From the Guidelines
Diclofenac gel should be applied at a dose of 3% in a 25% hyaluronic gel, twice daily for 60–90 days. This recommendation is based on the British Association of Dermatologists' guidelines for the care of patients with actinic keratosis 2017, which suggests that diclofenac gel can be applied as a lesion- or field-based treatment 1. The mechanism of action of diclofenac gel for actinic keratosis is not fully understood, but it may be related to the inhibition of the cyclooxygenase pathway, leading to reduced prostaglandin E2 synthesis.
Some key points to consider when using diclofenac gel include:
- The gel usually causes less intense local skin reaction compared to other treatments like 5-FU or imiquimod 5% cream 1
- The reduction of side-effects is matched by reduced efficacy, but both diclofenac gel and 5-FU 5% achieve high levels of patient satisfaction 1
- Vehicle-controlled studies have shown that diclofenac gel can achieve complete clearance of target lesions in 50% of patients after 90 days of treatment, compared to 20% in those using the vehicle alone 1
It is essential to follow the recommended dosage and treatment duration to minimize adverse effects and maximize efficacy. The recommended dose and frequency of diclofenac gel should not be exceeded, and patients should be monitored for any adverse effects. Additionally, patients should be advised to avoid sun exposure to treated areas as photosensitivity may occur. Overall, diclofenac gel is a viable treatment option for actinic keratosis, offering a balance between efficacy and tolerability 1.
From the FDA Drug Label
The recommended dose is 2 pump actuations on each painful knee, 2 times a day. For relief of the pain of osteoarthritis (OA) of the knee(s), the recommended dose is 40 mg of diclofenac sodium (2 pump actuations) on each painful knee, 2 times a day.
The recommended dose and frequency of Diclofenac (Diclofenac sodium) gel is 40 mg (2 pump actuations) per painful knee, 2 times a day 2.
- Apply the gel to clean, dry skin.
- Wash hands completely after administering the product.
- Wait until the area is completely dry before covering with clothing or applying sunscreen, insect repellent, cosmetics, topical medications, or other substances.
From the Research
Diclofenac Gel Dosage and Frequency
- The recommended dose and frequency of Diclofenac (Diclofenac sodium) gel can be found in several studies 3, 4, 5, 6.
- According to the studies, the dose of Diclofenac sodium 1% gel is 4 g applied to the affected area four times daily 3, 4, 5.
- However, a newer study 6 investigated the safety and efficacy of a new 3.06% diclofenac gel (AMZ001) applied once or twice daily, which may offer an alternative dosing regimen.
- The study found that treatment with AMZ001 once daily was effective at reducing pain scores, while twice daily application was not statistically significant 6.
Application and Tolerability
- The application of Diclofenac sodium 1% gel is typically 4 g to the affected knee, four times daily 3, 4, 5.
- The gel can be applied to one or both knees, depending on the affected area 5.
- The studies found that Diclofenac sodium 1% gel is generally well tolerated, with the most common adverse events being application site reactions 3, 4, 5.
- The newer study 6 also found that AMZ001 was generally well tolerated, with most adverse events being mild or moderate in severity.