What Do I Need To Tell My Doctor Before I Take Diclofenac Gel
- If you have an allergy to diclofenac or any other part of diclofenac gel .
- If you have an allergy to aspirin or NSAIDs.
- If you are allergic to diclofenac gel any part of diclofenac gel or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you have ever had asthma caused by a salicylate drug like aspirin or a drug like this one like NSAIDs.
- If you have any of these health problems: Dehydration, GI bleeding, heart failure , kidney disease, or liver disease.
- If you have had a recent heart attack.
- If you are having trouble getting pregnant or you are having your fertility checked.
- If you are pregnant or may be pregnant. Do not take diclofenac gel if you are in the third trimester of pregnancy. You may also need to avoid diclofenac gel at other times during pregnancy. Talk with your doctor to see when you need to avoid taking diclofenac gel during pregnancy.
- If you are taking any other NSAID.
- If you are taking a salicylate drug like aspirin.
- If you are taking pemetrexed.
- If you are breast-feeding or plan to breast-feed.
This is not a list of all drugs or health problems that interact with diclofenac gel .
Tell your doctor and pharmacist about all of your drugs and health problems. You must check to make sure that it is safe for you to take diclofenac gel with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
Proper Use Of Diclofenac
Keep using diclofenac for the full time of treatment. However, do not use diclofenac more often or for a longer time than your doctor ordered. Diclofenac is not for long-term use.
Diclofenac comes with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.
Follow the instructions on the medicine label if you are using diclofenac without a prescription.
To use the skin patch or topical system:
To use the topical gel:
- Wash your hands before and after using diclofenac.
- For VoltarenÂ® 1% topical gel: Use the enclosed dosing card to measure the correct dose. The gel should be applied within the oblong area of the dosing card up to the 2 or 4 gram line .
- Apply the medicine very carefully to clean, dry skin, and avoid getting any in your eyes, nose, or mouth.
- Do not apply diclofenac to areas with broken skin or open wounds, infection, or severely peeling skin.
- Apply enough medicine each time to cover the entire affected area.
- Do not use heating pads or cover the treated area with a bandage unless your doctor has told you to.
- Do not use cosmetics or other skin care products on the same skin areas where you have applied diclofenac.
- For VoltarenÂ® 1% topical gel: After applying diclofenac, do not shower, bathe, or wash the affected area for at least 1 hour. Wait for at least 10 minutes before covering the treated skin with gloves or clothing.
To use the topical solution:
Gastrointestinal Bleeding Ulceration And Perforation
NSAIDs, including diclofenac, cause serious gastrointestinal adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal. These serious adverse events can occur at any time, with or without warning symptoms, in patients treated with NSAIDs. Only one in five patients who develop a serious upper GI adverse event on NSAID therapy is symptomatic. Upper GI ulcers, gross bleeding, or perforation caused by NSAIDs occurred in approximately 1% of patients treated for 3 to 6 months, and in about 2% to 4% of patients treated for one year. However, even short-term NSAID therapy is not without risk.
Risk Factors for GI Bleeding, Ulceration, and Perforation
Patients with a prior history of peptic ulcer disease and/or GI bleeding who used NSAIDs had a greater than 10-fold increased risk for developing a GI bleed compared to patients without these risk factors. Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors smoking use of alcohol older age and poor general health status. Most postmarketing reports of fatal GI events occurred in elderly or debilitated patients. Additionally, patients with advanced liver disease and/or coagulopathy are at increased risk for GI bleeding.
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What Is Diclofenac Topical
Diclofenac is a nonsteroidal anti-inflammatory drug .
Diclofenac topical is used to treat joint pain caused by osteoarthritis. diclofenac topical is for use on the hands, wrists, elbows, knees, ankles, or feet. Diclofenac topical may not be effective in treating arthritis pain elsewhere in the body.
Pennsaid is for use only on the knees.
Solaraze is used to treat warty overgrowths of skin on sun-exposed areas of the body.
Diclofenac topical may also be used for purposes not listed in this medication guide.
About Diclofenac Gel For Sun Damage
|Type of medicine|
|Treating solar keratosis|
|Available as||Skin gel|
Solaraze® and Solacutan® gels contain diclofenac, which is a non-steroidal anti-inflammatory drug . They are used to treat skin damage caused by sun exposure – a condition called solar keratosis. Topical treatments are useful if you have a lot of small solar keratoses. Solar keratoses are small, thickened, scaly growths which develop on the skin. They usually develop on areas of skin which have received a lot of sun exposure over a period of time.
There are other brands of diclofenac gel manufactured too, but these are used to treat painful muscle and joint conditions – they are not interchangeable with Solaraze® or Solacutan®. Please see the separate medicine leaflet called Diclofenac gel/patch for pain and inflammation for more information about these other products.
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How To Use Topical Diclofenac Solutions
Diclofenac gel must be prescribed by a medical professional. Consult with a doctor to determine the diclofenac solution that is right for you, and always follow the accompanying medication guide.
Voltaren and Pennsaid should be applied to clean, dry skin . Avoid showering or bathing for at least 30 minutes after applying these medications. Do not apply a bandage or dressing to the treated area, and avoid heat. Try to maintain a regular application schedule.
Be careful to avoid the eyes, nose, and mouth. Rinse with water or a saline solution if the medication gets in your eyes. If your eyes are still irritated after an hour, call poison control.
Avoid applying diclofenac gels and liquids to peeling, infected, swollen or broken skin. Do not apply to open wounds or areas covered with a rash, as doing so may irritate the skin.
Before using diclofenac gel, patch-test by applying the gel in a small area at first. If the skin shows no signs of irritation after 24 hours, the gel should be safe to use.
Store the gel at room temperature and out of the reach of children.
Follow the directions on your dosing card carefully when using diclofenac gel and be sure to apply it to clean, unbroken skin.
Diclofenac Topical Side Effects
Get emergency medical help if you have signs of an allergic reaction or a severe skin reaction .
Stop using diclofenac and seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.
Stop using diclofenac and seek emergency medical attention if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.
Also call your doctor at once if you have:
a skin rash, no matter how mild
swelling, rapid weight gain
severe headache, blurred vision, pounding in your neck or ears
little or no urination
low red blood cells –pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet or
signs of stomach bleeding–bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.
Common side effects of diclofenac topical may include:
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Ask A Doctor Before Use If
- you have problems or serious side effects from taking pain relievers or fever reducers
- stomach bleeding warning applies to you you have a history of stomach problems, such as heartburn
- you have high blood pressure, heart disease, liver cirrhosis, kidney disease, asthma, or had a stroke
- you are taking a diuretic
- you are under age 18 years. It is not known if this drug works or is safe in children under age 18 years.
Diclofenac Tablets Capsules And Suppositories
You’ll usually take diclofenac tablets, capsules or suppositories 2 to 3 times a day.
The usual dose is 75mg to 150mg a day, depending on what your doctor prescribes for you. Follow your doctor’s advice on how many tablets to take, and how many times a day.
If your doctor prescribes diclofenac for your child, they’ll use your child’s weight to work out the right dose for them.
If you have pain all the time, your doctor may recommend slow-release diclofenac tablets or capsules. You’ll usually take these either once a day in the evening, or twice a day. If you’re taking slow-release diclofenac twice a day, leave a gap of 10 to 12 hours between your doses.
How to take tablets and capsules
Swallow diclofenac tablets or capsules with a drink of milk. If you need to take them with water, take them after a meal or snack. Taking them with milk or food means they’ll be less likely to upset or irritate your stomach.
Swallow them whole, do not crush, break or chew them.
How to use suppositories
What if I use too many plasters or patches or too much gel?
If you use too many plasters or patches or too much gel by mistake, it’s unlikely to do you any harm. But if you use too much and get any side effects, tell your doctor straight away.
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Reduced Incidence Of Side Effects
Topical NSAIDs, including gels, liquids and patches are as effective as oral NSAIDs, but generally carry fewer risks and side effects .
Oral NSAIDs, such as ibuprofen, naproxen and aspirin, alleviate pain and swelling, but can increase blood pressure and exacerbate heart conditions. In recent years, the FDA has issued stronger warnings about the increased risk of heart attack and stroke due to oral NSAIDs . Additionally, these medications often cause stomach pain.
In contrast, research indicates that topical NSAIDs provide similar pain relief to oral NSAIDs, with less risk .
A 2017 study investigated the use of topical and oral NSAIDs in the treatment of rheumatoid arthritis, and found that topical NSAID use resulted in fewer instances of cardiovascular complications .
Another study compared oral and topical diclofenac solutions, and found that topical treatments resulted in fewer gastrointestinal and heart-related adverse events .â
Medication For Eczema & Dermatitis
At-home therapies alone may not relieve moderate-to-severe eczema and dermatitis. Our dermatologists understand that persistent, intense itching and rash, especially in visible places such as the face and hands, may significantly affect your life. NYU Langone doctors can recommend medications in a variety of forms to relieve symptoms and manage eczema and dermatitis for the long term.
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Adverse Reactions Reported For Oral Diclofenac Dosage Form
Body as a Whole: abdominal pain or cramps4, headache4, fluid retention4, abdominal distention4, malaise, swelling of lips and tongue, photosensitivity, anaphylaxis, anaphylactoid reactions, chest pain.
Cardiovascular: hypertension, congestive heart failure, palpitations, flushing, tachycardia, premature ventricular contractions, myocardial infarction, hypotension.
Digestive: diarrhea4, indigestion4, nausea4, constipation4, flatulence4, liver test abnormalities4, PUB4, i.e., peptic ulcer, with or without bleeding and/or perforation, or bleeding without ulcer, vomiting, jaundice, melena, esophageal lesions, aphthous stomatitis, dry mouth and mucous membranes, bloody diarrhea, hepatitis, hepatic necrosis, cirrhosis, hepatorenal syndrome, appetite change, pancreatitis with or without concomitant hepatitis, colitis, intestinal perforation.
Hemic and Lymphatic: hemoglobin decrease, leukopenia, thrombocytopenia, eosinophilia, hemolytic anemia, aplastic anemia, agranulocytosis, purpura, allergic purpura, bruising.
Metabolic and Nutritional Disorders: azotemia, hypoglycemia, weight loss.
Nervous System: dizziness4, insomnia, drowsiness, depression, diplopia, anxiety, irritability, aseptic meningitis, convulsions, paresthesia, memory disturbance, nightmares, tremor, tic, abnormal coordination, disorientation, psychotic reaction.
Respiratory: epistaxis, asthma, laryngeal edema, dyspnea, hyperventilation, edema of pharynx.
- Incidence Greater than 1% marked with asterisk.
What Are Some Side Effects That I Need To Call My Doctor About Right Away
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
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Taking Diclofenac With Other Painkillers
It’s safe to take diclofenac with paracetamol or codeine.
Diclofenac, aspirin, ibuprofen and naproxen all belong to the same group of medicines called non-steroidal anti-inflammatory drugs . Taking diclofenac together with other NSAIDs may increase your chances of getting side effects like a stomach ache.
NSAIDs are also used in medicines you can buy from pharmacies, such as cough and cold remedies.
Carcinogenesis Mutagenesis Impairment Of Fertility
Carcinogenicity studies in mice and rats administered diclofenac sodium as a dietary constituent for 2 years resulted in no significant increases in tumor incidence at doses up to 2 mg/kg/day approximately 0.85 and 1.7 times, respectively, the maximum recommended human topical dose of Diclofenac Sodium Topical Solution .
In a dermal carcinogenicity study conducted in albino mice, daily topical applications of diclofenac sodium for two years at concentrations up to 0.035% diclofenac sodium did not increase neoplasm incidence.
In a photococarcinogenicity study conducted in hairless mice, topical application of diclofenac sodium at doses up to 0.035% diclofenac sodium resulted in an earlier median time of onset of tumors.
Diclofenac was not mutagenic or clastogenic in a battery of genotoxicity tests that included the bacterial reverse mutation assay, in vitro mouse lymphoma point mutation assay, chromosomal aberration studies in Chinese hamster ovarian cells in vitro, and in vivo rat chromosomal aberration assay of bone marrow cells.
Impairment of Fertility
Fertility studies have not been conducted with Diclofenac Sodium Topical Solution. Diclofenac sodium administered to male and female rats at doses up to 4 mg/kg/day did not affect fertility. Studies conducted in rats found no effect of dermally applied DMSO on fertility, reproductive performance, or offspring performance.
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How Should I Use Diclofenac Topical
Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.
Do not take by mouth. Topical medicine is for use only on the skin. Rinse with water if this medicine gets in your eyes or mouth.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Store at room temperature away from moisture and heat. Do not freeze.
What Side Effects May I Notice From Receiving This Medication
Side effects that you should report to your care team as soon as possible:
- Allergic reactionsâskin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleedingâbloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Heart attackâpain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heart failureâshortness of breath, swelling of ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Increase in blood pressure
- Kidney injuryâdecrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injuryâright upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Strokeâsudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Side effects that usually do not require medical attention :
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Before Using Diclofenac Gel
To make sure this is the right treatment for you, before you start using diclofenac gel it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have asthma or any other allergic disorder.
- If you have any other skin condition – eczema, for example.
- If you have ever had an allergic reaction to a non-steroidal painkiller or to any other medicine.
Can Diclofenac Sodium Topical Gel Be Used For Muscle Pain
It can be beneficial in treating acute pain from minor strains.
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