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Overview: Topical diclofenac is used for arthritis pain, osteoarthritis, and actinic keratosis (a skin condition). Common side effects include redness, itching, rash, dry skin, scaling, or peeling where you use it. Topical diclofenac is a non-steroidal anti-inflammatory drug (NSAID). Check with your healthcare provider before using it with other NSAIDs, which can be found in many over-the-counter medicines, including pain, swelling, and fever medicines as well as some cough and cold medicines.

Uses

What is topical diclofenac used for?

Topical diclofenac is commonly used to treat the following conditions.

  • Arthritis pain or osteoarthritis, a condition that causes inflammation in your joints
  • Actinic keratoses, a condition that causes rough and scaly patches on your skin

Topical diclofenac may also be used for other conditions as determined by your healthcare provider.

How does topical diclofenac work (mechanism of action)?

Topical diclofenac works by blocking certain substances in the body (prostaglandins) that cause pain, inflammation for arthritis and skin changes involved in actinic keratosis.

How is topical diclofenac supplied (dosage forms)?

Brands and other names

  • Pennsaid
  • Solaraze
  • Voltaren Arthritis Pain

Dosage forms and strengths

  • 1% topical gel
  • 3% topical gel
  • 1.5% topical solution
  • 2% topical solution

How should I store topical diclofenac?

Topical Solution. Topical diclofenac liquid should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Topical Gel. Topical diclofenac gel should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). Avoid freezing it.

Side Effects

What are the most common side effects of topical diclofenac?

The most common side effect of topical diclofenac is redness, itching, rash, dry skin, scaling, or peeling at the application site. Tell your healthcare provider if any of these symptoms bother you.

There may be other side effects of topical diclofenac that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of topical diclofenac?

While less common, the most serious side effects of topical diclofenac are described below, along with what to do if they happen.

Severe Allergic Reactions. Topical diclofenac can cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop using the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Heart Attack and Stroke. Topical diclofenac can increase your risk of a heart attack or stroke that can lead to death. This risk is increased in people with existing heart disease and with longer use of topical diclofenac and higher doses. Do not use topical diclofenac if you have had a recent heart attack without talking to your healthcare provider. This could increase your risk of having another heart attack. Get emergency help if you have any of the following symptoms of a heart attack or stroke.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech

Stomach Bleeding. Topical diclofenac can increase your risk of bleeding, ulcers, and tears (perforation) in your gut. The risk is higher if you have a history of stomach ulcers, bleeding problems, use higher doses of topical diclofenac or use it for longer than directed, have poor health, are of older age, have liver disease, smoke, drink alcohol, or take certain other medicines. Stop using topical diclofenac and get emergency help if you have any of the following symptoms.

  • Vomit blood
  • Black or tarry poop
  • Stomach pain that does not go away
  • Upset stomach
  • Feel faint

Bleeding. Topical diclofenac can increase your risk of bleeding, especially if you have a bleeding disorder or take other medicines that increase your risk of bleeding. Tell your healthcare provider right away if you notice signs of bleeding, including easy bruising or bleeding.

Anemia. Topical diclofenac may cause anemia, which is when you have low levels of red blood cells. Tell your healthcare provider if you have any of the following symptoms of anemia.

  • Unusual weakness or tiredness
  • Cold hands and feet
  • Fast or abnormal heartbeat
  • Pale or yellowish skin 
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Shortness of breath

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using topical diclofenac. Stop the medicine and call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Increased Blood Pressure (Hypertension). Topical diclofenac may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while using this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your healthcare provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Fluid Retention (Edema) and Heart Failure. Topical diclofenac can cause fluid retention, also called edema, which can lead to heart failure. Fluid retention can also cause serious issues in people with heart failure. Stop the medicine and call your healthcare provider right away if you have any of the following symptoms. 

  • Chest pain
  • Irregular heartbeat
  • Shortness of breath
  • Stretched or shiny skin
  • Swollen body parts, such as the belly or ankles
  • Unusually fast weight gain
  • Unusual tiredness

Kidney Damage. Kidney damage can happen when using topical diclofenac. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

High Potassium Levels (Hyperkalemia). Topical diclofenac can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your healthcare provider may check your potassium levels, especially if you take certain other medicines. Call your healthcare provider right away if you have any of the following symptoms of a high potassium level. 

  • Muscle weakness or unusual tiredness
  • Slow heartbeat or feeling of skipped heartbeats 
  • Nausea or vomiting
  • Trouble breathing
  • Abnormal heart rhythm

Severe Skin Reactions. Topical diclofenac can cause severe skin reactions, called Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop topical diclofenac and call your healthcare provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Warnings & Precautions

Who should not use topical diclofenac?

Allergies to Ingredients. People who are allergic to any of the following should not use topical diclofenac.

  • Diclofenac
  • Aspirin or any other medicine known as a non-steroidal anti-inflammatory (NSAID) 
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific topical diclofenac products they stock.

Heart Surgery. Do not use topical diclofenac right before or after a heart surgery called coronary artery bypass graft (CABG). Using topical diclofenac during this time can increase your risk of heart attack or stroke.

Damaged Skin. Do not apply topical diclofenac on damaged skin, skin that has eczema, open wounds, infected or inflamed skin, peeling skin, or skin that has been burned. 

What should I know about topical diclofenac before using it?

If topical diclofenac was prescribed to you by a healthcare provider, use it as prescribed. If you use over-the-counter (OTC) topical diclofenac, read and follow the product instructions. Do not use it for more than 21 days without talking with your healthcare provider.

Do not share topical diclofenac that was prescribed for you by a healthcare provider with other people, even if they have the same condition as you. It may harm them.

Keep topical diclofenac out of the reach of children.

Do not get topical diclofenac in your eyes, nose, or mouth. If you get the topical diclofenac in these areas, wash with water or saline right away. Contact your healthcare provider if these areas are still 

irritated one hour after washing the area.

Topical diclofenac can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin. If you get a sunburn, stop using topical diclofenac and call your healthcare provider right away.

People who are 65 and older can be at greater risk for some side effects from topical diclofenac. Talk to your healthcare provider about your risks if you are in this age group.

Topical diclofenac comes as a solution or a gel. If you are using the topical diclofenac solution, only use it on your knee(s) unless your healthcare provider instructs you to use it on other areas of your body.

After applying topical diclofenac, wait until the area is completely dry before wearing clothing or applying other products. Avoid skin-to-skin contact with other people until the area is dry. Wash your hands well after applying topical diclofenac.

If you are able to get pregnant, topical diclofenac may make this more difficult. These effects on fertility seem to be reversible. Talk to your healthcare provider if you have concerns about this. 

What should I tell my healthcare provider before using topical diclofenac?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical diclofenac is right for you.

In particular, make sure that you discuss any of the following.

Smoking. Tell your healthcare provider if you smoke tobacco. Smoking while using topical diclofenac can increase your risk of stomach bleeding or stomach ulcers. 

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Liver or kidney problems
  • High blood pressure
  • Asthma
  • Anemia
  • History of heartburn, stomach ulcers, or bleeding in your stomach or intestines
  • Heart problems, including heart failure, or any recent heart attacks 
  • Stroke

Other Medicines and Supplements. Topical diclofenac may interact with other medicines and supplements. Before using topical diclofenac, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Do not use topical diclofenac at 20 weeks or later in pregnancy without talking to your healthcare provider. Using topical diclofenac during this time may cause harm to an unborn baby and complications during delivery. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use topical diclofenac while you are pregnant or trying to get pregnant.

Breastfeeding. Topical diclofenac may pass into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use topical diclofenac while breastfeeding.

Interactions

Does topical diclofenac interact with foods or drinks?

There are no known interactions between topical diclofenac and foods or drinks.

It is unknown if drinking alcohol will affect topical diclofenac, but both topical diclofenac and alcohol can increase your risk of bleeding. It is best to limit the amount of alcohol you drink.

Does topical diclofenac interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using topical diclofenac.

  • A corticosteroid, such as dexamethasone, methylprednisolone, or prednisone, which is a medicine for certain inflammatory conditions
  • A blood thinner, such as warfarin, which is a medicine used to treat or prevent blood clots
  • An antiplatelet medicine, such as clopidogrel (Plavix), ticagrelor (Brilinta), aspirin/dipyridamole, or cilostazol, which is a medicine used to prevent blood clots
  • A selective serotonin reuptake inhibitor (SSRI) or serotonin and norepinephrine reuptake inhibitor (SNRI), which is a medicine commonly used for anxiety and depression
  • An angiotensin-converting enzyme (ACE) inhibitor, such as enalapril or lisinopril, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • An angiotensin II receptor blocker (ARB), such as losartan or valsartan, which is a medicine for high blood pressure, heart failure, and other heart conditions
  • A beta-blocker, such as metoprolol (Lopressor, Toprol XL, and others), atenolol (Tenormin), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Lithium, which is a medicine for certain mental health conditions
  • Methotrexate (Trexall and others), which is a medicine commonly used for rheumatoid arthritis or certain types of cancer
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune system
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
  • Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever
  • A salicylate, such as diflunisal or salsalate, which is a medicine used for osteoarthritis or rheumatoid arthritis
  • Pemetrexed (Alimta, Pemfexy), which is a medicine to treat certain cancers

This may not be a complete list of medicines that can interact with topical diclofenac. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much topical diclofenac?

If you or someone else has used too much topical diclofenac, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of topical diclofenac?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses. 

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