Dude, Where’s My Voltaren Gel?

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.
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Many arthritis sufferers are in a panic over the shortage of Voltaren gel (diclofenac sodium gel) and I get why they are worried. Voltaren gel is a prescription topical anti-inflammatory gel used for all kinds of arthritis pain: rheumatoid arthritis, lupus, and osteoarthritis of the knees, hands and hips. People who have stomach issues from taking anti-inflammatories by mouth can bypass that problem with Voltaren gel.

Endo Pharmaceuticals, the maker of Voltaren 1% gel, is the sole supplier and they have released a statement that Voltaren gel is on back order and they cannot estimate a release date. Hmm. Endo also could not provide a reason for the shortage, though it is suspected that cross contamination problems at the plant that manufactures Voltaren gel are the culprits.

What are your options now?

1) Flector patches (diclofenac epolamine 1.3%) are still available and an option to think about. The Flector patch is FDA approved for the treatment of pain due to strains and sprains.

2) Pennsaid solution (diclofenac sodium 1.5%) is another topical treatment similar to Voltaren gel (also made by Endo) that is approved for the treatment of knee arthritis symptoms. The recommended dose is 40 drops per knee, four times a day.

3) Lidoderm patches are patches with topical lidocaine, which works as a pain reliever. Lidoderm can work for low back pain among other things. Lidoderm, unlike Flector patches and Voltaren gel, is not a topical anti-inflammatory but rather a numbing medicine applied to the skin.

4) An over the counter option, though not as well studied, is Aspercreme cream, which is a topical salicylate (aspirin) pain reliever. It works by reducing swelling and inflammation in the muscle and joints.

Hang in there.

Dr. O.

None of these alternatives are available as generics, and some have better insurance coverage and pricing than others. Voltaren is typically considered a Tier 2 medication by insurance companies, meaning a moderate co-pay, and can be found for around $35 – $40 for 100 mg of gel. In contrast, if Flector patches are covered by insurance, they will likely fall under Tier 3, or your highest co-pay, and run about $175 for 30 patches. Lidoderm patches are more likely to be covered as Tier 2 drugs by insurance, but they’re a bit pricier at around $230 for 30 patches. Pennsaid is also typically a Tier 2 or 3 drug, and can be found for $180 for a 150 ml package.

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