Generally speaking, what are the advantages of using a topical gel NSAID, e.g., Voltaren Gel, rather than an oral NSAID? What are the disavantages? What about in the specific context of dealing with Achilles tendonitis?
The topical diclofenac gel is making a “resurgence” since they are now marketed by a new, larger company.
Their anti-inflammatory action is by blocking prostaglandins via the thromboxane/cyclo-oxeganse pathway and as such, have to interact “physically” to exert the chemical reaction (unlike ice for ex). Topical Voltaren per their own package insert is 8% absorbed systemicall - so, you should expect about 8% the response of taking oral diclofenac (usually chelated with sodium - Voltaren, or potassium (Cataflam). That is it.
The other aspect of topical meds effectiveness generally lies in that the patient feels like they are actually doing something (i.e. rubbing the area, etc.)
As always, thanks for the insight, Rod.
i thought the main benefit was to bypass all the GI bleed risks.
See above …
Take 8% of an oral Voltaren pill (usual dose is 75mg) and you get the same “risk reduction” 