Nonprescription (over the counter) topical diclofenac comes as a 1% gel (Voltaren Arthritis Pain) to apply to up to 2 body areas (e.g., 1 knee and 1 ankle, 2 knees, 1 foot and 1 ankle, or 2 hands) 4 times daily for up to 21 days or as recommended by your doctor.
This medicine may increase your risk of having a heart attack or stroke. This is more likely in people who already have heart disease or in people who use this medicine for a long time. This medicine may cause bleeding in your stomach or bowels. These problems can happen without warning signs.
How long can I use diclofenac sodium topical gel? Use diclofenac sodium topical gel 4 times a day every day for up to 21 days for treatment of arthritis pain or as directed by your doctor.
Keep using this medicine for the full time of treatment. However, do not use this medicine more often or for a longer time than your doctor ordered. This medicine is not for long-term use.
Diclofenac is typically prescribed as a long-term treatment. You'll take the medication for as long as it's safe and effective in treating symptoms of your condition. Diclofenac can sometimes be used short term if this works to treat symptoms of your condition.
Keep using this medicine for the full time of treatment. However, do not use this medicine more often or for a longer time than your doctor ordered. This medicine is not for long-term use.
Is it safe to take long term? Diclofenac tablets and capsules can cause an ulcer in your stomach or gut if you take them for a long time or in big doses. There's also a small risk of heart failure or kidney failure if you take very big doses (150mg a day) for a long time.
Long-term treatment with Voltaren can change your liver enzymes. On a blood test, your levels might be higher than normal even before you have symptoms. This can be a sign of serious liver problems that could lead to the need for a liver transplant or even be fatal if not treated.
As a topical gel, a smaller amount of diclofenac from Voltaren Arthritis Pain Gel reaches the bloodstream compared with the oral form of diclofenac. In a clinical study, the systemic exposure with Voltaren Arthritis Pain Gel was 6%, or 94% less than the systemic exposure with the oral NSAID diclofenac.
Stomach or intestine problems. Take medications that treat or prevent blood clots. An unusual or allergic reaction to diclofenac, other medications, foods, dyes, or preservatives. Pregnant or trying to get pregnant.
Symptoms of overdose/swallowing may include: severe stomach pain, change in the amount of urine, slow/shallow breathing. Lab and/or medical tests (such as blood pressure, complete blood count, liver/kidney function) should be done while you are using this medication. Keep all medical and lab appointments.
Taking too much diclofenac sodium does not usually cause serious problems. The person may have some stomach pain and vomiting (possibly with blood). However, these symptoms will likely get better. In rare cases, a blood transfusion is needed.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most frequently prescribed medications worldwide. Diclofenac sodium (DS), one of these NSAIDs, has a high specificity for arachidonic acid-degrading cyclooxygenase (COX)-2 enzymes. This drug can be used to relieve neuropathic pain.
Diclofenac is the generic name for the active ingredient in Voltaren Arthritis Pain. Diclofenac is also available in oral formulations for a broader range of pain indications. Voltaren Arthritis Pain is made of a smooth, non-greasy formula that combines a gel and cream (Voltaren Emulgel™) for topical application.
Danish researchers reported that oral diclofenac (Cataflam, Voltaren) increased the risk of the side effects you mention. Topical diclofenac (patches, spray and gel) appears to offer good pain relief without causing severe digestive irritation or ulcers (British Journal of Sports Medicine, May 2018).
The level of drug entering the bloodstream is much lower than when the NSAID is taken by mouth. For example, topical NSAIDs reduce the systemic exposure by almost 90 percent. This minimizes the risk of harmful side effects.
The medication typically reaches its highest level in the body roughly 10 to 14 hours after applying it. Diclofenac sodium (the medication in Voltaren gel) can stay in the body for nearly 3 weeks.
Comparison of skin permeability for three diclofenac topical formulations: an in vitro study. Pharmazie 2014;69:27-31 [PubMed], [Web of Science ®], [Google Scholar]. An aqueous solution of diclofenac has been shown to penetrate to a depth of around 3–4 mm into the underlying dermis and subcutaneous tissue56.
Diclofenac is one of the most likely NSAIDs to cause liver injury. In many cases, the damage is significant enough to cause elevated liver function tests (LFTs) but not enough to cause symptoms. LFTs measure liver enzymes (proteins), and increased numbers point to possible liver injury.
How to use Voltaren Emulgel. Rub gently into the affected area 3 or 4 times daily. Do not use for more than 2 weeks except on medical advice. Voltaren Emulgel contains 11.6mg/g of active ingredient diclofenac diethylamine, which is a non-steroidal anti-inflammatory (NSAID).
Consumers should stop use and seek medical attention if their arthritis pain is not improved in 7 days or they need to use the product for more than 21 days. The active ingredient in Voltaren Arthritis Pain, diclofenac, may cause a severe allergic reaction, especially in people allergic to aspirin.
Don't use the gel for longer than 14 days unless it has been recommended by your doctor. People with osteoarthritis should see their doctor after four weeks of treatment.
Despite the risks associated with taking NSAIDs daily, people who have been taking NSAIDs daily for long periods of time should not stop taking them abruptly. The body's reaction to such a cutoff could make blood clots more likely, adding to the risk of heart attack or stroke.
Celecoxib 100 or 200 mg twice daily is as effective as diclofenac 50 mg BID and naproxen 500 mg BID in treating osteoarthritis. Significantly less ulcer complications occur with celecoxib as compared to NSAIDs both in patients taking concomitant aspirin and in those who are not.
A 25mg diclofenac tablet used to be available OTC in the USA but was withdrawn because of safety and efficacy reasons. Both ibuprofen and diclofenac are in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). They work by reducing hormones that cause inflammation and pain in the body.