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The VN is also believed to activate splenic sympathetic nerves via a vagal-sympathetic reflex, releasing NE that binds to splenic lymphocytes, promoting the release of ACh, which in turn inhibits the secretion of pro-inflammatory cytokines from splenic macrophages through a negative feedback loop, thereby exerting anti-inflammatory effects via the splenic sympathetic nerve pathway (103, 104)

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Studies on cytochrome-P450-mediated bioactivation of diclofenac in rats and in human hepatotocytes: identification of glutathione conjugated metabolites

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Common side effects, if any, are mild and transient, including abdominal cramping, bloating, and loose stools