Generic Name: diclofenac topical (dye KLOE fen ak)Brand Names: Flector Patch, Solaraze, Voltaren Topical
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAIDs). It works by reducing hormones that cause inflammation and pain in the body.
Diclofenac topical skin patch (Flector Patch) is used to treat pain caused by minor sprains, strains, or bruising.
Diclofenac topical 1% gel (Voltaren Topical) is used to treat joint pain in the hands, wrists, elbows, knees, ankles, or feet caused by osteoarthritis. This medication may not be effective in treating arthritis pain elsewhere in the body.
Diclofenac topical 3% (Solaraze) gel is used to treat warty overgrowths of skin (actinic keratoses) on sun-exposed areas of the body.
Diclofenac topical may also be used for other purposes not listed in this medication guide.
Before using this medication, tell your doctor if you are allergic to any drugs, or if you have a history of stomach ulcer or bleeding, liver or kidney disease, high blood pressure, or congestive heart failure.
While the risk of absorbing diclofenac topical into your bloodstream is low, all non-steroidal anti-inflammatory drugs (NSAIDs) can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use diclofenac topical just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).
Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.
This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are using an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.
Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.What should I discuss with my healthcare provider before using diclofenac topical?Do not use this medication if you are allergic to diclofenac (Cataflam, Voltaren), aspirin, or another NSAID. Do not use just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).
While the risk of absorbing diclofenac topical into your bloodstream is low, all NSAIDs can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID.
NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning at any time while you are using an NSAID. Older adults may have an even greater risk of serious gastrointestinal side effects.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:
a history of asthma or severe allergic reaction after taking aspirin or any NSAID;
a history of stomach ulcer or bleeding;
high blood pressure; or
congestive heart failure.
Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.
This medication may come with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.Do not use diclofenac topical on an open skin wound, or on areas of eczema, infection, skin rash, or burn injury. Wait until the condition has fully healed before using diclofenac topical.
Do not cover the treated skin with a bandage or expose it to heat from a hot tub, heating pad, sauna, or heated water bed. Heat or bandaging can increase the amount of drug you absorb through your skin and may cause harmful effects.Wash your hands after applying this medication, unless you are treating the skin on your hands. Do not wear gloves for at least 10 minutes after applying diclofenac topical gel to the hands.
After you apply diclofenac topical gel, wait at least 10 minutes before dressing and at least 1 hour before you bathe or shower.
To treat actinic keratosis (with Solaraze): Apply enough gel to cover each lesion and rub in gently.Do not apply Solaraze gel more than 2 times daily and never use more than your prescribed dose.
To treat osteoarthritis pain (with Voltaren Topical): This medicine is supplied with dosing cards that show you how much gel to use for a 2-gram dose or a 4-gram dose. Squeeze the gel onto this card along the line for your dose. Use no more gel than will fit on the length of your dosing line. Wipe the card directly onto the treatment area and rub gently into the skin. Each dosing card is for only one use.Always use a dosing card to measure your Voltaren Topical dose. Fold the card and throw it away in a place where children and pets cannot get to it. A used dosing card will still have a small amount of diclofenac gel on it.
To treat arthritis pain in the foot, spread the gel out onto all areas of the foot including the toes and soles. When treating the hand, spread the gel out onto all areas of the hand including the fingers and palms.
When treating osteoarthritis, keep using any oral medications your doctor has prescribed.
To treat minor pain (with Flector skin patch): Apply the skin patch directly to the area of pain. The skin patch can be worn for up to 12 hours and then removed. Apply a new patch at that time if pain continues. Do not wear a skin patch while taking a bath or shower or while swimming.
If the patch falls off, try sticking it back on, or use medical tape to hold it on.After removing a skin patch fold it in half, sticky side in, and throw it away in a place where children or pets cannot get to it. Keep both used and unused diclofenac topical patches out of the reach of children or pets.
If you use diclofenac topical for a long period of time, your liver function may need to be checked with blood tests on a regular basis. Do not miss any scheduled visits to your doctor.Store diclofenac topical at room temperature away from moisture and heat. Do not take a skin patch out of the patch envelope until you are ready to use it. Reseal the envelope for storage.
Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose. Do not wear a diclofenac skin patch for longer than 12 hours.
While you are using diclofenac topical, avoid taking oral (pill form) of aspirin or NSAIDs such as ibuprofen (Motrin, Advil), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others;
Although the risk of serious side effects is low when diclofenac is applied to the skin, you should be aware of side effects that can occur if the medication is absorbed into your bloodstream.Stop using this medication and call your doctor at once if you have any of these serious side effects:
chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;
bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
swelling or rapid weight gain;
urinating less than usual or not at all;
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
bruising, severe tingling, numbness, pain, muscle weakness.
Less serious side effects may include:
dryness, itching, peeling, or scaling of treated skin; or
fever, chills, sore throat, body aches or other flu symptoms.
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.
Usual Adult Dose for Keratosis:
3% Gel: Apply amount sufficient to cover each actinic keratosis lesion twice daily and rub in gently for 60 to 90 days. Complete healing of lesions may not be evident for 30 days after discontinuation of therapy.
Usual Adult Dose for Osteoarthritis:
1% Gel:Apply the gel (4 g) to the affected foot or knee or ankle four times daily and rub in gently. Do not apply more than 16 g daily to any single joint of the lower extremities. Apply the gel (2 g) to the affected hand or elbow or wrist four times daily and rub in gently. Do not apply more than 8 g daily to any single joint of the upper extremities. Total dose should not exceed 32 g per day, over all affected joints.
Usual Adult Dose for Pain:
1.3% topical patch: Acute pain due to minor strains, sprains, and contusions: Apply one patch to the most painful area twice a day.
Tell your doctor about all other medicines you use, especially:
a blood thinner such as warfarin (Coumadin);
cyclosporine (Neoral, Sandimmune);
lithium (Eskalith, Lithobid);
methotrexate (Rheumatrex, Trexall);
a diuretic (water pills);
steroids (prednisone and others); or
an ACE inhibitor such as benazepril (Lotensin), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), y and others.
It is not likely that other drugs you take orally or inject will have an effect on topically applied diclofenac. But many drugs can interact with each other. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.