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Diclofenac vs Hydrochlorothiazide: side-by-side comparison

Diclofenac (NSAID (phenylacetic acid)) and Hydrochlorothiazide (Thiazide diuretic) belong to different therapeutic classes and are rarely substitutes for each other. The comparison is useful when a single patient is weighing both options for adjacent or overlapping needs.

Property Diclofenac Hydrochlorothiazide
Therapeutic class NSAID (phenylacetic acid) Thiazide diuretic
CAS 15307-86-5 58-93-5
ATC M01AB05 C03AA03
Molecular weight 296.15 g/mol 297.74 g/mol
Brands with this active ingredient 1 1

What they share

Diclofenac and Hydrochlorothiazide share the common regulatory framework for prescription active ingredients, bioequivalence standards for generics, and pharmacist oversight. Beyond that, points in common are limited.

Key differences

Diclofenac acts by a different mechanism than Hydrochlorothiazide, with indications that barely overlap. Comparing the two is useful when a clinician has mentioned both in the same context or the patient wants to understand why one was prescribed instead of the other.

Mechanisms compared

Diclofenac: Diclofenac reversibly inhibits cyclooxygenase enzymes COX-1 and COX-2, with somewhat greater selectivity for COX-2 than ibuprofen and naproxen. Hydrochlorothiazide: Hydrochlorothiazide blocks the sodium-chloride symporter in the distal convoluted tubule of the kidney, reducing sodium reabsorption and producing modest diuresis.

Indications compared

Diclofenac: Diclofenac is approved in adults for the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute musculoskeletal pain, post-surgical pain, primary dysmenorrhoea, acute migraine and ureteric colic… Hydrochlorothiazide: Hydrochlorothiazide is approved for hypertension (alone or in combination), oedema in heart failure, hepatic cirrhosis or nephrotic syndrome, and certain renal conditions.

Safety profile

Diclofenac: Common adverse effects include gastrointestinal symptoms, headache, dizziness and elevated liver enzymes. Hydrochlorothiazide: Common adverse effects include hypokalaemia, hyponatraemia, hyperuricaemia (with gout flares), hyperglycaemia, dyslipidaemia and orthostatic hypotension.

Frequently asked questions

Is Diclofenac better than Hydrochlorothiazide?

Diclofenac and Hydrochlorothiazide are not "better or worse" — they treat different things. The sensible question is which fits your specific need.

Can Diclofenac and Hydrochlorothiazide be combined?

Whether they can be combined depends on the indications and the interaction profile of each. If both are in a single prescription, the prescriber has weighed it; in self-medication they should never be combined.

Do they have the same side-effect profile?

No — they belong to different classes and have distinct side-effect profiles. Each has its own prescribing information.

Products with Diclofenac

Products with Hydrochlorothiazide

The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.