In this particular study, based on an overall number of 10 cases of liver injury associated with diclofenac, the adjusted odds ratio increased further with female gender, doses of 150 mg or more, and duration of use for more than 90 days.Physicians should measure transaminases at baseline and periodically in patients receiving long-term therapy with diclofenac, because severe hepatotoxicity may develop without a prodrome of distinguishing symptoms.

The optimum times for making the first and subsequent transaminase measurements are not known.
These events can occur at any time during use and without warning symptoms.

Voltaren gel dosing card copy.

Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment.

The molecular weight is 318.14. The gel should be applied within the oblong area of the dosing card up to the 2 or 4 gram line (2 grams for each elbow, wrist, or hand, and 4 grams for each knee, ankle, or foot). There are no specific antidotes. help relieve arthritis pain in some of your joints. Coupons, discounts, and promos updated 2020. The relative increase in serious CV thrombotic events over baseline conferred by NSAID use appears to be similar in those with and without known CV disease or risk factors for CV disease.

The hands should then be used to gently rub the gel into the skin. Copyright © 2018 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. However, severe hepatic reactions can occur at any time during treatment with diclofenac. If VOLTAREN GEL is used in patients with a recent MI, monitor patients for signs of cardiac ischemia.NSAIDs, including diclofenac, cause serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal. In animal studies, NSAIDS, including diclofenac, inhibit prostaglandin synthesis, cause delayed parturition, and increase the incidence of stillbirth.Reproductive and developmental studies in animals demonstrated that diclofenac sodium administration during organogenesis did not produce teratogenicity despite the induction of maternal toxicity and fetal toxicity in mice at oral doses up to 20 mg/kg/day (approximately 5 times the maximum recommended human dose (MRHD) of VOLTAREN GEL based on bioavailability and body surface area (BSA) comparison), and in rats and rabbits at oral doses up to 10 mg/kg/day (approximately 5 and 10 times the MRHD based on bioavailability and BSA comparison). Diclofenac was not detectable in breast milk in 12 women using diclofenac (after either 100 mg/day orally for 7 days or a single 50 mg intramuscular dose administered in the immediate postpartum period).Based on the mechanism of action, the use of prostaglandin-mediated NSAIDs, including VOLTAREN GEL, may delay or prevent rupture of ovarian follicles, which has been associated with reversible infertility in some women. Pain in the target hand as assessed by the patients at Weeks 4 and 6 on a visual Medication Guide for Nonsteroidal Anti-inflammatory Drugs Before you use VOLTAREN GEL for the first time, your healthcare provider or pharmacist should show you how to correctly measure your dose using the dosing card.Do not use more than a total of 32 grams of VOLTAREN GEL each day.

Diclofenac sodium is a benzeneacetic acid derivative. Non-serious Application Site Adverse Reactions (≥1% VOLTAREN GEL Patients) – Short-term Controlled TrialsTable 2. Abnormal tests occurred during the first 2 months of therapy with diclofenac in 42 of the 51 patients in all trials who developed marked transaminase elevations.In postmarketing reports, cases of drug-induced hepatotoxicity have been reported in the first month, and in some cases, the first 2 months of therapy, but can occur at any time during treatment with diclofenac.

more than 3 times the ULN) of AST (SGOT) were observed in about 2% of approximately 5,700 patients at some time during diclofenac treatment (ALT was not measured in all studies).In a large, open-label, controlled trial of 3,700 patients treated with oral diclofenac sodium for 2-6 months, patients were monitored first at 8 weeks and 1,200 patients were monitored again at 24 weeks. The dosing card should be used for each application of drug product. (14.1) DOSAGE AND ADMINISTRATION Total dose should not exceed 32 g per day, over all affected joints.

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