How to Use Voltaren Gel Safely

For most people, Voltaren (diclofenac) gel is safe when used as instructed. However, some people should not use this medication due to its potentially serious side effects. Therefore, you should consult with a healthcare provider before adding this medication to your treatment plan.

In certain people, Voltaren can increase the risks of gastrointestinal (GI) bleeding, and serious cardiovascular events such as heart attack and stroke. Certain factors, like nonsteroidal anti-inflammatory drug (NSAIDs) use and chronic health conditions, can contribute to this risk. Milder reactions to Voltaren may include skin irritation with topical use.

This article will discuss how to use Voltaren gel safely, its side effects and risks, and who should not use the medication.

What Is Voltaren Gel Used For?

Voltaren gel is commonly used to treat OA, the most common type of arthritis. It occurs over time because of age-related "wear and tear" on joints.

People with OA usually have joint pain, swelling, and stiffness. Voltaren gel can help with these symptoms.

The FDA has also approved a 3% strength Voltaren gel that can be bought over the counter (OTC) and used by people with actinic keratosis—a condition that causes rough, scaly skin patches that can turn into cancer.

While Voltaren can help with some joint pain related to arthritis, the gel has not been shown to help with pain from:

• Sports injuries
• Bruises
• Sprains
• Strains
  

Black Box Warnings for Voltaren Gel

Some medications have black box warnings to show that they have a high risk for serious side effects.

Like other NSAIDs, Voltaren gel can cause serious side effects and they can come on without warning. Your risk might be higher if you've been taking NSAIDs for a long time or at high doses.

Who Should Not Use Voltaren Gel?

Your provider might tell you not to use Voltaren at all. For example, you should not use Voltaren:

• If you have any heart issues or are at risk for adverse events such as heart attack and stroke
• If you have allergies to this drug or other pain or fever aids such as aspirin
• Before or after heart surgery

In other situations, you might be able to use Voltaren as long as you talk to your provider about it first. For example, your provider would want to talk with you about Voltaren if you:

• Have had problems or serious side effects from taking drugs for pain or fever
• Are at risk for bleeding in your GI tract or have had stomach conditions like heartburn
• Are pregnant or breastfeeding
• Take a diuretic or ACE inhibitor
• Are younger than 18 years old (the effects of Voltaren have not been looked at in children younger than age 18)
• Are age 60 or older

If you have chronic medical conditions, you should also ask your provider about Voltaren before you try it. For example, don't just use Voltaren on your own without asking your provider first if you have:

• Asthma
• Heart disease
• High blood pressure
• Heart failure
• Kidney disease or kidney failure
• Cirrhosis or another liver disease
• Stroke

Before Using Voltaren Gel

Talk with your healthcare provider before using Voltaren gel to be sure it's right for you. You might be able to switch to the gel if the oral form of diclofenac or other NSAIDs upset your stomach or you are at risk of side effects.

Most studies have shown that Voltaren Gel can ease the pain just as well as the oral form, but the risk of serious side effects is much lower with the gel.

The gel comes with less risk because it is put on and absorbed through your skin, while the oral form goes through your entire body (systemic).

The FDA approved Voltaren gel for OTC use based on the results of studies on its effectiveness and safety. Since then, studies have supported the use of the NSAID gel as a first-line treatment for knee OA and hand OA.

This is especially true for older adults or people at risk of harm from the effects of oral NSAIDs, like damage to the liver, kidneys, and heart.

Before you use Voltaren in any form, you should tell your provider about any other medications or supplements you take. Sometimes, taking Voltaren with another supplement can cause problems.

Tell your provider if you take or use any:

• Prescriptions
• OTC drugs
• Dietary supplements
• Herbal remedies
• Essential oils

Some of the interactions between Voltaren and other medications or supplements are not a big deal, but others can be serious. You and your provider can talk about the risks and benefits and decide if it would be a good idea for you to use Voltaren.

Voltaren Gel Dosage

Voltaren will come with a dosing card that you can use to measure the correct dose of the gel. The card can be reused to measure to the 2-gram or 4-gram mark, depending on the size of the area you are treating.

Apply 2 grams of the gel to each upper body part affected:

• Hand
• Wrist
• Elbow

Apply 4 grams of the gel to each lower body part affected:

• Foot
• Ankle
• Knee

The doses can be applied to the affected upper or lower body part up to four times per day.

When you're using Voltaren, do not apply:

• A higher dose than is directed on the drug label or that has been prescribed by your provider
• More than 32 grams total per day
• To more than two body parts at once
• To your eyes, nose, or mouth
• To open wounds or infected areas
  

How to Use and Store Voltaren

Here's how to use Voltaren:

1. Wash your hands before and after you apply the gel
2. Use the gel for up to 21 days unless your healthcare provider instructs you otherwise
3. Store at 68-77 degrees F (20-25 degrees C)

When you are using Voltaren, do not:

• Wash the gel off if you apply it t the joints of your hands
• Freeze the gel

Side Effects of Voltaren Gel

You might have skin reactions where the gel was applied. A skin reaction was the most common adverse reaction that people reported in Voltaren clinical trials.

NSAIDs like Voltaren can also:

• Raise your blood pressure
• Make you retain fluid
• Cause swelling in your tissues from the fluid build-up (edema)

Voltaren can also cause you to have higher levels of a type of white blood cell (WBC) called eosinophils. If this happens, you might have symptoms like:

• Rash
• Diarrhea
• Stomach pain
• Dark urine

If you have any of these side effects from Voltaren, stop using it and tell your provider.

Severe Adverse Reactions to Voltaren

Read the drug label and package insert that comes with Voltaren gel. This information will help you understand the serious adverse reactions that could happen.

You should also know that long-term NSAID use can lead to serious kidney problems like renal papillary necrosis, a condition where parts of the kidney die.

NSAIDs can also lead to severe and sometimes fatal skin conditions such as:

• Erythroderma
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis
  

Long-term treatment with Voltaren can change your liver enzymes. On a blood test, your levels might be higher than normal even before you have symptoms. This can be a sign of serious liver problems that could lead to the need for a liver transplant or even be fatal if not treated.

Voltaren Gel Interactions

Do not use Voltaren gel when you're already taking oral NSAIDs or aspirin because it raises your risk of having adverse events.

Using these drugs at the same time makes the total drug dose that your body absorbs increase and can make side effects more likely to happen.

Skin Products

There has not been much research on whether you can use Voltaren gel with other kinds of skin products.

Since it's not clear whether it's safe, do not put Voltaren gel on your face or body if they have makeup or sunscreen on them. Mixing skin products can also change how your body absorbs and reacts to the NSAID gel.

Summary

Voltaren gel is a non-steroidal anti-inflammatory drug (NSAID) that can be prescribed by your healthcare provider to help with pain from OA in the knees, hands, and other joints. The gel might work just as well as NSAIDs that you take by mouth.

Some people can't use Voltaren because they have medical conditions or take other medications that aren't safe to mix with NSAIDs.

If you want to try Voltaren for joint pain, talk to your provider. They can help you figure out if it's the best treatment for you.