The following information is NOT meant to be used to treat yourself or patients

  • Generic name = Diclofenac
  • Trade name = Voltaren, Voltaren-XR, Voltaren gel, Arthrotec, Flector patch
  • Class = anti-inflammatory
  • MOA
    • Blocks cyclooxygenase (COX-1 & COX-2) and thus production of prostaglandins
  • Advantages
    • Relatively inexpensive as generic
    • Comes in multiple formulations (pills, gel, patch)
  • Dosing
    • 25, 50, 75-mg tablets
    • 100-mg extended release tablet
    • 25-mg capsule
    • 1% and 3% gel (Voltaren Gel)
      • Apply 2-grams (upper extremities) or 4-grams (lower extremities) to painful joint QID [no more than 8 or 16-gram/day to any single joint respectively]
      • How to measure and apply the gel
    • 1.5% topical solution
    • 180-mg patch (Flector patch)
  • Note:
    • COX-1 normally produces prostaglandins that are gastroprotective.  Thus, blocking it can lead to gastric ulcers/bleeds
      • Arthrotec is a combination with misoprostol (to protect the stomach)
    • Take with food or 8-oz of water
    • May increase risk of cardiovascular thrombotic events, MI, and stroke
      • Avoid in patients with cardiac history
      • The flector patch and topical formulations are great as alternatives for these patients
    • Flector patch– good for areas where local inflammatory relief is needed, but in patients who can’t take systemic NSAIDs
      • medium and large joints (examples: shoulder, sacroiliac, knee, ankle, elbow)
      • superficial painful tendons (examples: biceps tendon, DeQuervain’s, achilles)
    • Arthrotec gel
      • good for superficial, small joints and other small areas (ex: finger joints, tendonitis at wrist)
    • Absolute contraindication: ASA allergy
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