Definition
Diclofenac is used as an active ingredient primarily for pain relief, fever reduction or inflammation inhibition. The substance is available in numerous dosage forms, including as an ointment.
Indication
The indication of the drug plays a decisive role in the decision whether a drug is dispensed on prescription or over the counter. Drugs that are only approved for specifically diagnosed diseases are generally available only on prescription. The background to this is that the layperson is usually unable to decide what type of disease he or she has and whether or not the corresponding drug is needed at all. For example, a painkiller such as Diclofenac, which is more likely to be considered a broad-spectrum therapeutic agent and is used for a variety of minor ailments (grippling infections, mild pain, colds), would not necessarily require a specialist consultation with a physician, while antibiotics, for example, would require medical diagnosis and the associated weighing of the use of antibiotics.
Dosage
Furthermore, the dosage at which a particular drug is delivered is an important decision criterion. As a rule, the drugs that are dispensed over the counter are available in smaller dosages, while the same preparations in higher dosages require a prescription. In the case of Diclofenac, all ointments in which the active ingredient is added are available without a prescription but require a pharmacy.
The reason is that the dosage in which Diclofenac is added to the ointment or gel is relatively low. Diclofenac can be purchased as a tablet up to a dosage of 25 mg. Diclofenac of 50 mg or even 75 mg, however, can only be obtained with a prescription. All suspensions that have to be injected by syringe can only be obtained with a prescription.
Each drug that is taken has, besides the desired effect, several side effects, which can become stronger the higher the dose taken. This is one of the main reasons why only low doses of Diclofenac are available without prescription. Although the effect of the side effects would increase if a dose were taken repeatedly, the risk is smaller than if one tablet were to be taken in 3 times the dose.
Diclofenac is available in different types of tablets. A distinction is made between coated tablets and gastro-resistant tablets. Coated tablets are usually coated with cellulose, glucose or shellac to make them easier to take.
They are also odorless and tasteless. Gastric juice-resistant tablets are coated with synthetic polymers so that they can no longer be broken down by gastric acid. Only in the intestine does the pH value change accordingly and the tablets release their active ingredient.
Diclofenac with 25 mg active ingredient as coated tablet is available without prescription in pharmacies, while gastric juice-resistant 25 mg tablets of Diclofenac are available only on prescription. From a dosage of 50 mg diclofenac on, all types of tablets are available only on prescription. The reason for this is the prescription regulation, which stipulates that above a certain amount of active ingredient, drugs are only available on prescription, since the probability of side effects occurring increases with the amount of active ingredient.
Diclofenac is available as a gel without a prescription. However, due to its chemical properties it is not produced in the form of ointments or creams. The basis is a swellable substance, which is mixed with water and the drug.
The advantage of a gel is the additional cooling effect that ointments and creams do not have. Diclofenac gel is often also known as Voltaren® pain gel. It usually contains around 10 mg diclofenac per gram of gel.
Gels with the additional designation “forte” contain twice this amount, i.e. about 20 mg diclofenac per gram of gel. This sounds like a very high concentration. However, it should be noted that due to the pronounced barrier function of the skin, only a fraction of the active ingredient is actually absorbed into the body. For this reason, Diclofenac Gel should never be taken orally, as this could lead to a massive overdose.