Diclofenac sodium topical gel 1% (Voltaren Gel, Novartis) has been approved as the first topical prescription treatment that patients can apply directly to sites of pain associated with osteoarthritis, a condition in which the cartilage in the joint breaks down.
The gel has a favorable safety profile. Its systemic absorption is 94% less than the comparable oral diclofenac treatment. However, it should not be administered to asthmatic patients or to those with urticaria or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients.
This product is contraindicated for treating perioperative pain in the setting of coronary artery bypass graft surgery, and it should not be used in combination with other oral NSAIDs or aspirin.
The combined use of the gel with other topical products, such as sunscreens and cosmetics, on the same skin area has not been tested and should be avoided because of the potential to alter local tolerability and absorption.
Voltaren is also available as 25-, 50-, and 75-mg tablets.
(Sources: Novartis, October 22, 2007;