (LUF), reducing fertility 1

Diclofenaco is not teratogenic and may be used if necessary during the first trimester, according to the Annals of the Rheumatic Diseases 1
The use of diclofenaco in the first trimester does not increase the risk of congenital defects or spontaneous abortion, as per the EULAR 2025 guidelines 1

Short-term use (7-10 days) in the early second trimester is relatively safe, but requires strict precautions after week 20, as recommended by the EULAR and Arthritis Care & Research 1, 2
The use of diclofenaco after week 20 requires careful monitoring due to the risk of fetal renal dysfunction and oligohydramnios, as stated by the EULAR and Arthritis Care & Research 1, 2

Diclofenaco is contraindicated after week 28 of gestation due to the risk of premature closure of the fetal ductus arteriosus and fetal renal damage, as recommended by the EULAR and Arthritis Care & Research 1, 2
The use of diclofenaco after week 28 can cause severe fetal risks, including oligohydramnios, renal damage, and premature closure of the ductus arteriosus, as stated by the EULAR and Arthritis Care & Research 1, 2

If a patient is taking diclofenaco and plans to become pregnant, consider switching to acetaminophen as the first-line analgesic, or use ibuprofen if an NSAID is required, as recommended by the EULAR 1
If a pregnant patient needs analgesia, use the lowest effective dose of diclofenaco for the shortest possible duration, and avoid use after week 20 if possible, as stated by the EULAR 1

Do not assume that diclofenaco is safe to use freely until week 28, as fetal renal risks begin around week 20, as warned by the EULAR and Arthritis Care & Research 1, 2
Avoid using high doses (≥150 mg/day) for prolonged periods, even in the early second trimester, due to the risk of oligohydramnios, as stated by the EULAR and Arthritis Care & Research 1, 2
Be cautious with chronic use in women trying to conceive, as NSAIDs can cause LUF syndrome and reduce fertility, as recommended by the EULAR 1