Adults—Apply 4 grams (g) to the affected skin areas four times a day (a total of 16 g each day). However, the total dose should not exceed 32 g per day over all affected joints.
Symptoms of a diclofenac sodium overdose include: Diarrhea. Dizziness (common) Drowsiness (common)
The full effects of diclofenac gel are typically felt within 7 days of applying four times daily (although it is possible to feel some relief after a few hours), and may last for 1-2 days after final application. In addition, diclofenac gel should only be used on the hands, wrists, elbows, knees, ankles, and feet.
Diclofenac sodium topical gel may take up to 7 days to work for your arthritis pain; it is not for immediate relief. With 4 times-a-day use, you may start to feel relief within a few days. You should feel significant pain relief within 7 days of continuous use.
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.
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.
Voltaren Gel® is a type of nonsteroidal anti-inflammatory drug (NSAID) that treats joint pain caused by arthritis. The medication in Voltaren Gel is diclofenac. It works by decreasing inflammation.
Apply the gel to the directed skin areas, using the dosing card to help apply the gel to the skin to up to 2 body areas. Do not apply to more than 2 body areas. Use your hands to gently rub the gel into the skin. Make sure to cover the entire affected area with the gel.
Diclofenac sodium topical gel is a medication that treats arthritis of the knee. It's a type of NSAID that decreases inflammation. You can apply this gel to your skin as directed on the affected area of your body.
Research shows that diclofenac gel effectively relieves low back pain, especially when combined with other therapies such as muscle relaxers and ultrasound therapy (6).
A 25mg diclofenac tablet used to be available OTC in the USA but was withdrawn because of safety and efficacy reasons.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.
Lidocaine is an anesthetic and works by blocking nerve conduction to numb the feeling of pain. This makes the lidocaine versions of Aspercreme, Icy Hot, and Bengay better for nerve pain than Voltaren.
The authors conclude that celecoxib exhibits anti-inflammatory and analgesic activity comparable to that of diclofenac, but results in significantly better GI tolerability and safety.
Common side effects are stomach pain, feeling or being sick and rashes. Diclofenac gel and plasters can be used twice a day to target pain in a particular area of your body.
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.
Research shows diclofenac is the strongest and most effective non-steroidal anti-inflammatory medicine available.10 Diclofenec is sold under the prescription brand names Cambia, Cataflam, Zipsor, and Zorvolex. It is also available as a topical gel, Voltaren, which is available over the counter.
Other NSAIDs
You shouldn't take diclofenac with other NSAIDs, like ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). Most NSAIDs work similarly and can cause comparable side effects. These can be mild, like heartburn. But they can also be serious, like stomach ulcers or kidney damage.
The relative efficacy of the two drugs comes down to dose, 50 mg of diclofenac may provide better analgesia than 400 mg of ibuprofen but it is one third of the maximum daily dose whereas ibuprofen 400 mg is only one sixth.
At 2 hours, significantly more patients treated with ibuprofen/levomenthol gel reported a cooling sensation (45.8%) compared with diclofenac (16.4%) or ibuprofen (14.7%) gels, and both ibuprofen/levomenthol and diclofenac gels provided significantly more effective global pain relief compared with ibuprofen gel.
For Voltaren® 1% topical gel: After applying this medicine, do not shower, bathe, or wash the affected area for at least 1 hour.
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.
The gel should be applied within the oblong area of the dosing card up to the 2 or 4 gram line (2 grams for each elbow, wrist, or hand, and 4 grams for each knee, ankle, or foot). Apply the medicine very carefully to clean, dry skin, and avoid getting any in your eyes, nose, or mouth.
For superficial joints – like hands, wrists and even knees – it can be very effective. However, the joints of the cervical spine in the neck, and most of the shoulder joint, are deeper than the Voltaren can penetrate. Voltaren is not appreciably absorbed into the blood, so all of its actions are local.
Why can't I use Voltaren Arthritis Pain Gel for shoulders, hips, etc.? Voltaren has not been studied for the relief of arthritis pain in the shoulders, hips, and back.
Wash your hands after applying Voltaren Arthritis Pain gel, unless you are treating the skin on your hands. Wait at least 10 minutes before dressing or wearing gloves. Wait at least 1 hour before you bathe or shower. Do not apply to an open skin wound, or on areas of infection, rash, burn, or peeling skin.