Do Topical Medications Voltaren, Pennsaid, and Flector Work for Pain?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
Posted on

Joint pain from arthritis, an injury, or overuse often requires the use of anti-inflammatory medications. Many people hate taking pills by mouth because they can be hard on the stomach and kidneys. But do the topical options work? What are your options and which is the best?

Non-steroidal anti-inflammatory (NSAID) topical options:

In the United States, three topical NSAID products are approved to treat pain including Voltaren Gel (diclofenac sodium 1%), Pennsaid topical solution (diclofenac sodium 1.5%), and Flector patches (diclofenac epolamine 1.3%).

Do they work for arthritis pain?

Yes, several recent studies suggest topical NSAID options are effective for arthritis pain and some studies suggest pain relief is similar to that achieved by taking oral NSAIDs (e.g. naproxen, ibuprofen, Aleve, Advil).

Are the topical NSAIDs safer?

Yes, topical NSAIDs are likely safer than oral NSAIDs due to the low blood concentrations that occur when you use the topical NSAIDs (Voltaren Gel, Pennsaid and Flector patches). So in other words, using a topical won’t affect the GI tract or kidneys nearly as much as the oral medications.

How are they used?
Pennsaid is used two pumps, two times a day where Voltaren gel is applied four times a day. A Flector patch is changed twice a day on painful areas.

What are the benefits of the topical NSAIDs over pills?

Oral NSAIDs work well, but concern over cardiovascular and GI side effects can potentially limit their use. The three topical options have been shown to provide effective pain relief with minimal side effects. Among the topical options, in one head to head comparison patients preferred Pennsaid over Voltaren gel.

What is the downside?

I’d say cost. Depending on what your insurance company will cover, know that Pennsaid comes in a generic diclofenac sodium spray, but it may still be more expensive than brand name Voltaren Gel. Flector patches come in a box of 30 and they are pricey, but if you can get it covered, worth a try.

Dr O.

Drugs featured in this story

Filed under