How Safe Are Topical NSAIDs Like Voltaren Gel?

February 28, 2024

https://www.peoplespharmacy.com/articles/how-safe-are-topical-nsaids-like-voltaren-gel

How Safe Are Topical NSAIDs Like Voltaren Gel?

FDA’s warning on doctor-prescribed topical NSAIDs like Voltaren Gel is scary. Are gels as dangerous as oral NSAIDs like ibuprofen or naproxen?
Joe Graedon
February 20, 2024
 
When the FDA allowed drug companies to sell NSAIDs over the counter we were concerned. That’s because drugs like ibuprofen (Advil, Motrin IB, etc) and naproxen (Aleve) came with some pretty serious side effects including stomach irritation and bleeding ulcers. Given that tens of millions of Americans use such drugs every day, the potential problem worried us. When the FDA gave the green light to topical NSAIDs like Voltaren Gel (diclofenac), we thought it was probably a good idea. It seemed to suggest that people could get localized relief for arthritic fingers, knees, shoulders and hips without as many systemic side effects. Were we wrong?

Oral NSAIDS Come With Other Worrisome Side effects:

Americans are in a lot of pain! Medscape provides physicians and other healthcare professionals up-to-date medical news and information. It offered this overview of “Nonsteroidal Anti-inflammatory drug (NSAID) Toxicity” on Sept. 15, 2023:

“More than 70 million prescriptions for NSAIDs are written each year in the United States. With over-the-counter use included, more than 30 billion doses of NSAIDs are consumed annually in the United States alone.”

(See link for article)

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**Comment**

Important article for Lyme/MSIDS patients who deal with excruciating pain.

Many oral NSAIDs can cause heart attacks and strokes, hypertension, irregular heart beats, dizziness, blood clots, fluid retention, heart failure, tinnitus, and liver or kidney damage.

Regarding topical NSAIDs, a Cochrane review for ACUTE pain showed that they provide similar relief as orals with minimal adverse events. So topical NSAIDs used for a short period of time appear to work and are fairly safe; however, less than a year later some of the same authors published a new review for CHRONIC pain which found they only worked for 10% more people than those who got a placebo for osteoarthritis and that there is no evidence for other conditions. While the authors admit the quality of evidence was low, the side-effects were wide ranging but supposedly mild and included:

  • headache
  • diarrhoea
  • drowsiness
  • dyspepsia [heartburn]

Some patients wrote in that they experienced more serious side-effects like stomach pain, abdominal cramps, and high blood pressure.

The article author is puzzled as to why the FDA took so long to allow topical NSAIDs to be sold over the counter when orals have been available OTC despite scary warnings.

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Category:

Activism, Pain Management, research, Treatment, Uncategorized

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