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Diclofenac topical

Generic Name: diclofenac topical (dye KLOE fen ak TOP ik al)
Brand Name: DST Plus Pak, Pennsaid, Solaraze, Voltaren Topical

Medically reviewed on Oct 5, 2018

What is diclofenac topical?

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID).

Diclofenac topical (for the skin) is used to treat joint pain caused by osteoarthritis. Pennsaid is for use on the knees. Voltaren 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.

Solaraze is used to treat warty overgrowths of skin (actinic keratoses) on sun-exposed areas of the body.

Diclofenac topical may also be used for purposes not listed in this medication guide.

Important Information

Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using diclofenac, especially in older adults.

Before taking this medicine

Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking diclofenac topical.

Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using diclofenac, especially in older adults.

You should not use this medicine if you are allergic to diclofenac (Voltaren, Cataflam, Flector, and others), or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Diclofenac topical is not approved for use by anyone younger than 18 years old.

Tell your doctor if you have ever had:

Diclofenac can affect ovulation and it may be harder to get pregnant while you are using this medicine. However, using diclofenac topical during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

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.

Do not apply diclofenac topical to an open skin wound, or on areas of infection, rash, burn, or peeling skin.

Store at room temperature away from moisture and heat. Do not freeze. Store Pennsaid in an upright position.

What happens if I miss a dose?

Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not apply two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using diclofenac topical?

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to diclofenac (such as aspirin, ibuprofen, ketoprofen, or naproxen).

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid exposing treated skin to heat, sunlight, or tanning beds. Heat can increase the amount of diclofenac you absorb through your skin.

Avoid getting diclofenac topical in your eyes. If contact does occur, rinse with water. Call your doctor if you have eye irritation that lasts longer than 1 hour.

Do not use cosmetics, sunscreen, lotions, insect repellant, or other medicated skin products on the same area you treat with diclofenac topical.

Diclofenac topical side effects

Get emergency medical help if you have signs of an allergic reaction (hives, sneezing, runny or stuffy nose, wheezing or trouble breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Although the risk of serious side effects is low when diclofenac is applied to the skin, this medicine can be absorbed through the skin, which may cause steroid side effects throughout the body.

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:

  • the first sign of any skin rash, no matter how mild;

  • swelling, rapid weight gain;

  • severe headache, blurred vision, pounding in your neck or ears;

  • little or no urination;

  • liver problems--nausea, diarrhea, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • low red blood cells (anemia)--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 may include:

  • heartburn, gas, stomach pain, nausea, vomiting;

  • diarrhea, constipation;

  • headache, dizziness, drowsiness;

  • stuffy nose;

  • itching, increased sweating;

  • increased blood pressure; or

  • skin redness, itching, dryness, scaling, or peeling where the medicine was applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Diclofenac topical dosing information

Usual Adult Dose for Actinic Keratosis:

3% Gel:
-Apply an amount sufficient to cover each lesion twice a day and rub in gently
-Duration of therapy: 60 to 90 days; complete healing of lesions may not be evident for up to 30 days following cessation of therapy

Comments:
-Normally, 0.5 g is used on each 5 cm x 5 cm lesion site.
-Lesions that do not respond to therapy should be carefully reevaluated and management reconsidered.
-Sun exposure should be avoided during therapy.

Use: For the topical treatment of actinic keratosis

Usual Adult Dose for Osteoarthritis:

1% Gel:
Lower Extremities: Apply 4 g to the affected foot, knee, or ankle 4 times a day and rub in gently; not to exceed 16 g/day to any single joint of the lower extremities

Upper Extremities: Apply 2 g to the affected hand, wrist, or elbow 4 times a day and rub in gently; not to exceed 8 g/day to any single joint of the upper extremities

Maximum dose: 32 g/day over all affected joints

Comments:
-When used on the lower extremities, this drug should be applied to the entire affected foot, knee, or ankle; the entire foot includes the sole, the top of the foot, and the toes.
-When used on the upper extremities, apply to the entire affected hand, wrist, or elbow; the entire hand includes the palm, the back of the hands, and the fingers.
-The accompanying dosing card should be used for application; consult manufacturer product information for instructions.

Use: For the relief of pain associated with osteoarthritis of the joints amenable to topical treatment, such as the knees and those of the hands; this drug has not been evaluated for use on the spine, hip, or shoulder

1.5% Topical Solution: Apply 40 drops to each affected knee 4 times a day

2% Topical Solution: Apply 40 mg (2 pump actuations) to each affected knee 2 times a day

Use: For the relief of signs and symptoms of osteoarthritis of the knee(s)

Usual Adult Dose for Pain:

1.3% Topical Patch:
-Apply 1 patch to the most painful area twice a day

Use: For the topical treatment of acute pain due to minor strains, sprains, and contusions

What other drugs will affect diclofenac topical?

Ask your doctor before using diclofenac if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your current medicines, especially:

This list is not complete and many other drugs may affect diclofenac. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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