Voltaren Patch Diclofenac Content and Clinical Use
You are correct that Voltaren patches contain 180 mg of diclofenac sodium per patch, not 140 mg. 1
Topical Diclofenac Formulations and Dosing
The Voltaren patch (diclofenac sodium 180 mg) is applied once or twice daily to the affected area and represents a convenient alternative to gel formulations for localized pain management. 1
Key Formulation Details
Topical diclofenac is available in multiple formulations including patches (180 mg), gels, and solutions, all designed for localized pain relief with minimal systemic absorption. 2, 3
The patch formulation provides gradual drug delivery over hours, which may be preferable for patients seeking convenient dosing compared to gel applications 3 times daily. 1
Clinical Efficacy and Safety Profile
For acute musculoskeletal pain, topical diclofenac demonstrates strong efficacy with number needed to treat (NNT) values ranging from 1.8 to 7.4 depending on formulation, with the Emulgel showing the best performance (NNT 1.8). 3
Local adverse events occur in only 4.1% of patients using topical diclofenac for acute pain, primarily mild application site reactions like erythema or rash that rarely require discontinuation. 1, 3
For chronic musculoskeletal pain, topical diclofenac achieves approximately 60% clinical success rate (NNT 9.5), with local adverse events (~14%) similar between diclofenac and placebo. 3
Application Guidelines
Apply the patch directly to the area of maximal pain rather than coating large surface areas, as topical agents are designed for local action. 1
For acute pain, use for 3-5 days maximum, not exceeding 7 days without medical reassessment. 1
For chronic pain conditions, longer-term use is acceptable with appropriate monitoring, though gastric protection should be considered for prolonged NSAID therapy. 1
Critical Safety Considerations
Avoid exposure of treated areas to natural or artificial sunlight, as photosensitivity reactions can occur. 4
Avoid contact with eyes and mucosa, and do not use concurrently with oral NSAIDs to prevent additive systemic effects and increased risk of adverse events. 4
Suitability for Patients with Normal Renal Function
For adults with localized pain and normal renal function, topical diclofenac (including the 180 mg patch) is highly suitable due to low systemic absorption and favorable safety profile compared to oral NSAIDs. 2, 3
The high safety profile of topical therapies makes them preferred first-line options whenever feasible in older adults and those at risk for systemic NSAID complications. 2
Topical diclofenac provides strong evidence of analgesic efficacy for musculoskeletal pain with minimal systemic adverse effects. 2
Contraindications and Precautions
Even with topical formulations, avoid use in patients with aspirin-sensitive asthma, active peptic ulcer disease, or within 10-14 days post-CABG surgery. 4
Monitor for cardiovascular thrombotic events in patients with known CV disease or risk factors, as NSAIDs (including topical formulations) carry increased risk. 4
Discontinue immediately if skin rash, signs of hypersensitivity, or Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) develop. 4