Voltaren with prednisone?

[Spartans1]

I am 2 1/2 years into PMR and have been doing great. Now at 1.75 mg of prednisone. My orthopedist has suggested I try voltaren on a toe that shows arthritis and has some pain/discomfort if I have any elevation on the heels of shoes. It’s a gel that is to be applied twice a day…with, hopefully some relief after using for 7 days. It does have ibuprofen in it. (Diclofenac..a NSAID). I suspect that the stronger doses of prednisone have been “hiding” the pain and it’s now surfaced a bit more noticeable. Just wondering about the ibuprofen issue. Thank you for any insights!! So happy to have this site.

[PMRpro Ambassador]

In small amounts for a short time, probably OK but it IS absorbed into the blood stream so there is a small risk associated with it.

An alternative non-drug option for osteoarthitis is Flexiseq

flexiseq.com/

which I think you can get in the USA via Amazon - quite a few on the forum have used it with success. It was originally developed for knees but people realised that their hands improved a lot too as the cream was on their hands while they waited for the knee to absorb the cream and dry off. So you might imagine it would do the same in feet!

I always swore that if a low dose of pred hid any arthritis I'd say the PMR pain returned! Never got that low to find out but I don't think I have much in the way of OA anyway. And haven't worn heels for YEARS!

[Spartans1 in reply to PMRpro]

Thank you for the quick response. I will check on the alternative that you suggested!!

[DorsetLady PMRGCAuk volunteer]

I have used similar in past when still on Pred, but as PMRpro has said, do try Flexiseq- and there are other options for OA apart from NSAIDs

Depends on how bad OA isn’t- but all of these have been recommended over the years - these are links to uk sites but many available on usual online store as previously mentioned.

naturalskincarefactory.com/...

5kind.com

motorbikers.cc/product/warr...

pernaton.co.uk

[PMRnewbie2017]

On a matter of pharmacology to assist your understanding:

Yes, Diclofenac and Ibuprofen are both NSAIDs and inhibit COX enzymes but they are not the same drug. Diclo is more potent than Ibu. In gel form, the Diclo comes in two strengths 1% or 3%. Diclo gels are said to provide better pain relief more quickly than Ibu gels. Absorption of NSAIDs into the blood stream from the use of topical gels is very low compared with absorption from the oral route. The risk of gastro-intestinal complications from the topical route are considered minimal.

Topical NSAIDs penetrate the skin, enter tissues or joints, and reduce processes causing pain in the tissue. Drug levels in the blood with topical NSAIDs are very much lower than with the same drug taken by mouth. This minimises the risk of harmful effects.

Cochrane Database Syst Rev. 2015 Jun; 2015(6): CD007402.

[HeronNS]

I actually got a stomach bleed from using Voltaren on an injured knee! And I heartily support the use of Flexiseq as a useful and side effect free alternative to any type of gel or cream containing an NSAID as NSAIDs are known to interfere with cartilage renewal and hence actually should be contraindicated for osteoarthritis. (Glucosamine sulfate taken long term can help maintain cartilage. I take 2000 mg a day, which is a bit over the recommended maximum, have done for many years.)

[Kaaswinkel72]

flexiseq

does nt seem to be available from the Netherlands so we found a Similar product sold under the name Flexiumgel 10% ( it comes in various strenghts)

Which “ we” can obtain from here.

My OA neck has been playing up for ages, severe pain really after diminishing the prednisolone, and Voltaren creme did nt help me.

It sounds crazy but 1 application already made a considerable positive difference to me ( of course: can be co incidence, I know). Yes, of course symptom relieve only! Succes to us all!

[PMRpro Ambassador in reply to Kaaswinkel72]

Not a similar product - the principle is very different. It contains plant extracts. But if it works ...

[PMRpro Ambassador in reply to PMRpro]

PS - this site says it ships to the Netherlands

inishpharmacy.com/p/flexise...

Amazon.nl lists it but it is out of stock.