Diclofenac Topical (actinic keratosis)
Diclofenac sodium topical gel is a prescription anti-inflammatory gel applied directly to the skin to relieve joint pain from osteoarthritis of the hands and knees.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
This medication carries the FDA's most serious warning. NSAIDs like diclofenac can increase the risk of heart attack and stroke — both of which can be fatal. This risk can grow with longer use and is higher in people who already have heart or blood vessel disease. Separately, NSAIDs can cause serious stomach and intestinal bleeding, ulcers, or perforation — also potentially fatal — and these can happen at any time, even without stomach pain as a warning sign. Older adults face a higher risk of these GI complications. This gel must not be used around the time of heart bypass (CABG) surgery.
📖 Diclofenac Topical (actinic keratosis): Patient Information Guide
A plain-language walkthrough of Diclofenac Topical (actinic keratosis) — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Diclofenac sodium topical gel is used to relieve pain from osteoarthritis in joints near the skin's surface:
- Knees
- Hands and fingers
- Feet and toes
- Ankles
- Wrists
- Elbows
⚙️How it works▾
Diclofenac blocks an enzyme called cyclooxygenase (COX), which your body needs to produce prostaglandins — the chemical signals that trigger pain, swelling, and inflammation in joints. By reducing prostaglandin production, diclofenac helps calm the inflammation that makes arthritic joints hurt. It also has mild fever-reducing and pain-dampening effects throughout the body.
💊How it's taken▾
The gel is applied to the skin over the affected joint and rubbed in gently, four times a day. A dosing card is included in the carton to help you measure the correct amount — different joints require different amounts, so always use the card. There are daily limits per joint and for total use across all joints; do not exceed them.
- Lower extremity joints (knee, ankle, foot): apply a larger measured amount four times daily
- Upper extremity joints (hand, wrist, elbow): apply a smaller measured amount four times daily
- If treating your hands, wait at least one hour before washing them
- Rinse and dry the dosing card after each use
🤒Side effects — in detail▾
The most common side effects are local skin reactions at the spot where you apply the gel:
- Skin redness or irritation
- Contact dermatitis (a rash at the application site)
- Dry or flaking skin
- Itching
- Skin discoloration
Stop using the gel and get medical help right away if you develop chest pain, signs of stomach bleeding (black stools, vomiting blood), difficulty breathing, severe swelling, or a spreading skin rash — these can be signs of a serious reaction that needs immediate attention.
⚠️Warnings & precautions▾
- Heart attack and stroke: NSAIDs can increase the risk of serious cardiovascular events, even with short-term use. People with heart disease or high blood pressure face higher risk.
- Stomach and intestinal bleeding: Serious GI bleeding or ulcers can occur without any warning symptoms. Older adults are at the greatest risk.
- Kidney problems: Long-term use can injure the kidneys, especially in older adults, those with existing kidney issues, heart failure, or liver disease, and those taking diuretics or ACE inhibitors.
- Liver effects: Liver enzyme levels may rise during treatment. Stop using the gel if you develop symptoms of liver problems (yellowing of skin/eyes, unusual fatigue, dark urine).
- High blood pressure and fluid retention: NSAIDs can raise blood pressure and cause swelling. Monitor blood pressure during treatment.
- Severe skin reactions: Rare but potentially fatal skin conditions (such as Stevens-Johnson Syndrome) have been reported with NSAIDs. Stop using if a serious rash or blistering develops.
- Severe allergic reactions: People who have had asthma, hives, or other reactions to aspirin or NSAIDs should not use this gel.
🔀What it interacts with▾
Diclofenac topical gel can interact with several common medications — always share your full medication list with your prescriber:
- Aspirin: Combining the two raises the risk of stomach bleeding and is generally not recommended
- Blood thinners (e.g., warfarin): The combination significantly increases the risk of serious GI bleeding
- ACE inhibitors (blood pressure drugs): Diclofenac may reduce their blood-pressure-lowering effect
- Diuretics (water pills): Diclofenac can blunt their effectiveness and put extra strain on the kidneys
- Lithium: Diclofenac can raise lithium blood levels, increasing the risk of lithium toxicity
- Methotrexate: Diclofenac may increase the toxic effects of this medication
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Do not use if you are allergic to diclofenac, aspirin, or any other NSAID
- Do not use if you have ever had asthma, hives, or a serious allergic reaction triggered by aspirin or NSAIDs
- Do not use around the time of coronary artery bypass graft (CABG) heart surgery
- Tell your doctor if you have heart disease, prior stroke, or risk factors such as high blood pressure or high cholesterol
- Tell your doctor if you have a history of stomach ulcers or GI bleeding
- Tell your doctor if you have kidney or liver disease, or heart failure
- Avoid during late pregnancy — it can cause premature closure of an important blood vessel in the baby's heart
- Use with caution if breastfeeding; discuss the risks and benefits with your doctor
- Safety and effectiveness have not been established in children
- Older adults should use with extra caution due to higher risk of GI and kidney complications
🚑If you take too much▾
If the gel is accidentally swallowed in significant amounts, it can cause symptoms similar to taking too much of an NSAID pill — including nausea, vomiting, stomach pain, drowsiness, and in serious cases, GI bleeding, high blood pressure, or kidney problems. If this happens, call Poison Control at 1-800-222-1222 right away or seek emergency care.
📡Pharmacodynamics — effects in the body▾
Diclofenac has three main effects on the body: it reduces inflammation, relieves pain (anti-nociception means it dulls the body's pain signals), and lowers fever. These effects all stem from its ability to reduce the production of prostaglandins, the chemical messengers that amplify inflammation, pain sensitivity, and elevated body temperature.
🔬Pharmacokinetics — how your body processes it▾
When applied to the skin as a gel, diclofenac is absorbed through the skin but reaches the bloodstream at dramatically lower levels than oral diclofenac — on average about 17 times less drug in the body compared to taking the equivalent oral dose. This means the gel acts mainly at the local joint level rather than throughout the whole body. Heat or exercise at the application site may affect how the drug is absorbed, so avoid applying heat patches immediately before using the gel.
📦How to store it▾
Store at 20°C to 25°C (68°F to 77°F). Store the dosing card with your diclofenac sodium topical gel.
📄 Written from Diclofenac Topical (actinic keratosis)’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Diclofenac Topical (actinic keratosis) — the kind of thing our pharmacy team would talk through with you at the counter.
Is this gel the same as taking an NSAID pill like ibuprofen? ▾
How do I actually use the dosing card that comes in the box? ▾
What side effects should I just watch for versus ones that mean I need to call someone right away? ▾
I already take a blood thinner and a water pill — is it safe to use this gel? ▾
Can I use this if I'm pregnant or breastfeeding? ▾
Can I put this gel on my hip or back? ▾
Is Diclofenac Topical (actinic keratosis) available over the counter? ▾
💬 Answers drafted from Diclofenac Topical (actinic keratosis)’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
📈 How widely Diclofenac Topical (actinic keratosis) is used
A general measure of how commonly Diclofenac Topical (actinic keratosis) is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Diclofenac Topical (actinic keratosis) is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Diclofenac Topical (actinic keratosis) prescribed? Of the 1,596 medications we measure, Diclofenac Topical (actinic keratosis) ranks #44 by Medicaid prescriptions — more than 97% of them.
Utilization by Diclofenac Topical (actinic keratosis) product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
diclofenac sodium 0.01 MG/MG Topical Gel Most dispensed
Summed across the 23 of 255 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 855633
diclofenac sodium 75 MG Delayed Release Oral Tablet
Summed across the 27 of 346 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 855926
diclofenac sodium 50 MG Delayed Release Oral Tablet
Summed across the 19 of 217 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 855906
diclofenac sodium 20 MG/ML Topical Solution
Summed across the 8 of 39 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1487074
diclofenac potassium 50 MG Oral Tablet
Summed across the 9 of 138 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 855942
diclofenac sodium 0.03 MG/MG Topical Gel
Summed across the 5 of 51 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 855642
diclofenac potassium 25 MG Oral Tablet
Summed across the 9 of 24 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 857702
24 HR diclofenac sodium 100 MG Extended Release Oral Tablet
Summed across the 4 of 119 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 855657
Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch
Summed across the 1 of 27 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 855626
diclofenac sodium 1 MG/ML Ophthalmic Solution
Summed across the 4 of 13 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 854801
diclofenac sodium 25 MG Delayed Release Oral Tablet
Summed across the 4 of 28 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 855664
diclofenac sodium 15 MG/ML Topical Solution
Summed across the 2 of 81 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 857700
diclofenac 25 MG Oral Capsule
Summed across the 4 of 17 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 858342
diclofenac potassium 50 MG Powder for Oral Solution
Summed across the 5 of 19 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 859063
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Diclofenac Topical (actinic keratosis), and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 124 of 1,374 listed Diclofenac Topical (actinic keratosis) NDCs with Medicaid activity.
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Diclofenac Topical (actinic keratosis) — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Diclofenac Topical (actinic keratosis) in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Diclofenac Topical (actinic keratosis) went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 3355 15 dose forms · 30 strengths
-
Dose form (SCDF) Delayed Release Oral Capsule RxCUI 438955No current FDA listingClinical drug / strength (SCD) sodium 25 MGRxCUI 1234844sodium 50 MGRxCUI 1234853 -
Dose form (SCDF) Delayed Release Oral Tablet RxCUI 371794No current FDA listingClinical drug / strength (SCD) sodium 25 MGRxCUI 855664sodium 50 MGRxCUI 855906sodium 75 MGRxCUI 855926 -
Dose form (SCDF) Extended Release Oral Capsule RxCUI 371793No current FDA listingClinical drug / strength (SCD) 24 HR diclofenac sodium 100 MGRxCUI 41184624 HR diclofenac sodium 75 MGRxCUI 411848 -
Dose form (SCDF) Extended Release Oral Tablet RxCUI 371799No current FDA listingClinical drug / strength (SCD) sodium 75 MGRxCUI 85771324 HR diclofenac sodium 100 MGRxCUI 855657 -
Dose form (SCDF) Injectable Solution RxCUI 371795No current FDA listingClinical drug / strength (SCD) sodium 25 MG/MLRxCUI 857705 -
Dose form (SCDF) Medicated Patch RxCUI 1792846No current FDA listingClinical drug / strength (SCD) Once-Daily diclofenac epolamine 0.013 MG/MGRxCUI 2385117Twice-Daily diclofenac epolamine 0.013 MG/MGRxCUI 8556260.0125 MG/MGRxCUI 2705052 -
Dose form (SCDF) Ophthalmic Solution RxCUI 378986No current FDA listingClinical drug / strength (SCD) sodium 1 MG/MLRxCUI 854801 -
Dose form (SCDF) Oral Capsule RxCUI 376352No current FDA listing -
Dose form (SCDF) Oral Solution RxCUI 393225No current FDA listingClinical drug / strength (SCD) sodium 0.25 MG/MLRxCUI 857689 -
Dose form (SCDF) Oral Tablet RxCUI 371798No current FDA listing -
Dose form (SCDF) Powder for Oral Solution RxCUI 1856554No current FDA listingClinical drug / strength (SCD) potassium 50 MGRxCUI 859063 -
Dose form (SCDF) Rectal Suppository RxCUI 371796No current FDA listingClinical drug / strength (SCD) sodium 100 MGRxCUI 857696sodium 12.5 MGRxCUI 857698sodium 25 MGRxCUI 857703sodium 50 MGRxCUI 857709 -
Dose form (SCDF) Topical Cream RxCUI 438948No current FDA listingClinical drug / strength (SCD) sodium 10 MG/MLRxCUI 1043479 -
Dose form (SCDF) Topical Gel RxCUI 377959No current FDA listing -
Dose form (SCDF) Topical Solution RxCUI 393139No current FDA listing
Look up RxCUI 3355 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Diclofenac Topical (actinic keratosis) is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
RxNorm drug class
Diclofenac Topical (actinic keratosis) belongs to the Nonsteroidal Anti-inflammatory Drug class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Proficient Rx LP is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.