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diclofenac topical
generic
Black Box Warnings .
Cardiovascular Thrombotic Event
NSAIDs incr. risk of serious and potentially fatal cardiovascular thrombotic events, incl. MI and stroke; risk may occur early in tx and may incr. w/ duration of use; contraindicated in CABG periop setting
GI Bleeding, Ulceration, and Perforation
NSAIDs incr. risk of serious and potentially fatal GI adverse events incl. bleeding, ulcer, and stomach or intestine perforation; GI events may occur at any time during use and w/o warning sx; elderly pts and pts w/ hx of PUD or GI bleeding at greater risk for serious GI events
Adult Dosing .
Dosage forms: GEL: 1%, 3%; SOL: 1.5%
actinic keratosis
- [apply 0.5 g (3% gel) to each 5 cm^2 lesion bid x60-90 days]
- Info: use lowest effective dose, shortest effective tx duration; D/C if abnormal liver or renal tests persist or worsen
osteoarthritis
- [upper extremity joints]
- Dose: apply 2 g (1% gel) qid; Max: 8 g/joint/day up to 32 g/day total; Info: for elbows, wrists, hands; use lowest effective dose, shortest effective tx duration; avoid occlusive dressings or heat; D/C if abnormal liver or renal tests persist or worsen
- [lower extremity joints]
- Dose: apply 4 g (1% gel) qid; Max: 16 g/joint/day up to 32 g/day total; Info: for knees, ankles, feet; use lowest effective dose, shortest effective tx duration; avoid occlusive dressings or heat; D/C if abnormal liver or renal tests persist or worsen
- [knee]
- Dose: apply 40 gtt (1.5% solution) per knee qid; Info: use lowest effective dose, shortest effective tx duration; avoid occlusive dressings or heat; D/C if abnormal liver or renal tests persist or worsen
renal dosing
- [see below]
- CrCl >60: no adjustment; CrCl 30-60: not defined, caution advised; CrCl <30: avoid use; advanced renal dz: avoid use
- HD/PD: avoid use
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.