What is the prescription for Voltaren (diclofenac) gel for osteoarthritis pain management?

Prescription for Voltaren (Diclofenac) Gel for Osteoarthritis Pain Management

Apply diclofenac sodium topical gel to clean, dry skin on each painful knee, 2 times a day. Use the lowest effective dosage for the shortest duration consistent with treatment goals. 1

Dosing Instructions

• Apply to clean, dry skin on affected area(s) 1
• For knee osteoarthritis: Apply 2 pump actuations (40 mg diclofenac) on each painful knee, twice daily 1
• For hand osteoarthritis: Apply a small amount to cover the affected joints 4 times daily 2
• Spread evenly around front, back and sides of the affected joint 1
• Wash hands completely after application unless hands are the treated area 1

Special Precautions

• Wait at least 30 minutes after application before showering/bathing 1
• Wait until the treated area is completely dry before covering with clothing or applying sunscreen, insect repellent, cosmetics, or other topical medications 1
• Avoid skin-to-skin contact between other people and the treated area until completely dry 1
• Do not apply to open wounds or get the gel in eyes, nose, or mouth 1
• Do not apply external heat or occlusive dressings to treated areas 1

Clinical Benefits

• Topical diclofenac provides effective pain relief for osteoarthritis with limited systemic exposure 3
• Clinical trials demonstrate significant improvement in pain, physical function, and stiffness compared to placebo 4, 5
• Topical NSAIDs are preferred over oral NSAIDs for patients with knee or hand OA of mild-to-moderate severity 3
• Diclofenac sodium gel has shown efficacy in both knee and hand osteoarthritis 5, 2

Safety Considerations

• Topical diclofenac has better tolerability than oral NSAIDs, with fewer gastrointestinal side effects 6
• Most common adverse events are application site reactions, primarily mild skin dryness or irritation 4
• Use with caution in older adults and patients with cardiovascular comorbidities, chronic renal failure, or history of gastrointestinal bleeding 7
• No serious gastrointestinal or renal adverse events were reported in clinical trials of topical diclofenac 4

Alternative Options

• For patients with osteoarthritis pain in multiple joints or pain incompletely controlled with topical NSAIDs, oral NSAIDs or duloxetine can be considered 7
• Acetaminophen may be considered as an alternative, though it may be less effective than NSAIDs 7

Monitoring

• Regular assessment of pain relief and functional improvement is recommended during treatment 8
• Do not use combination therapy with topical diclofenac and oral NSAIDs unless benefit outweighs risk 1
• If using long-term, conduct periodic laboratory evaluations to monitor for potential systemic effects 1