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diclofenac (Oxa Gel / diclofenac, topical)

✓ Approved

Actavis · PTGS1 · Small Molecule

What is diclofenac?

diclofenac is a small molecule developed by Actavis. It is approved for therapeutic indications via transdermal.

Drug Profile

Brand NamesOxa Gel, diclofenac, topical
CompanyActavis
Drug ClassSmall Molecule
Molecular TargetPTGS1, PTGS2
RouteTransdermal
StatusApproved
Sources: ClinicalTrials.gov, Actavis

Mechanism of Action

Molecular Targets

diclofenac acts on 2 molecular targets:

PTGS1prostaglandin-endoperoxide synthase 1 (COX3, PCOX1)
PTGS2prostaglandin-endoperoxide synthase 2 (GRIPGHS, hCox-2)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

diclofenac is developed for 5 unique indications across 3 therapeutic areas.

Therapeutic AreaConditionPhase
Musculoskeletal and connective tissue disordersMusculoskeletal pain✓ Approved
Musculoskeletal and connective tissue disordersMyositis✓ Approved
Musculoskeletal and connective tissue disordersRheumatoid arthritis✓ Approved
Injury, poisoning and procedural complicationsTraumatic shock✓ Approved
Skin and subcutaneous tissue disordersActinic keratosisPhase III

Related Research Articles

PubMedAllergologia et immunopathologia2026-09-19

Systematic allergological evaluation enables NSAID allergy delabeling and identification of safe alternatives in adults.

Guzmán Avilán Rosa I RI, Avilés Vargas Silvia Rosario SR, González Díaz Sandra N SN, Ortega Natalhie Acuña NA et al.

Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are a frequent reason for allergy referral and a major diagnostic challenge. In everyday practice, overdiagnosis contributes to unnecessary drug avoidance, restricting therapeutic access to first-line analgesic and anti-inflammatory treatments and impacting clinical care. To determine the true prevalence of confirmed NSAID hypersensitivity in adults with suspected reactions through systematic allergological evaluation and assess its clinical impact on therapeutic access through safe delabeling and identification of alternative agents. We conducted a prospective, cross-sectional study including adults ≥18 years with suspected NSAID hypersensitivity evaluated at a tertiary referral center in Mexico between March and November 2025. All patients underwent standardized assessment including detailed clinical history, skin testing (prick and intradermal), and controlled drug provocation tests (DPTs) with acetylsalicylic acid, the implicated NSAID, and celecoxib. Clinical phenotypes were classified according to EAACI/ENDA guidelines. Associations between clinical variables and confirmed hypersensitivity were analyzed. Thirty-three patients were included; 72.7% were women, and 42.4% were aged 18-30 years. Atopy was present in 63.6%. Urticaria/angioedema predominated (69.7%). Ibuprofen and diclofenac were most frequently implicated (45.5%). Skin testing showed low diagnostic yield (6.1% prick; 21.2% intradermal). DPT was positive in 24.2%, mainly inducing urticaria. Celecoxib was tolerated in all patients with multiple hypersensitivity. Overall, 48.5% had no confirmed hypersensitivity and were successfully delabeled, restoring access to NSAID therapy. Multiple hypersensitivity occurred in 39.4% and selective reactions in 12.1%, with NIUAA as the predominant phenotype (33.4%). Atopy (p = 0.002) and recurrent episodes (p < 0.001) were associated with multiple hypersensitivity. Nearly half of adults labeled as NSAID-allergic were not truly hypersensitive. These prospective Mexican data demonstrate the clinical impact of systematic evaluation in reducing overdiagnosis and improving therapeutic access.

PMID 42760878
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PubMedFrontiers in allergy2026-09-19

Severe anaphylactic shock suspectedly induced by injection of recombinant humanized type III collagen lyophilized fiber for facial skin improvement: a case report.

Liu Junjie J, Yan Wenjing W, Liu Jing J, Yang Bowen B et al.

Recombinant humanized type III collagen is widely used in facial rejuvenation due to its excellent biocompatibility and overall favorable safety profile; however, severe systemic hypersensitivity reactions are exceedingly rare. We report a case of a 47-year-old woman with no prior history of allergy who received topical lidocaine to the face, followed by injection of recombinant humanized type III collagen lyophilized fibers for skin texture improvement. Immediately after the injection, she developed suspectedly severe anaphylactic shock temporally associated with the recombinant collagen injectionpresenting with confusion, respiratory distress, followed by marked bradycardia (33 beats/min), and loss of palpable arterial pulse. Emergency protocols were activated immediately, including cardiopulmonary resuscitation, intravenous adrenaline, corticosteroids, and fluid resuscitation. The patient's vital signs gradually recovered, and she was discharged after complete recovery two days later after complete recovery. This case suggests that recombinant humanized collagen, as a macromolecular protein, inherently carries the risk of triggering immediate-type anaphylactic shock despite its favorable safety profile. Clinicians should perform rigorous preoperative assessment, adhere to standardized procedures, and be proficient in the emergency management of anaphylactic shock to minimize the risk of severe adverse reactions and ensure medical safety.

PMID 42760965
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PubMedActa neuropathologica communications2026-09-19

Experimental induction of myelin damage in post-mortem human brain slice cultures.

Meijns Niels Reinder Coenraad NRC, Muñoz González Gema G, Stolker Sabine S, T Hart Bert B et al.

The mechanisms that drive myelin damage as seen in demyelinating disorders such as multiple sclerosis remain incompletely understood. Much of our current knowledge is derived from animal models, but interspecies differences limit their relevance in the context of human pathology and could explain why various promising therapies failed during clinical translation. Human post-mortem organotypic brain slice cultures provide a unique platform to study human myelin biology, as they preserve genetic, cytoarchitectural, pathological and species-specific context. Here, we evaluated myelin integrity in a human post-mortem organotypic brain slice culture model and experimentally induced focal myelin damage. Human post-mortem organotypic brain slice cultures retain key features throughout the culturing period, but exhibit gradual cellular and myelin loss over time. Myelin fibres within the white matter remain detectable and display preserved structural and chemical integrity up to 13 days in vitro, as indicated by the conserved ultrastructure, paranodal and nodal organization, and stable myelin spectroscopic signature. Topical delivery of lysophosphatidylcholine using cryogel scaffolds enables focal drug administration throughout the full depth of the slice with minimal diffusion into surrounding tissue and induces localized demyelination. Similar focal application of β-scorpion toxin Cn2, a Nav1.6 channel agonist, induces subtle myelin destabilization. Overall, our results demonstrate human post-mortem organotypic brain slice culture model as an adequate platform for studying myelin damage in a human context.

PMID 42760561
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PubMedFrontiers in medicine2026-09-19

An open-label randomised controlled trial protocol evaluating a Siddha add-on regimen for radiotherapy induced oral mucositis in head and neck cancer patients.

P Shanmugapriya S, T Subathra S, S Sowmiya S, R Gayatri G et al.

Radiation-induced oral mucositis (RIOM) is a common and clinically significant complication in patients undergoing radiotherapy or concurrent chemoradiotherapy for head and neck cancers. It can cause severe oral pain, dysphagia, nutritional compromise, secondary infections, and treatment interruptions, thereby affecting treatment compliance and oncological outcomes. Since the current standard of care (SOC) mainly focuses on symptomatic relief, there is a need for integrative treatment approaches that may improve overall patient outcomes. The present study is designed as a randomised controlled Phase II superiority trial involving 160 participants, with 80 participants allocated to each study arm. Participants in the control arm will receive benzydamine mouthwash six times daily as SOC, while those in the intervention arm will receive Siddha formulations such as Thiripala Chooranam mouthwash and Gungiliya Vennai topical application three times daily in addition to SOC. Weekly assessments will be carried out by oncologists using validated tools including the Radiation Therapy Oncology Group (RTOG) Oral Mucositis Scale, WHO Oral Mucositis Scale, Visual Analogue Scale (VAS) for oral pain, and WHO three-step analgesic ladder. The primary outcome of the study is the assessment of RIOM severity using RTOG grading scale. Secondary outcomes include evaluation of mucositis severity using the WHO Oral Mucositis Scale, reduction in oral pain assessed by VAS (minimum 2-point reduction), analgesic usage based on the WHO three-step analgesic ladder, safety outcomes, and treatment interruptions. This study may provide evidence on the effectiveness and safety of an integrative Siddha-based approach in reducing RIOM severity and improving supportive care in patients undergoing radiotherapy for head and neck cancers. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTQ2MTYw&Enc=&userName=, Registered in Clinical Trial Registry, India (CTRI/2025/12/098832- registered on 10-12-2025). Participant enrolment for the trial has commenced, and the study is currently ongoing.

PMID 42761039
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PubMedACS omega2026-09-18

Visible-Light Photocatalytic Abatement of Diclofenac Potassium over Bismuth Sulfoiodide.

Ali Sajid S, Kallestewa LaShaunte L, Alzard Reem H RH, Watanabe Fumiya F et al.

The growing presence of pharmaceutical residues in aquatic systems underscores the need for effective and efficient treatment processes capable of eliminating persistent contaminants under mild conditions. In this study, bismuth sulfoiodide (BiSI) was investigated as a visible-light-responsive photocatalyst for the abatement of diclofenac potassium from aqueous media. Orthorhombic bismuth sulfoiodide nanorods were synthesized via a solution-phase method and comprehensively characterized using multiple analytical techniques. Powder X-ray diffraction (PXRD) confirmed the phase purity of crystalline BiSI, whereas UV-vis diffuse reflectance spectroscopy (UV-vis DRS) revealed strong visible-light absorption with an optical band gap of 1.65 eV. Scanning electron microscopy (SEM) and high-resolution transmission electron microscopy (HRTEM) images showed uniform nanorod morphology with an average width of 148 ± 46 nm and an average length of 2.84 ± 1.37 μm, indicating a high aspect ratio. Energy-dispersive X-ray spectroscopy (EDX) analysis confirmed the elemental composition of the material. X-ray photoelectron spectroscopy (XPS) confirmed the presence of Bi3+, S2-, and I- ions, consistent with the BiSI lattice structure. The photocatalyst demonstrated excellent performance under visible-light irradiation, achieving 95.2% removal of the parent diclofenac potassium, as determined by UV-vis spectroscopic analysis, within 120 min. The reaction was described by a pseudo-first-order Langmuir-Hinshelwood model with an apparent rate constant of 2.999 × 10-2 min-1; however, the moderate fitting indicates that this model does not represent ideal pseudo-first-order kinetic behavior.

PMID 42756766
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PubMedANZ journal of surgery2026-09-18

Topical Tranexamic Acid in Breast Surgery: A Systematic Review and Meta-Analysis of Postoperative Bleeding Outcomes.

Sobhanmanesh Sina S, Ayeni Femi E FE, Cheung Deborah S M DSM

Haematoma and seroma formation are recognised postoperative complications following breast surgery. Tranexamic acid (TXA), an antifibrinolytic agent widely used in other surgical specialties, has not yet been routinely adopted in breast surgery. This systematic review and meta-analysis evaluated the effect of topical TXA on postoperative outcomes in breast surgery. A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed, Embase and Cochrane CENTRAL were searched from inception to February 2026 using the terms (tranexamic OR TXA) AND breast AND topical. Outcomes included postoperative haematoma, seroma and drain output. Random-effects meta-analysis was performed to calculate mean differences and risk ratios (RRs). Seven studies (five randomised controlled trials and two cohort studies) involving 1258 breasts (629 topical TXA and 629 controls) were included. Meta-analysis demonstrated a significant reduction in postoperative drain output with topical TXA (mean difference -16.22 mL; 95% CI: -26.54 to -5.91; p = 0.002). Topical TXA was associated with a 75% reduction in haematoma risk (RR 0.25; 95% CI: 0.08-0.72; p = 0.01). Seroma rates did not differ significantly between groups (p = 0.26). Subgroup analysis by procedure type showed numerically greater effects in mastectomy cohorts, with no significant subgroup differences for drain output (p = 0.31) or haematoma (p = 0.19). No TXA-related adverse events were reported. Topical tranexamic acid appears to be a safe adjunct in breast surgery, reducing postoperative drain output and haematoma formation. Larger, high-quality randomised controlled trials are needed to validate these findings and establish standardised protocols.

PMID 42760100
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