diclofenac topical (Solaraze, Voltaren gel)
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Indications
- topical NSAID for treatment of actinic keratosis (about 50% effective)
- treatment of osteoarthritis of the knee, ankle, elbow, wrist, & hand[4][7]
- inflammatory conditions of the elbow (lateral epicondylitis)
Contraindications
- not useful for osteoarthritis of the hip[7]
Caution:
- avoid exposure to sunlight & sunlamps
- avoid applying to broken skin
Dosage
- apply twice daily for 60-90 days
- in DMSO, Voltaren Gel, apply QID
- may take up to 7 days to work
- Flector patch BID
- Pennsaid, topical solution for osteoarthritis of the knee (Diclofenac Sodium Topical Solution 1.5%)
- 1% Gel
Gel: contains 1-3% diclofenac. 1% dispensed in 100 g tubes.
Pharmacokinetics
- 10% of dose is absorbed through the skin
Adverse effects
- better tolerated than 5-fluorouracil (Effudex), but less effective
- gastrointestinal effects are uncommon
- hepatotoxicity with 1% topical gel can occur at any time during treatment with diclofenac[5]
- localized skin rash[6]
Notes
cost about $112/month (2004)[3]
More general terms
Additional terms
Components
References
- ↑ Prescriber's Letter 8(2):supplement 2001
- ↑ Prescriber's Letter 9(2):11 2002
- ↑ 3.0 3.1 Prescriber's Letter 11(5):28 2004
- ↑ 4.0 4.1 Barthel HR1, Axford-Gatley RA. Topical nonsteroidal anti-inflammatory drugs for osteoarthritis. Postgrad Med. 2010 Nov;122(6):98-106 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21084786
- ↑ 5.0 5.1 FDA MedWatch Voltaren Gel (diclofenac sodium topical gel) 1% - Hepatic Effects Labeling Changes http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm193047.htm
- ↑ 6.0 6.1 Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
- ↑ 7.0 7.1 7.2 a Costa BR, Pereira TV, Saadat P et al. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: Network meta-analysis. BMJ 2021 Oct 12; 375:n2321. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34642179 PMCID: PMC8506236 Free PMC article https://www.bmj.com/content/375/bmj.n2321
- ↑ Bariguian Revel F, Fayet M, Hagen M. Topical diclofenac, an efficacious treatment for osteoarthritis: a narrative review. Rheumatol Ther. 2020;7(2):217-236 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32086778 PMCID: PMC7211216 Free PMC article https://link.springer.com/article/10.1007/s40744-020-00196-6