Diclofenac (Topical

This information from Lexicomp^® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Aspercreme Arthritis Pain [OTC]; Diclogen; Diclotrex II [DSC]; Diclotrex [DSC]; Flector; FT Arthritis Pain [OTC]; Licart; Lixofen; Motrin Arthritis Pain [OTC]; Pennsaid; Pharmacist Choice Diclofenac [OTC]; Profinac; Rexaphenac [DSC]; Voltaren Arthritis Pain [OTC]; Voltaren [DSC]; Xrylix II [DSC]; Xrylix [DSC]

Brand Names: Canada

JAMP Diclofenac; Pennsaid; PMS-Diclofenac; TARO-Diclofenac

What is this drug used for?

• It is used to treat a precancerous skin problem called actinic keratosis.
• It is used to manage pain.
• It is used to treat some types of arthritis.

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have an allergy to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
• If you have ever had asthma caused by a salicylate drug like aspirin or a drug like this one like NSAIDs.
• If you have any of these health problems: Dehydration, GI (gastrointestinal) bleeding, heart failure (weak heart), kidney disease, or liver disease.
• If you have had a recent heart attack.
• If you are taking any other NSAID, a salicylate drug like aspirin, or pemetrexed.
• If you are having trouble getting pregnant or you are having your fertility checked.
• If you are pregnant, plan to become pregnant, or get pregnant while taking this drug. This drug may cause harm to an unborn baby if taken at 20 weeks or later in pregnancy. If you are between 20 to 30 weeks of pregnancy, only take this drug if your doctor has told you to. Do not take this drug if you are more than 30 weeks pregnant.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• High blood pressure has happened with drugs like this one. Have your blood pressure checked as you have been told by your doctor.
• If you smoke, talk with your doctor.
• If you have asthma, talk with your doctor. You may be more sensitive to this drug.
• Talk with your doctor before you drink alcohol.
• Do not use on skin that has any problems.
• Do not use more than told. Unsafe side effects may happen.
• Do not use longer than you have been told by the doctor.
• The chance of heart failure is raised with the use of drugs like this one. In people who already have heart failure, the chance of heart attack, having to go to the hospital for heart failure, and death is raised. Talk with the doctor.
• The chance of heart attack and heart-related death is raised in people taking drugs like this one after a recent heart attack. People taking drugs like this one after a first heart attack were also more likely to die in the year after the heart attack compared with people not taking drugs like this one. Talk with the doctor.
• If you are taking aspirin to help prevent a heart attack, talk with your doctor.
• Not all products are meant for use in children. Talk with the doctor.
• If you are 60 or older, use this drug with care. You could have more side effects.
• NSAIDs like this drug may affect egg release (ovulation). This may affect being able to get pregnant. This goes back to normal when this drug is stopped. Talk with the doctor.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Skin patch:

• This drug may cause harm if chewed or swallowed. If this drug has been put in the mouth, call a doctor or poison control center right away.

All other products:

• Avoid sunlight on treated area.
• This drug may cause harm if swallowed. If this drug is swallowed, call a doctor or poison control center right away.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

All products:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
• Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
• Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
• Signs of high potassium levels like a heartbeat that does not feel normal; feeling confused; feeling weak, lightheaded, or dizzy; feeling like passing out; numbness or tingling; or shortness of breath.
• Skin irritation.
• Chest pain or pressure or a fast heartbeat.
• Shortness of breath, a big weight gain, or swelling in the arms or legs.
• Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
• Feeling very tired or weak.
• Flu-like signs.
• Very bad back pain.
• Severe skin reactions may happen with this drug. These include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious reactions. Sometimes, body organs may also be affected. These reactions can be deadly. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or any areas of skin; fever; chills; body aches; shortness of breath; or swollen glands.
• Liver problems have happened with drugs like this one. Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

3% gel:

• A burning, numbness, or tingling feeling that is not normal.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dizziness or headache.
• Constipation, diarrhea, stomach pain, upset stomach, or throwing up.
• Gas.
• Heartburn.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

All products:

• Do not take this drug by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn).
• Wash your hands before and after use.
• Clean affected part before use. Make sure to dry well.
• If you get this drug in your eyes, wash right away with water. If you have eye irritation that lasts or a change in eyesight, call your doctor.

Cream and gel:

• Put a thin layer on the affected skin and rub in gently.
• Do not use sunscreen, insect repellant, or other drugs on affected part.
• If putting this drug on the hand, do not wash your hands for at least 1 hour after putting on.
• Do not use heat or bandages on the treated part.
• Let the drug dry for at least 10 minutes before you cover it with clothes or gloves.
• Do not bathe, shower, or swim for 1 hour after putting on.
• Do not use on open wounds or infected skin.

Gel (Voltaren):

• This drug comes with a dosing card. Be sure you know how to use it. Talk with your doctor or pharmacist if you have any questions.

Skin patch:

• Put patch on clean, dry, healthy skin.
• Do not put on cuts, scrapes, eczema, or damaged skin.
• Do not bathe, shower, or swim after putting on.
• If the patch loosens, put tape ONLY on the edges of the patch to hold it in place.
• If the patch does not stick well, talk with your pharmacist about what to do. Certain things can be done to help hold it in place.
• If the patch falls off, put a new one on.

Skin solution:

• Some products come in a pump. Some products come in a packet or in a bottle with a dropper. If you are using a pump, you will need to prime it before you use it the first time. Prime the pump as you are told in the package insert.
• Put on clean, dry, healthy skin. You may put right on the knee or on the hand and then onto the knee.
• Spread evenly on front, back, and side of knee.
• Let dry before covering with clothing.
• Do not bathe, shower, or swim for 30 minutes after applying.
• Do not use on open wounds or infected skin.
• You may use cosmetics, lotions, insect repellant, sunscreen, or other skin drugs after the skin has dried.
• Do not use heat or bandages on the treated part.
• Let the treated skin dry before touching it or letting it touch anyone else’s skin.

What do I do if I miss a dose?

• Skip the missed dose and go back to your normal time unless your doctor tells you to do something else.
• Do not put on 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

All products:

• Store at room temperature. Do not freeze.
• Protect from heat.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Skin patch:

• Store in the envelope that this drug comes in to help keep away from children. Do not open the envelope until you are ready to use this drug.
• After opening, be sure you know how long the product is good for and how to store it. Ask the doctor or pharmacist if you are not sure.
• After you take off a skin patch, be sure to fold the sticky sides of the patch to each other. Throw away used patches where children and pets cannot get to them.
• Throw away unused patches when they are no longer needed. Take them from the pouch, take off liner, and fold the sticky side of the patch together.

Skin solution:

• If you are using a pump, store upright with the cap on.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2022-05-02

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