diclofenac diethylamine: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
diclofenac diethylamine: clinical details
Prescribing considerations
- Confirm that symptoms fit an acute traumatic soft-tissue injury and that the skin is intact.
- Systemic adverse effects remain possible when absorption is increased by a large treated area or occlusion.
- Use additional caution with active peptic ulceration or impaired renal, hepatic or cardiac function.
- Patients with asthma, nasal polyps, chronic respiratory disease or multiple allergies may have greater hypersensitivity risk.
- Counsel about photosensitivity, preventing child contact with treated skin and fire risk from contaminated fabrics.
Contraindications and cautions
- Hypersensitivity to diclofenac, an excipient, aspirin or another NSAID where the reaction included asthma, bronchospasm, rhinitis, urticaria or angioedema
- Application to open injuries, infected or inflamed skin, eczema or mucous membranes
- Third trimester of pregnancy
- Age under 14 years for the selected product
Monitoring
- Review for local dermatitis, rash, photosensitivity or hypersensitivity and discontinue if a rash develops.
- Reassess the diagnosis if symptoms worsen or fail to improve as expected.
- Consider systemic gastrointestinal, renal, hepatic or hypersensitivity effects if exposure is extensive.
Clinical pharmacology
Diclofenac reduces prostaglandin synthesis through cyclo-oxygenase inhibition. Percutaneous absorption is low but varies with the treated area, contact time, skin hydration and occlusion. Diclofenac preferentially distributes into inflamed tissue beneath the application site.
Formulation and product differences
- The selected product is a white to almost white homogeneous cutaneous gel.
- It contains propylene glycol, isopropyl alcohol, paraffin and fragrance components that may irritate skin or cause allergic reactions.
- A breathable bandage may be used after drying, but an airtight occlusive dressing should not be used.
- Topical diclofenac products differ in concentration and instructions; directions should not be transferred between formulations.
diclofenac diethylamine preparations and strengths
Gel
Route: Cutaneous
Strengths: 1.16%, 2.32%, 2.32% w/w
diclofenac diethylamine interactions
Interactions are unlikely when the gel is used as intended because systemic absorption is low. A pharmacist or prescriber should still review medicines that interact with diclofenac, particularly if systemic exposure may be increased.
Other NSAIDs, including ibuprofen, naproxen and aspirin used for pain
Combining NSAIDs can increase gastrointestinal and other NSAID adverse effects; check before using them together.
Anticoagulants such as warfarin
Diclofenac may add to bleeding risk, although this is less likely with limited topical use.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.