Who should avoid diclofenac sodium topical gel

Diclofenac sodium is a medication that comes in a topical gel form. You can use it to manage inflammation and pain, especially in the musculoskeletal system, which means doctors often prescribe it to treat arthritis-related conditions, such as rheumatoid arthritis (RA) and osteoarthritis.

Some milder versions of diclofenac sodium gel are available over the counter (OTC), but stronger formulations are only available on prescription.

The medication has some contraindications, which means it isn’t suitable for everyone to use. Speak with a doctor if you have any concerns.

Need a diagnosis or prescription quickly? Optum Perks offers personalized on-demand care in as little as 15 minutes. For $29, answer a few questions online and receive a diagnosis and treatment plan from a US-licensed healthcare professional. Get started here.

Who should not use diclofenac sodium?

There are several reasons why diclofenac sodium may not be suitable for you. Before prescribing the medication, doctors will generally ask you about your health history to rule out any of these contraindications. The OTC versions will usually also contain information that lists possible contraindications.

Cardiovascular effects

Diclofenac has a boxed warning from the Food and Drug Administration (FDA). A boxed warning means that the FDA is drawing attention to a particular safety concern with the drug.

Diclofenac’s boxed warning is for an increased risk of serious cardiovascular events caused by blood clots, such as myocardial infarction (MI) or stroke. This means diclofenac sodium is not suitable for anyone with a previous history of these events, and doctors will use caution if you have any cardiovascular conditions.

Gastrointestinal (GI) effects

Diclofenac also has a boxed warning for an increased risk of GI bleeding, ulcers, or perforation of your stomach or intestines. People with a history of peptic ulcer disease or previous GI bleeding have a 10-fold higher risk of experiencing these than people without this history.

People with asthma

People with a form of asthma called aspirin-exacerbated respiratory disease (AERD) should not use diclofenac sodium topical gel. In this condition, people experience worsened asthma symptoms after taking aspirin or an NSAID. Around 9% of adults with asthma have AERD.

If you have asthma, you may not know if you have AERD. Consider speaking with a doctor before using diclofenac if you have asthma.

During pregnancy

Healthcare professionals do not recommend using diclofenac sodium topical gel during late pregnancy. They recommend limiting the use of diclofenac sodium topical gel after 20 weeks and stopping it completely after 30 weeks of gestation. This is because the medication can affect the unborn baby, particularly the kidneys.

However, no data is available to suggest that you should not use diclofenac during lactation.

Age and diclofenac sodium use

Diclofenac sodium topical gel should not be used by children or adults older than ages 65 years. Older patients are at a higher risk of cardiovascular and GI adverse events.

How does diclofenac gel work?

Diclofenac is a medication that can reduce inflammation and pain. It does so by stopping the action of prostaglandins, the substances that cause pain and swelling. Diclofenac sodium topical gel is a form of this drug that you can apply directly to the affected area and is approved by the FDA to treat:

• osteoarthritis
• RA
• ankylosing spondylitis
• actinic keratosis

While it can manage the symptoms of these conditions, it often doesn’t treat or prevent the joint damage caused by these conditions, and other treatments may also be necessary.

You can use diclofenac sodium, particularly its weaker OTC form, to manage general aches and pains, including back pain.

A 2022 research review suggests that topical formulations are as effective as oral medications in managing osteoarthritis. Some evidence even suggests they may be slightly safer, although more research is needed in this area.

The OTC form of diclofenac sodium (Voltaren) comes in 1% strength, but prescription options are stronger — usually around 3%. Doctors recommend using the lowest possible strength for the shortest possible duration to avoid side effects or adverse events.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Alternative options

If diclofenac sodium isn’t right for you, other options are available that you may try. Doctors might specifically recommend non-NSAID options as other NSAIDs may have the same risks as diclofenac. Here are some non-NSAID options:

• capsaicin cream
• acetaminophen (Tylenol)
• arnica gel
• ice or heat packs

Corticosteroids might be a good prescription alternative to diclofenac. They come in many forms, including creams and oral tablets, and doctors use them to treat a variety of inflammatory conditions, including arthritis. Some examples include prednisone (Rayos) and hydrocortisone (Cortef).

Summary

Diclofenac sodium topical gel is a type of medication called an NSAID that can help manage pain and inflammation, particularly due to forms of arthritis. It comes in OTC and prescription formulations. However, it may not be suitable for everyone.

Diclofenac comes with some boxed warnings from the FDA. It’s not suitable for anyone with a history of cardiovascular events like stroke or MI. Also, it is not suitable for people with a history of ulcers or GI bleeding, as diclofenac can increase the risk of these events.

You should also use caution or avoid the medication if you are pregnant, have asthma, or are over the age of 65 years. Children should avoid this medication.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.