From the Guidelines
Topical application of Voltaren does not significantly increase blood pressure in most individuals when used as directed, but caution is advised in patients with pre-existing hypertension or cardiovascular risk factors. The primary concern with nonsteroidal anti-inflammatory drugs (NSAIDs) like Voltaren (diclofenac) is their potential to interfere with blood pressure control, particularly in patients with resistant hypertension, as noted in a scientific statement from the American Heart Association 1. However, this concern is more relevant to systemic NSAID use rather than topical application. Topical Voltaren is designed for local action with minimal systemic absorption, reducing the risk of blood pressure elevation. Some key considerations for minimizing potential blood pressure effects include:
- Applying Voltaren only to limited areas
- Avoiding use of more than the recommended amount (typically 2-4 grams per application site)
- Not covering treated areas with occlusive dressings
- Washing hands after application unless treating the hands These precautions can help minimize systemic absorption of the medication. It's also important for individuals with cardiovascular risk factors or those taking other medications that affect blood pressure to consult their healthcare provider before using topical Voltaren regularly, as even small amounts of systemic absorption could potentially affect blood pressure in sensitive individuals.
From the FDA Drug Label
NSAIDs, including diclofenac sodium topical solution, can lead to new onset of hypertension or worsening of preexisting hypertension, either of which may contribute to the increased incidence of CV events Monitor blood pressure (BP) during the initiation of NSAID treatment and throughout the course of therapy.
The topical application of Voltaren (diclofenac) may increase blood pressure.
- Key points:
- NSAIDs, including diclofenac sodium topical solution, can lead to new onset of hypertension or worsening of preexisting hypertension.
- Monitor blood pressure during the initiation of NSAID treatment and throughout the course of therapy 2.
- Clinical decision: Monitor blood pressure in patients using topical diclofenac to minimize the risk of hypertension.
From the Research
Topical Application of Voltaren and Blood Pressure
- The provided studies do not directly address the effect of topical application of Voltaren on blood pressure 3, 4, 5, 6, 7.
- However, some studies discuss the relationship between nonsteroidal anti-inflammatory drugs (NSAIDs) and cardiovascular risk, including blood pressure 6, 7.
- One study found that NSAIDs, including diclofenac (the active ingredient in Voltaren), may be associated with higher cardiovascular risks, but it did not specifically examine the topical application of these drugs 7.
- Another study discussed the risks of cardiovascular disease associated with NSAIDs, but it did not provide information on the effects of topical application on blood pressure 6.
NSAIDs and Cardiovascular Risk
- The studies suggest that NSAIDs, including COX-2-selective and nonselective NSAIDs, may be associated with an increased risk of major cardiovascular events, such as ischemic stroke, acute myocardial infarction, and congestive heart failure 6, 7.
- However, the studies did not examine the specific effects of topical application of Voltaren on blood pressure or cardiovascular risk.