Long-term use of diclofenac patches carries systemic health risks
Evidence indicates that topical diclofenac formulations, such as patches and gels, result in significantly lower systemic absorption compared to oral administration and are not associated with increased systemic health risks.
The claim states that long-term use of diclofenac patches carries systemic health risks. However, clinical and pharmacological studies (e.g., [8], [10]) demonstrate that topical delivery results in drastically lower systemic bioavailability (5- to 17-fold lower than oral administration) and largely avoids the systemic adverse events associated with oral NSAIDs. Furthermore, systematic reviews and meta-analyses ([3], [6]) find no significant increase in systemic adverse events or serious complications with topical diclofenac compared to placebos. Therefore, the evidence refutes the claim that topical/patch application carries notable systemic risks.
Sheena Derry, Philip G. Conaghan, José António Pereira da Silva, Philip J Wiffen, Andrew Moore. Topical NSAIDs for chronic musculoskeletal pain in adults. 2016. https://doi.org/10.1002/14651858.cd007400.pub3
This systematic review found that reporting of systemic adverse events for topical NSAIDs was poor, but where reported there was no difference compared to carrier, and serious adverse events were infrequent and not different from placebo.
See more details
Chao Zeng, Jie Wei, Monica S M Persson, Aliya Sarmanova, Michael Doherty, Dongxing Xie, Yilun Wang, Xiaoxiao Li, Jiatian Li, Huizhong Long, Guanghua Lei, Weiya Zhang. Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies. 2018. https://doi.org/10.1136/bjsports-2017-098043
This network meta-analysis found that while diclofenac patches were effective for osteoarthritis pain, they were not associated with increased systemic adverse events.
Jean‐Luc Kienzler, Morris Gold, Fabrice Nollevaux. Systemic Bioavailability of Topical Diclofenac Sodium Gel 1% Versus Oral Diclofenac Sodium in Healthy Volunteers. 2010. https://doi.org/10.1177/0091270009336234
This study demonstrated that systemic exposure to topical diclofenac is 5- to 17-fold lower than oral formulations, resulting in minimal systemic effects and primarily mild local skin reactions.
Robert L. Barkin. Topical Nonsteroidal Anti-Inflammatory Drugs. 2012. https://doi.org/10.1097/mjt.0b013e3182459abd
This review notes that topical diclofenac formulations provide local drug delivery while minimizing systemic concentrations and are not significantly associated with the systemic adverse events typical of oral NSAIDs.
The paper trail · every fact has a biography
Challenge the receipt
Citation formatting by citeproc-js (Frank Bennett) and the Citation Style Language project. Source and licenses.
Terms · Privacy · How verdicts work · Dispute this receipt