From the Guidelines
Combining diclofenac and lidocaine ointments is not recommended without specific medical guidance, as they have different purposes and formulations that may not be compatible when physically mixed. These medications should typically be used separately, as diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation and pain, while lidocaine is a local anesthetic that numbs the area 1. If pain management requires both anti-inflammatory and anesthetic effects, it's better to apply them sequentially rather than mixing them together—for example, applying lidocaine first for immediate numbing, then diclofenac 30 minutes later for longer-lasting anti-inflammatory effects. Some key points to consider when using these medications include:
- Diclofenac gel can be applied 3 times daily, or a diclofenac patch can be used, with 180 mg, one patch daily or one patch twice daily 1.
- Lidocaine patch, 5%, can be applied daily to the painful site, with minimal systemic absorption 1. The reason for this caution is that combining these medications could potentially alter their chemical stability, absorption rates, or effectiveness. Additionally, using both simultaneously might increase the risk of side effects such as skin irritation or systemic absorption. Key considerations for their use include:
- Act locally and may be used as coanalgesic in combination with an opioid, antidepressant, and/or an anticonvulsant 1.
- Topical agents like lidocaine and diclofenac can be used to manage pain, but their compatibility and potential interactions must be carefully considered 1.
From the Research
Combining Diclofenac and Lidocaine Ointments
- The combination of diclofenac and lidocaine ointments is not directly addressed in the provided studies, but the individual components are discussed in several studies 2, 3, 4, 5, 6.
- Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that has been shown to be effective in treating acute and chronic pain conditions, including osteoarthritis and musculoskeletal pain 2, 3, 5.
- Lidocaine is a local anesthetic that has been used to treat various pain conditions, including postherpetic neuralgia, diabetic neuropathy, and chronic lower back pain 2, 4, 6.
- The studies suggest that topical diclofenac and lidocaine can be effective in providing pain relief with minimal systemic adverse effects 2, 3, 4, 5, 6.
- However, there is no direct evidence to support the combination of diclofenac and lidocaine ointments, and further research would be needed to determine the efficacy and safety of such a combination.
Efficacy of Diclofenac and Lidocaine
- Diclofenac has been shown to be effective in treating acute soft tissue injuries and chronic joint-related conditions, such as osteoarthritis 2, 3, 5.
- Lidocaine has been shown to be effective in treating postherpetic neuralgia and diabetic neuropathy 2, 6.
- The number needed to treat (NNT) for diclofenac and lidocaine varies depending on the specific formulation and condition being treated, but generally ranges from 1.8 to 11 3, 5.
Safety of Diclofenac and Lidocaine
- Topical diclofenac and lidocaine are generally well-tolerated and have minimal systemic adverse effects 2, 3, 4, 5, 6.
- Local skin reactions, such as redness and itching, are common but usually mild and transient 3, 5.
- Systemic adverse events are rare, but can occur, especially with prolonged use or high doses of diclofenac 3, 5.