Diclofenac Sodium Topical Gel

Voltaren Gel 

Voltaren Gel is a type of nonsteroidal anti-inflammatory drug (NSAID) formulated explicitly for topical application. Made to treat pain and inflammation associated with osteoarthritis and minor injuries, it is particularly effective for areas like the knees, ankles, feet, hands, wrists, and elbows. Voltaren Gel works by inhibiting the cyclooxygenase (COX) enzymes, significantly reducing the production of prostaglandins involved in the inflammation process. This targeted approach ensures effective relief directly at the site of discomfort while minimizing systemic exposure and potential side effects. Recommended dosages for the treatment of osteoarthritis include applying 4 grams of the gel to larger joints and 2 grams to smaller ones up to four times daily. Users should use the gel to clean dry skin and avoid heat or direct sunlight exposure after application. While Voltaren Gel is safe for many, it carries risks typical of NSAIDs and should be used under a doctor’s guidance, especially by those with underlying health conditions.

Voltaren Gel Overview

Voltaren Gel (diclofenac sodium topical gel) is a highly effective medication to treat pain associated with osteoarthritis, minor injuries, and other inflammatory conditions. It is available as a 1% gel applied directly to the affected area, providing targeted pain relief by reducing inflammation. Voltaren Gel is suitable for application on joints such as the knees, hands, wrists, feet, ankles, and elbows. For managing osteoarthritis pain, the recommended dosage involves applying 4 grams of the gel to areas like the knees, ankles, or feet and 2 grams to smaller areas such as hands, wrists, or elbows four times daily. This regimen ensures sustained relief throughout the day. A dosing card accompanies the gel to ensure accurate application.

Simply apply the Voltaren gel to clean, dry skin and gently rub it in to promote absorption. It is crucial to avoid covering the treated areas with clothing or bandages immediately after application and to avoid exposure to heat or sunlight. Hands should be washed after application unless they are treated at the site. Voltaren Gel operates by inhibiting the cyclooxygenase (COX) enzymes, which are crucial in the prostaglandin synthesis pathway, thereby lowering the production of inflammatory mediators in the body. This mechanism alleviates pain and diminishes inflammation directly at the source.

While generally safe for topical use, Voltaren Gel can result in side effects like skin irritation or increased sensitivity to sunlight. It is also associated with potential risks similar to other NSAIDs, such as gastrointestinal issues or rare cardiovascular events. It should be used cautiously under medical advice, especially in individuals with existing health concerns. Alternatives to Voltaren Gel include other topical treatments such as Pennsaid, Solaraze, and Flector Patch, as well as different formulations like creams and patches from brands like Aspercreme, Bengay, and Icy Hot, which offer varied methods of pain relief depending on patient needs and preferences.

What Are the Uses of Voltaren Gel?

• Osteoarthritis Pain Relief
• Acute Pain from Minor Injuries
• Other Inflammatory Conditions

What Are the Forms & Strengths of Voltaren Gel?

Voltaren Gel is available in the following forms and strengths, primarily designed for topical use to ease pain and inflammation:

• Topical Gel
  • 1% Gel
• Topical Patch and Solution

What Are the Recommended Dosage of Voltaren Gel?

For Osteoarthritis:

• Knees, Ankles, or Feet: Apply 4 grams of the gel to the affected area four times daily.
• Hands, Wrists, or Elbows: Apply 2 grams of the gel to the affected area four times daily.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Use Voltaren Gel? 

To use Voltaren Gel effectively and safely, follow these steps:

• Read the Patient Information Leaflet: Before starting treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about diclofenac and a complete list of the side effects you could experience from using it.
• Clean and Dry the Affected Area: Ensure the skin is clean and dry before applying the gel.
• Measuring the Gel: Use the dosing card provided with the product to measure the prescribed amount of gel correctly. The dosing card is marked in 2-gram increments (used for the hand, wrist, or elbow) and 4-gram increments (for the knee, ankle, or foot).
• Apply the Gel: Gently apply the gel to the ‘s skin affected area’s skin, rubbing it in lightly.
• Wash Your Hands: After applying the gel, unless the hands are the treated joint, wash your hands to avoid spreading the medication to other areas.
• Avoid Bandaging: Avoid covering the treated area with a bandage or dressing unless your doctor instructs you.
• Avoid Heat or Sunlight: Avoid exposing the treated areas to heat (such as heating pads or hot water bottles) or direct sunlight.
• Wait Before Bathing: Avoid bathing, showering, or swimming for at least one hour after applying the gel.
• Repeat as Directed: Follow your doctor’s directions on how often to apply the gel, usually 2-4 times daily, depending on the treated condition.
• Monitor for Side Effects: Be aware of any signs of side effects, such as skin rash, irritation, or excessive redness where the gel is applied.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Voltaren Gel Work?

Voltaren Gel works by inhibiting the enzyme cyclooxygenase (COX), which is involved in the production of prostaglandins. Prostaglandins are substances in the body that are crucial in inflammation and pain signaling. By blocking the COX enzymes, Voltaren Gel reduces the levels of prostaglandins, leading to decreased inflammation and pain in the treated area. This makes it particularly effective for treating local symptoms of osteoarthritis, such as pain and inflammation in the joints, because its action is localized, targeting only the area where the gel is applied. This localized effect minimizes the systemic absorption and side effects typically associated with oral nonsteroidal anti-inflammatory drugs (NSAIDs).

Important Safety Information for Using Voltaren Gel

What Are the Side Effects of Voltaren Gel?

Common Side Effects of Voltaren Gel

Voltaren Gel is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation. Here are some of the common side effects associated with its use:

• Skin reactions:

• • • Rash
    • Itching
    • Dryness
    • Redness
    • Scaling
    • Increased sensitivity to sunlight

• Gastrointestinal issues:

• • • Stomach pain or discomfort
    • Nausea
    • Diarrhea

• Neurological effects:

• • • Headache
    • Dizziness

• Other:

• • Increased blood pressure
  • Fluid retention
  • Slight warming or burning sensation at the application site

Serious Side Effects of Voltaren Gel

Voltaren Gel is generally well tolerated, but like all medications, it can cause serious side effects in some people. It’s important to be aware of these potential risks and seek immediate medical attention if they occur. Here are the severe side effects associated with Voltaren Gel:

• Cardiovascular Problems:

• • • Increased risk of serious cardiovascular events, including heart attack and stroke, which can be fatal. This risk may increase with the duration of use and in patients who have cardiovascular disease or risk factors for cardiovascular disease.

• Gastrointestinal Issues:

• • • Severe gastrointestinal bleeding, ulcers, and perforation of the stomach or intestines can be fatal. These events can occur at any time during use without warning symptoms.

• Hepatic Reactions:

• • • Liver toxicity, including hepatitis, jaundice, and liver failure. Symptoms might include nausea, fatigue, lethargy, itching, yellowing of the skin or eyes, right upper quadrant tenderness, and “flu-like” symptoms.

• Renal Toxicity:

• • • Kidney damage, including acute renal failure. Risk factors include dehydration, pre-existing kidney disease, or concomitant use of medications that affect renal function.

• Severe Allergic Reactions:

• • • Anaphylactic reactions can occur even in individuals without prior exposure to diclofenac. Symptoms might include difficulty breathing, hives, swelling of the face or throat, and chest pain.

• Skin Reactions:

• • • Severe skin reactions such as exfoliative dermatitis, Stevens-Johnson Syndrome, and toxic epidermal necrolysis can be life-threatening.

• Respiratory Issues:

• • Asthma exacerbations in specific individuals are sensitive to aspirin or other NSAIDs. Symptoms include shortness of breath, wheezing, or chest tightness.

[Note: These are not all the possible serious side effects of Voltaren Gel. If you experience any side effects that seem severe or concerning, it is essential to contact your healthcare provider immediately. Regular monitoring and prompt reporting of side effects can help manage risks associated with this medication.]

Are There Any Warnings for Voltaren Gel? 

Voltaren Gel carries potential risks, especially for specific individuals. If you have concerns about using the medication, discussing these with your doctor or pharmacist is crucial.

• Heart Risks: Diclofenac sodium topical gel can increase the risk of serious cardiovascular events like heart attacks or strokes. This risk is higher if you have a history of heart issues, use the gel in high doses or for prolonged periods, or have undergone heart bypass surgery. Use the lowest effective dose for the shortest duration possible. Seek immediate medical attention if you experience symptoms such as chest pain or difficulty breathing.
• Gastrointestinal Risks: The gel can cause ulcers and stomach bleeding, mainly if used in combination with other NSAIDs, corticosteroids, blood thinners, SSRIs, or if you regularly consume alcohol or smoke. Symptoms might include blood in vomit or stools that resemble coffee grounds. Utilize the minimal effective dose for the shortest time necessary to reduce risks.
• Liver Health: Rarely, the gel can cause severe liver damage. Symptoms might not be apparent, but if you experience unusual fatigue, nausea, yellowing of the skin or eyes, or dark urine, discontinue use and consult your healthcare provider immediately.
• Renal Health: Using diclofenac sodium topical gel can adversely affect kidney function, particularly in conjunction with certain medications like ACE inhibitors or in patients with existing kidney, liver, or heart conditions. Inform your doctor if changes in urination patterns occur.
• Blood Pressure and Fluid Retention: The gel can elevate blood pressure and cause fluid retention, leading to swelling and worsening hypertension or heart failure. Monitor your blood pressure regularly, and avoid the gel if you have severe heart failure.
• High Potassium Levels: The medication can cause hyperkalemia, which can be dangerous. Symptoms include nausea, muscle weakness, and tingling sensations. Report these symptoms to your healthcare provider promptly.
• Asthma and Allergic Reactions: Diclofenac sodium topical gel may trigger severe asthma attacks or other allergic reactions, especially in individuals allergic to aspirin or other NSAIDs. Seek emergency help if you experience difficulty breathing or facial swelling.
• Pregnancy: The gel can harm an unborn baby when used during the second and third trimesters by reducing amniotic fluid and causing renal or cardiac issues in the fetus. Discuss potential risks with your healthcare provider if you are pregnant or planning to become pregnant.
• Severe Skin Reactions: There is a risk of serious skin reactions with symptoms including widespread rashes, peeling, and painful blisters. Discontinue use and seek immediate medical assistance if you experience these symptoms.

What Are the FDA Boxed Warning for Voltaren Gel?

Voltaren Gel carries an FDA-boxed warning, the strongest warning the FDA requires. It highlights potential serious risks associated with the drug. The boxed warning for Voltaren Gel emphasizes the following risks:

• Cardiovascular Risk: Non-steroidal anti-inflammatory drugs (NSAIDs), including diclofenac, which is the active ingredient in Voltaren Gel, may increase the risk of serious cardiovascular thrombotic events, such as myocardial infarction and stroke. This risk may occur early in treatment and may increase with duration of use.
• Gastrointestinal Risk: NSAIDs, including diclofenac, may cause an increased risk of serious gastrointestinal 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.

What Are the Voltaren Gel Precautions?

When using Voltaren Gel, it’s essential to consider several precautions to ensure safe and effective use. Here are critical precautions associated with Voltaren Gel:

• Avoid Certain Conditions: Voltaren Gel should not be used in individuals who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic reactions to NSAIDs have been reported in such individuals.
• Gastrointestinal Risks: Although less systemic exposure occurs with topical administration compared to oral NSAIDs, there is still a risk of causing severe gastrointestinal events such as bleeding, ulceration, and perforation.
• Cardiovascular Risks: As with other NSAIDs, Voltaren Gel may increase the risk of heart attack or stroke, which can be fatal. This risk may increase with more prolonged use of the drug and in people who have heart disease.
• Skin Reactions: NSAIDs, including Voltaren Gel, can cause severe skin adverse reactions such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. These serious events may occur without warning.
• Hepatic Effects: Elevations in liver enzymes can occur. Severe hepatic reactions, including jaundice and cases of fatal hepatitis, have been reported with NSAID use.
• Renal Toxicity: Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury. Caution should be used when initiating treatment with Voltaren Gel in patients with considerable dehydration or pre-existing renal failure.
• Pregnancy: Use of NSAIDs, including Voltaren Gel, during the third trimester of pregnancy increases the risk of premature closure of the fetal ductus arteriosus.
• Photosensitivity: Diclofenac has been associated with cases of photosensitivity. Patients should limit exposure to sunlight and artificial UV rays while using Voltaren Gel.
• Pediatric Use: The safety and effectiveness of Voltaren Gel in pediatric patients have not been established.
• Elderly Patients: Elderly patients are at greater risk for serious gastrointestinal, cardiovascular, and renal adverse events.

What Are the Contraindications of Voltaren Gel? 

Voltaren Gel has several contraindications. You should not use it if you have:

• Known hypersensitivity to diclofenac or any other component of the formulation or to aspirin or other NSAIDs.
• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like responses to NSAIDs have been reported in such cases.
• During the peri-operative period in the setting of coronary artery bypass graft (CABG) surgery.
• In the third trimester of pregnancy, like other NSAIDs, Voltaren Gel may cause premature closure of the ductus arteriosus.
• Active gastrointestinal bleeding, ulceration, or inflammatory bowel disease: Topical diclofenac has been associated with localized skin reactions and could theoretically exacerbate gastrointestinal conditions when absorbed systemically.
• Severe hepatic impairment, the drug might exacerbate liver conditions.

What If You Missed a Dose of Voltaren Gel?

If you miss a dose of Voltaren Gel, apply it as soon as you remember. However, if it is almost time for your next scheduled application, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one.

[Note: If you have missed a medication dose and are unsure regarding the next one, immediately consult your doctor or pharmacist.]

What Happens If You Take Too Much of Voltaren Gel?

If you use too much Voltaren Gel, you might increase your risk of side effects. While systemic absorption is lower than with oral diclofenac, excessive or prolonged use can still lead to issues typically associated with NSAIDs. These include gastrointestinal problems such as stomach pain, heartburn, nausea, and, more rarely, kidney problems, liver damage, or severe heart issues. In case of significant overuse, you should contact a healthcare provider or poison control center to understand the necessary actions, especially if you experience any adverse symptoms.

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

How to Store a Voltaren Gel?

Here are the key guidelines for properly storing Voltaren Gel:

• Store Voltaren Gel at room temperature, ideally between 20°C to 25°C (68°F to 77°F).
• Do not freeze the gel. Keep it in a location where the temperature remains consistent and does not drop to freezing levels.
• Store the gel away from direct sunlight to prevent degradation of the active ingredients.
• Ensure the cap is securely closed after each use to prevent the gel from drying out and to maintain its efficacy.
• Keep the gel out of reach of children and pets to prevent accidental ingestion or contact.
• Do not use the gel beyond the expiry date stated on the packaging. The expired gel may not be effective and should be disposed of properly.

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

What Medications Interact with Voltaren Gel?

Voltaren Gel can interact with certain medications, particularly those that affect renal function or increase the risk of bleeding. Here are some key interactions to be aware of:

• Anticoagulants and Antiplatelet Drugs: Such as warfarin, aspirin, and clopidogrel. Using Voltaren Gel with these medications can increase the risk of bleeding.
• Other NSAIDs: Including oral diclofenac, ibuprofen, and naproxen. Concurrent use with other NSAIDs can increase the risk of gastrointestinal ulcers or bleeding and may also lead to increased systemic exposure to diclofenac.
• Corticosteroids: Such as prednisone. Combined use can increase the risk of gastrointestinal side effects like ulcers and bleeding.
• Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications such as fluoxetine and venlafaxine may increase the risk of gastrointestinal bleeding when used with Voltaren Gel.
• ACE Inhibitors and ARBs: Such as lisinopril or losartan. Voltaren Gel can reduce the effectiveness of these drugs used to treat high blood pressure and may also worsen renal function.
• Diuretics: Concurrent use with diuretics like furosemide or hydrochlorothiazide can affect renal function and decrease the diuretic effect.
• Cyclosporine and Lithium: Voltaren Gel can increase the plasma concentration of these drugs, leading to potential toxicity.

What Are the Other Voltaren Gel Interactions?

Voltaren Gel, which contains diclofenac, is used primarily to treat pain and inflammation associated with conditions like osteoarthritis. Here are some alternatives that may be considered depending on the specific needs and medical advice:

• Ibuprofen Gel: Similar to Voltaren, it’s applied topically and reduces inflammation and pain.
• Menthol Creams: These provide a cooling sensation to help soothe sore muscles and joints.
• Capsaicin Cream: Derived from chili peppers, it reduces the intensity of pain signals through the skin.
• Aspercreme: Contains trolamine salicylate and is used to temporarily relieve joint and muscle pain.
• Biofreeze: A gel that uses menthol to cool the pain, popular among athletes.
• CBD Creams: Known for anti-inflammatory properties without psychoactive effects.
• Tiger Balm: A blend of herbal ingredients relieving muscle and joint pain.
• Salonpas Patches: Adhesive patches that contain methyl salicylate and menthol for pain relief.
• Penetrex Cream: Often used for arthritis-related inflammation and soft tissue pain.

[Note: It’s important to discuss all your current medications, including over-the-counter drugs and supplements, with your healthcare provider to manage any potential interactions effectively when using Voltaren Gel.]

What Are the Voltaren Gel Alternatives?

• Pennsaid (diclofenac sodium topical solution)
• Solaraze (diclofenac sodium topical gel)
• Flector Patch (diclofenac epolamine topical patch)
• Lidoderm (lidocaine patch)
• Aspercreme (trolamine salicylate cream)
• Bengay (methyl salicylate + menthol cream)
• Icy Hot (menthol + methyl salicylate cream)
• Capzasin (capsaicin cream)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Voltaren Gel Cost & Coupons

Voltaren Gel is an effective treatment for joint pain associated with osteoarthritis, but its high retail prices in the US can be a burden for many patients. US residents can consider purchasing Voltaren Gel from Canadian pharmacies for more affordable options for more affordable options. Polar Bear Meds is a reputable provider known for its competitive pricing. By using the coupon code “WELCOMEPB10” at checkout, customers can receive up to a 10% discount on their first order. Additionally, our referral program offers further savings, including a free coupon for future purchases. Secure your supply of Voltaren Gel from Canada and enjoy substantial cost savings.

Frequently Asked Questions

Why shouldn’t I use Voltaren gel on my back?

Voltaren gel is not FDA-approved for use on the back primarily because there is insufficient research to confirm its safety and effectiveness for treating back pain. The approval for topical diclofenac currently extends only to smaller joints like the hands, wrists, elbows, and knees. If you’re experiencing back pain, it’s important to consult with your healthcare provider. They can assess the cause of your pain and recommend suitable treatment options tailored to your specific needs.

Is Voltaren gel safe to use?

Voltaren gel, an NSAID, comes with risks of serious side effects similar to those associated with oral NSAIDs, such as an increased risk of heart attack, stroke, high blood pressure, and severe skin reactions. However, because it is applied topically, Voltaren gel is generally less likely to cause systemic side effects than oral forms like Cambia or Cataflam. Despite this, it’s crucial to use the gel strictly as prescribed by your healthcare provider to minimize any risks. If you have concerns about using diclofenac sodium topical gel, discuss them with your healthcare provider to ensure it’s safe for you.

How quickly does Voltaren gel provide relief for osteoarthritis pain?

You may experience slight pain relief after using diclofenac sodium topical gel (Voltaren gel) for a few days. However, consistent application is required, and it generally takes about a week to observe significant improvements in pain. For some individuals, continued use for several weeks may be necessary to achieve the full therapeutic effects of the medication.

Can I take ibuprofen (Advil) along with diclofenac sodium topical gel (Voltaren gel)?

It is generally not advised to combine ibuprofen (Advil) with diclofenac sodium topical gel (Voltaren gel) without medical guidance. Both are NSAIDs and using them together increases the risk of adverse effects such as stomach bleeding, stroke, and kidney issues. If the topical gel alone does not adequately manage your pain, consult your healthcare provider for alternative treatment options. Remember, NSAIDs are common ingredients in many over-the-counter and prescription medications, including those for colds or sleep issues. Always check with your healthcare provider or pharmacist to confirm if you are taking any NSAIDs.

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