Non-steroidal anti-inflammatory drug (NSAID) — topical gel and oral tabletOver the counter and by prescription

Voltarendiclofenac

Also sold as: Voltaren Emulgel, Voltaren SR, Pennsaid, diclofenac sodium, diclofenac diethylamine

An anti-inflammatory applied to the skin over a painful joint or muscle — useful when oral NSAIDs are not a good idea.

Quick answer

What it is: Diclofenac is an NSAID. In Canada it is sold over the counter as a gel you rub into the skin (Voltaren Emulgel) and on prescription as tablets.
What it's used for: The gel is used for localised muscle, tendon and joint pain, including osteoarthritis of the knees and hands. The tablets are used for more widespread inflammatory pain under medical supervision.
Worth knowing: Apply the gel to clean, intact skin over the painful area and wash your hands afterwards. It may take several days of regular use before the benefit is obvious.
Main safety point: Far less diclofenac reaches the bloodstream from the gel than from a tablet, which is why it is often preferred for older adults — but it is still an NSAID and should not be layered on top of oral ones.

Not sure which option is right for you? Pill4Me pharmacists in Chilliwack can help.

Call 604-705-3644 Book a doctor

Drug class

Non-steroidal anti-inflammatory drug (NSAID) — topical gel and oral tablet

Use in Canada

Voltaren Emulgel is one of Canada's most-used topical anti-inflammatories; oral diclofenac is prescription-only

What is Voltaren?

Topical diclofenac is used for pain and inflammation close to the skin surface — sprains, strains, tendon and muscle injuries, and osteoarthritis of joints such as the knees, hands and elbows. Oral diclofenac, available on prescription, is used for inflammatory arthritis and other painful conditions where a systemic anti-inflammatory is needed.

How Voltaren works

Diclofenac blocks the COX enzymes that generate inflammatory prostaglandins, the same mechanism as ibuprofen and naproxen. Applied as a gel, it concentrates in the tissue underneath the application site, so the joint or muscle gets a useful dose while the amount circulating through the rest of the body stays low — typically a small fraction of what an equivalent tablet would deliver.

Forms and strengths

Voltaren Emulgel and Emulgel Extra Strength for over-the-counter use, in tubes and pump packs. Prescription oral diclofenac as immediate-release and sustained-release tablets, and enteric-coated forms. A prescription topical solution (Pennsaid) is also available for knee osteoarthritis.

How Voltaren is taken

For the gel, apply the amount indicated on the package to the affected area and rub it in gently, usually a few times a day; the label gives the dosing card or measurement to use. Do not apply it to broken skin, open wounds, or a rash, and wash your hands afterwards unless your hands are the treated area. Over-the-counter use is intended to be short-term unless a prescriber has advised otherwise. Oral diclofenac dosing is individualised and set by your prescriber.

This is general information, not a dose for you. Dosing depends on the reason you are taking it, your kidney and liver function, your age, and everything else you take — follow the directions on your own label, and ask us if they differ from what you read here.

If you miss a dose

The gel is applied as directed rather than on a strict schedule. If you miss an application, simply apply the next one at the usual time — do not use extra to compensate. For prescription oral diclofenac, take the missed dose with food when you remember and skip it if the next dose is nearly due.

Side effects

Common — usually manageable

Gel: dryness, redness, itch, or a rash where it is applied
Gel: a tingling or mild burning sensation shortly after applying
Tablets: heartburn, indigestion, nausea or abdominal discomfort
Tablets: headache or dizziness
Tablets: fluid retention and a modest rise in blood pressure

Get medical help for these

Severe or spreading skin reaction, blistering, or signs of infection at the application site — stop and seek advice
Wheeze, facial swelling or widespread hives — an allergic reaction; seek emergency care
With tablets: stomach or intestinal bleeding — black stools or vomiting blood; emergency care
With tablets: signs of heart attack or stroke — chest pain, one-sided weakness, slurred speech; call 911
With tablets: signs of liver injury — yellowing of the skin or eyes, dark urine, persistent nausea; diclofenac affects liver enzymes more than other NSAIDs, so this is monitored

Important warnings

Do not use the gel at the same time as oral ibuprofen, naproxen or prescription diclofenac unless a prescriber has told you to — the doses add together.

Treated skin becomes more sensitive to sunlight. Keep the area covered or out of strong sun, and do not use tanning beds on it.

Do not cover the treated area with an airtight dressing or wrap, which increases how much is absorbed.

Keep it well away from the eyes, mouth and mucous membranes, and wash your hands after applying unless you are treating your hands.

Oral diclofenac carries the full set of NSAID risks — stomach, kidney, cardiovascular and liver — and needs prescriber supervision.

Who should take extra care

Older adults: Topical diclofenac is often preferred over oral NSAIDs here precisely because whole-body exposure is much lower.
People already taking an oral NSAID: Do not layer the gel on top of ibuprofen, naproxen or oral diclofenac without advice — the effect is cumulative.
Kidney disease or heart failure: The gel is generally lower risk than tablets, but it is still worth confirming with a pharmacist before regular use.
Sun exposure: Treated skin is more sensitive to UV — keep it covered and avoid tanning beds.
Broken or infected skin: Do not apply the gel to open wounds, eczema, or infected areas.
Pregnancy: Avoided in the third trimester; check before use at any stage, including the gel.

Who should not take it

Known allergy to diclofenac, or asthma or hives triggered by aspirin or another NSAID
Broken, infected or inflamed skin at the application site (for the gel)
Active ulcer or previous NSAID-related gastrointestinal bleeding (particularly relevant to the oral form)
Severe heart failure or severe kidney impairment
Third trimester of pregnancy
Around the time of coronary artery bypass graft (CABG) surgery

Drug interactions

Topical diclofenac produces much lower blood levels than tablets, so interactions are far less likely — but the principle still holds, and it should not be combined with oral NSAIDs. For oral diclofenac the interactions match the NSAID class: anticoagulants and antiplatelets such as apixaban, rivaroxaban, warfarin, clopidogrel and aspirin raise bleeding risk; ACE inhibitors, ARBs and diuretics combine to strain the kidneys and blunt blood pressure control; lithium and methotrexate levels rise; SSRIs add to gastrointestinal bleeding risk; corticosteroids add ulcer risk. If you take a blood thinner and are considering the gel, it is still worth a quick check with a pharmacist.

Commonly asked about alongside Voltaren: Advil, Aleve, Tylenol, Aspirin.

This is not a complete list. If you take several medications, or buy anything over the counter, a pharmacist medication review is the reliable way to catch interactions that matter.

Coverage in British Columbia

Over-the-counter Voltaren gel is generally not a PharmaCare benefit. Prescription diclofenac products may be covered depending on your plan. Coverage may depend on indication, PharmaCare plan and Special Authority requirements — ask Pill4Me Pharmacy to check your coverage, or call 604-705-3644.

Coverage may depend on indication, PharmaCare plan and Special Authority requirements. Ask Pill4Me Pharmacy to check your coverage, or see BC PharmaCare.

Frequently asked questions

Is Voltaren gel safer than taking ibuprofen tablets?

For most people it carries lower whole-body risk, because only a small fraction of the diclofenac in the gel reaches the bloodstream compared with an equivalent tablet. That is why it is frequently suggested for older adults, or for people whose stomach, kidneys or blood pressure make oral anti-inflammatories a poor idea. It is not risk-free, though, and it works best for pain that sits close to the surface — a knee, a hand, an elbow, a strained muscle — rather than deep or widespread pain.

How long does Voltaren gel take to work?

Some people notice relief within a day, but for osteoarthritis it is normal for the benefit to build over about a week of regular use. If you have applied it as directed for a week or so with no difference at all, it is worth reassessing rather than simply using more. Applying extra gel does not speed it up and does increase how much is absorbed.

Can I use Voltaren gel while taking a blood thinner?

Often yes, and it is frequently the preferred option for someone on apixaban, rivaroxaban or warfarin who needs anti-inflammatory relief — precisely because so little enters the bloodstream. It is still worth a quick check with a pharmacist first, particularly if you would be using it over a large area or for a long period. Bring your medication list in, or call us at 604-705-3644.

Can I use Voltaren gel and take Tylenol at the same time?

Generally yes — acetaminophen works differently and does not add to the anti-inflammatory load. The combination to avoid is Voltaren gel plus an oral NSAID such as ibuprofen or naproxen, since those are the same class of medicine and the doses add together.

Why does the label say to keep the treated area out of the sun?

Diclofenac can make skin more sensitive to ultraviolet light, so treated areas may burn more easily than usual. Keeping the area covered with clothing, or out of strong sun, is enough for most people. Avoid tanning beds on any area you are treating.

What is the difference between Voltaren gel and Voltaren tablets?

They contain the same active ingredient but behave very differently. The gel is available over the counter and delivers diclofenac mainly into the tissue under the application site. The tablets are prescription-only in Canada, act throughout the body, and carry the full range of NSAID risks — stomach bleeding, kidney effects, cardiovascular risk, and effects on liver enzymes that are monitored during longer use. They are not interchangeable, and they should not be used together unless a prescriber has specifically directed it.

Related medications

Advil (ibuprofen)Aleve (naproxen sodium)Tylenol (acetaminophen)Aspirin (acetylsalicylic acid (ASA))

Compare your options

Compare acetaminophen, ibuprofen, naproxen and Voltaren

Not sure which option is right for you?

You don't need an appointment to ask. Our pharmacists can check this against your other medications and your health history, in the store or over the phone — there's no charge for the conversation.

Call 604-705-3644 Minor ailments service Transfer my prescription

Pill4Me Pharmacy is at 5625 Promontory Rd Unit 101, Chilliwack, BC. We deliver free to Chilliwack, Sardis, Promontory, Vedder and Yarrow, and you can reach a pharmacist directly at 604-705-3644.