Diclofenac patch

Contact dermatitis on the eyelids developed in a 70-year-old-woman after she had used eye-drops containing diclofenac. Patch tests were positive to both diclofenac and indometacin, suggesting possible crossreactivity between the two compounds (32). 

Ten to 20 hours after a single application of the diclofenac patch to the upper inner arm, peak plasma diclofenac concentrations of 0.7-6 ng/mL were recorded. Diclofenac plasma concentrations of 1.3-8.8 226 were noted after 5 days of twice-daily patch... 

Diclofenac gel is indicated for the relief of the pain of osteoarthritis of the joints amenable to topical treatments such as the knees and those of the hands. Diclofenac patch is indicated for the topical treatment of acute pain due to minor strains, sprains and contusions [2,3]. In controlled trials during the premarketing development approximately 600 patients with minor sprains, strains, and contusions were treated safely with diclofenac patch for up to 2 weeks [4j. A randomized, double-blind, placebo-controlled, trial evaluated the efficacy and tolerability of diclofenac patch, self-administered every 12 h to injury site, in 384 patients aged 18-65 years with minor soft tissue injury and moderate to severe pain intensity >5 (0-10 scale). The most common injuries were contusion (42.6%), strain (31.1%), and sprain (24.4%) most common sites were ankle, shoulder, knee, and foot (67.3%). Patients treated with diclofenac patch experienced improved mean pain scores (40.4% of baseline score) vs. patients using placebo (47.4%, P < 0.05) with an overall pain reduction of 14.8% (Figure 52.3). Patients treated with the patch reached pain resolution 3 days sooner than those in the placebo group (median 10.0 vs. 13.5 days, P = 0.01). Patient response to treatment was rated good to excellent 57.8% for the diclofenac patch vs. 48.4% placebo (P < 0.01). 

Diclofenac patch and gel preparations have not been evaluated for use in labor and delivery, in pregnant and nursing women or in pediatrics. The Fleeter diclofenac patch is supplied in resealable envelopes. 

The diclofenac patch measures 10 cm x 14 cm and is composed of an adhesive material containing 1.3% diclofenac epolamine. There is a total of 180 mg of diclofenac epolamine distributed throughout each patch (13 mg of diclofenac per gram of adhesive). The recommended dose of the diclofenac patch is one patch to the most painful area of the body apphed up to twice daily. 

Both diclofenac gel and the diclofenac patch have been designed with the idea of providing local analgesia... 

Diclofenac Transdermal patch For osteoarthritis soft tissue injury... 

The manufacturers of other topical preparations Solaraze 3% w/w gel and Voltarol 1% w/w gel patch) state that interactions are not anticipated due to the low level of systemic absorption, although one manufacturer still warns not to administer concurrently, by either the topical or systemic route, any medicinal product containing diclofenac or other NSAIDs. ... 

Voltarol Gel Patch (Diclofenac epolamine). Novartis Consumer Health. UK Summary of product characteristics, March 2004,... 

Generic Names diclofenac sodium topical gel diclofenac epolamine topical patch Trade/Proprietary Names Voltaren Gel Elector Patch... 

Chemical Structures diclofenac sodium topical gel (Figure52.1) molecularformula Cj HjjjCljN-NaO diclofenac epolamine patch (Figure 52.2) molecular formula C jH CljN Oj... 

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) and is the active ingredient in both the gel and patch formulations described in this chapter. Diclofenac inhibits the enzyme cyclooxygenase (COX), an early component of the arachidonic acid cascade, resulting in reduced formation of prostaglandins, thromboxane, and prostacyclin. It is not completely understood how reduced synthesis of these compounds results in therapeutic efficacy. The chief therapeutic effects of diclofenac are anti-inflammatory activity, anti-nociception and antipyresis. When applied topically (via gel or patch), diclofenac is absorbed into the epidermis. However, the amount of topical diclofenac absorbed and the ultimate systemic exposure is substantially less than that seen after oral administration of the compound. 

For both the gel and patch preparations of diclofenac, by far the most common drug-related adverse events were site-specific reactions such as itching and irritation. 

Petersen B. Diclofenac epolamine (Flector) patch evidence for topical activity. J Clin Druginvestig 2009 9 1-9. 

Flector Patch (diclofenac epolamine topical patch 1.3%). Prescribing information September 2007, Alpharma, Inc, Bridgewater, NJ. 

Carr W, Beks P, Jones C, et al. Efficacy and tolerability of FLECTOR Patch (diclofenac epolamine topical patch) in the treatment of minor soft tissue injury pain (Poster Presentation American Pain Society Annual meeting 2008). /Pain 2008 9(4, Suppl. 2) 45. 

---