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Topical analgesics for treatment of knee and hand osteoarthritis

Topical analgesics for treatment of knee and hand osteoarthritis
Topical analgesic Usual dose (adult)
Topical nonsteroidal antiinflammatory drugs (NSAIDs)*
Diclofenac topical gel (1%)

Knees: rub in 4 g of gel to affected knee(s) three to four times daily

Hands: rub in 2 g of gel to affected joint(s) three to four times daily

Maximum 16 g per joint per day; 32 g total per day

Diclofenac topical solution drops (1.5%) Knees: rub in 40 drops to affected knee(s) up to four times daily
Diclofenac topical solution pump (2%) Knees: rub in two pump actions to affected knee(s) up to two times daily
Ibuprofen topical gel (5, 10%); not available in the United States Knees or hands: rub in dose (depends on joint size and location) up to four times daily; refer to product-specific information for detail
Ketoprofen topical gel (2.5%); not available in the United States Knees or hands: rub in 2 to 4 g of gel two to four times daily (maximum 15 g of gel per day); refer to product-specific information for detail
Topical capsaicin
Capsaicin creams, gels, liquids, lotions (0.025 to 0.1%) Rub in a small amount (pea-sized) one to four times daily; the preparation most often studied in osteoarthritis was 0.025% cream
Capsaicin topical patches (0.025 to 0.05%) Apply one patch to affected area for up to eight hours (maximum four patches per day)
* For patients already on oral NSAIDs, topical therapies are generally not recommended because they are unlikely to provide additional pain relief. Gel measurements from tubes are approximate.
¶ Pain relief usually begins within the first week of treatment, and full effect is seen with regular application over approximately four weeks. Topical capsaicin should not come in contact with mucous membranes, abraded skin, eyes, or genital areas.
Data from: Lexicomp Online (Lexi-Interact). Copyright © 1978-2023 Lexicomp, Inc. All Rights Reserved and The electronic Medicines Compendium (eMC) DataPharm Ltd. Surrey United Kingdom (https://www.medicines.org.uk/emc/)
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