Diclofenac / Menthol Topical Dosage

Medically reviewed by Drugs.com. Last updated on Oct 18, 2023.

Applies to the following strengths: 1.5%-10%

Usual Adult Dose for Osteoarthritis

40 drops topically per knee 4 times a day

Comments:

Use the lowest effective dose for the shortest duration consistent with treatment goals; application in an amount exceeding or less than the recommended dose has not been studied and is therefore, not recommended.
To avoid spillage dispense 10 drops at a time directly onto knee or into hand then onto knee; repeat until all drops have been applied.

Use: For the treatment of signs and symptoms of osteoarthritis of the knee.

No adjustment recommended

No adjustment recommended

US BOXED WARNINGS: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use.
This drug is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.
NSAIDs, cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and or GI bleeding are at greater risk for serious GI events.

CONTRAINDICATIONS:

Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to active substance or any product excipients
History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs; severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients
In the setting of coronary artery bypass graft (CABG) surgery

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Data not available

Administration advice:

Apply to clean, dry skin
To avoid spillage, dispense 10 drops at a time either directly onto the knee or first into the hand and then onto knee; spread topical solution evenly around front, back, and sides of the knee
Repeat procedure until entire dose (40 drops) has been applied and the knee is completely covered with solution; treat other knee if symptomatic
Wash hands after applying solution
Avoid showering/bathing for 30 minutes after application
Do not apply solution to open wounds
Avoid contact with eyes and mucous membranes; if eye contact occurs, immediately wash out eye with water or saline and consult a physician if irritation persists for than 1 hour
Do not apply external heat and/or occlusive dressings to treated knees
Avoid wearing clothing over the application site until the treated area has dried
Protect treated knee(s) from natural or artificial sunlight
If applying sunscreen, insect repellant, lotion, moisturizer, cosmetics, or other topical medication to knee, wait until the treated area is dry
Avoid skin to skin contact with other people until the knee(s) is completely dry

General:

Combination with other NSAIDs should be avoided unless the benefit outweighs the risk; if used, laboratory monitoring should be performed periodically.

Monitoring:

Blood pressure should be monitored closely during initiation and throughout course of therapy.
Monitor for signs/symptoms of gastrointestinal bleeding.
Monitor renal status, especially in patients with conditions where renal prostaglandins have a supportive role in the maintenance of renal perfusion.
Monitor blood counts, renal, and hepatic function periodically for patients receiving long-term therapy.

Patient advice:

Patients should be instructed to read the US FDA-approved patient labeling (Medication Guide).
Patients should seek medical advice for signs and symptoms of cardiovascular events, gastrointestinal events, adverse skin reactions, allergic reactions, hepatotoxicity, or unexplained weight gain or edema.
Patients should talk to their health care provider if they are pregnant, planning to become pregnant, or breastfeeding.