Yes, Voltaren is an NSAID. Its active ingredient is diclofenac, a nonsteroidal anti-inflammatory drug that reduces pain and swelling by blocking the enzymes your body uses to produce inflammation. Voltaren is available as a topical gel you can buy without a prescription, and in oral and other forms that require one.
How Voltaren Works as an NSAID
When tissue is injured or irritated, your body produces chemicals called prostaglandins that trigger inflammation, swelling, and pain. Diclofenac, the drug inside Voltaren, blocks the two enzymes responsible for making those prostaglandins (known as COX-1 and COX-2) with roughly equal strength. This is the same basic mechanism behind ibuprofen and naproxen, though diclofenac tends to be more potent at standard doses.
A large network analysis comparing common NSAIDs found that diclofenac at 150 mg per day was more effective at relieving pain than ibuprofen at 2,400 mg per day, naproxen at 1,000 mg per day, and celecoxib at 200 mg per day. Even at a lower 100 mg daily dose, diclofenac performed comparably to all of those options. That potency is one reason prescription Voltaren tablets have been widely used for arthritis, back pain, and post-surgical inflammation for decades.
Available Forms of Voltaren
Voltaren comes in several formulations, each suited to different situations:
- Topical gel (1%): The over-the-counter version in the U.S., approved for arthritis pain in specific joints. The FDA switched it from prescription-only to OTC in February 2020.
- Oral tablets: Prescription-only enteric-coated tablets used for arthritis, acute pain, and other inflammatory conditions.
- Suppositories: Available by prescription in some countries for arthritis, back pain, muscle strains, menstrual cramps, and migraines.
Why the Gel Has Fewer Side Effects
One of the biggest advantages of topical Voltaren is that very little of the drug reaches your bloodstream. In a study comparing the gel to oral diclofenac in healthy volunteers, systemic absorption from the 1% gel was 5 to 17 times lower than from the oral form. That means you get concentrated relief at the joint where you apply it, with far less drug circulating through the rest of your body. This substantially lowers the risk of the stomach and cardiovascular problems that come with oral NSAIDs.
That said, “lower risk” is not “no risk.” Topical Voltaren still carries the standard NSAID warnings, and the drug can build up if you apply it to multiple areas simultaneously.
How to Use the OTC Gel
The over-the-counter gel is approved for arthritis pain in the hands, wrists, elbows, feet, ankles, and knees. Dosing depends on which joint you’re treating:
- Upper body areas (hand, wrist, or elbow): Squeeze out about 2.25 inches of gel, which equals roughly 2 grams per application.
- Lower body areas (foot, ankle, or knee): Squeeze out about 4.5 inches of gel, roughly 4 grams per application.
You apply it four times a day, every day, and you should not treat more than two body areas at the same time. The gel needs to be rubbed into the skin over the affected joint, not just layered on top.
NSAID Risks That Apply to Voltaren
Because Voltaren is an NSAID, it shares the class-wide safety concerns that the FDA highlights with a boxed warning on all NSAID labels. These risks are most relevant to the oral and suppository forms, though they technically apply to all formulations.
The cardiovascular warning states that NSAIDs increase the risk of heart attack and stroke, and that this risk can appear early in treatment and grow with longer use. Oral Voltaren is specifically contraindicated after coronary artery bypass surgery.
The gastrointestinal warning notes that NSAIDs can cause bleeding, ulcers, and perforation in the stomach or intestines, sometimes without any preceding symptoms. Older adults and anyone with a history of stomach ulcers face the highest risk. Notably, the network analysis mentioned earlier found that diclofenac caused fewer major upper GI events than naproxen or ibuprofen, putting its stomach safety profile closer to celecoxib, a drug specifically designed to be gentler on the gut.
Who Should Avoid Voltaren
You should not use any form of Voltaren if you’ve ever had an allergic reaction to aspirin or another NSAID, particularly reactions involving asthma, hives, or facial swelling. People with a history of serious heart disease or recent heart surgery also need to avoid it.
Diclofenac interacts with several common medications. Blood thinners like warfarin can become dangerously more effective when combined with an NSAID, increasing bleeding risk. Blood pressure medications and diuretics (water pills) may work less effectively. If you take any of these, the interaction is worth discussing with a pharmacist, even if you’re only using the OTC gel. The systemic absorption from the gel is low, but it is not zero.