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Generic name: diclofenac and menthol topical [dye-KLOE-fen-ak-and-MEN-thol-TOP-i-kal]

Drug class: Topical non-steroidal anti-inflammatories

What is DicloStream?

Diclofenac can be described as an anti-inflammatory non-steroidal drug (NSAID). Menthol gives a cooling sensation upon application to the skin. DicloStream (for your skin) is a combination medicine that is used to treat osteoarthritis of the knee. DicloStream can be used for other purposes that are not mentioned in this guide.

Side effects of DicloStream

Contact emergency medical assistance when you are experiencing symptoms warning signs of an allergic response (hives or breathing difficulties and swelling in your throat or face) or a severe reaction to your skin (fever, sore throat, burnt eyes, irritation, as well as red or purple itching, blisters, and peeling).

Stop taking DicloStream and seek immediate medical attention if you show indications of an attack on your heart or stroke: chest pain spreading into your shoulder or jaw, suddenly feeling numb or weak in one area of your body, speech slurred, feeling breathless.

Contact your doctor at the earliest opportunity if you are suffering from:

  • A skin rash, however mild,
  • Symptoms of stomach bleeding—bloody or tarry stool—and vomiting the blood or vomiting that looks like coffee grounds
  • Kidney issues: no or little urine output, swelling of your ankles or feet, and feeling exhausted or sluggish;
  • Liver issues: nausea, diarrhea, stomach discomfort (upper right side) fatigue, itching, black stools, dark urine, jaundice (yellowing of the eyes or skin), as well as
  • Red blood cells are low (anemia)—pale skin and fatigue; being lightheaded or tired; cold hands and feet.

Risky side effects are more frequent in older adults.

Common adverse consequences of diclostream could include:

  • Dryness of the skin, redness, itching, or rash
  • The hardening or blistering of the treated skin
  • Numbness, tingling, burning pain;
  • Acne;
  • Flushing (sudden heat, redness, or a tingly sensation);
  • Stomach discomfort, constipation, gas, diarrhea, heartburn, nausea, vomiting, or

This is not a comprehensive list of all side effects. Other side effects could occur. Contact your doctor to seek medical advice on adverse effects. You may report any adverse reactions to the FDA at 1-800-FDA-1088.


Diclofenac and menthol may increase the risk of a fatal cardiac attack as well as a stroke. Don't use this medication immediately prior to or after the heart bypass surgery (coronary bypass graft for an artery, or CABG). Diclofenac and menthol can cause intestinal or stomach bleeding that can be fatal.

Before you take this drug

Diclostream is not recommended for use if you are sensitive to menthol or diclofenac (Voltaren, Cataflam, Flector, and others) or if you have experienced the symptoms of asthma or a severe allergic reaction when taking aspirin or any NSAID.

Inform your doctor if you have ever suffered from:

  • Heart issues, high blood pressure, or if you smoke
  • A heart attack, stroke, or blood clot
  • Gastric ulcers and bleeding from the stomach or intestines of your
  • Fluid retention;
  • Asthma or
  • Kidney disease.

Diclofenac can alter ovulation and may make it harder to become pregnant when you're taking this medication.

If you are expecting, then you shouldn't use DicloStream unless your doctor has advised you not to. Using an NSAID in the final twenty weeks of pregnancy could result in serious kidney or heart issues in the baby who is not yet born and may cause complications during the pregnancy. It might not be safe to breastfeed while taking this medication. Talk to your doctor regarding any risks.

What should I do with DicloStream?

Follow the directions on your prescription label and study all the medication guidelines. Make sure you are using the dose that will be effective in treating your illness. Do not consume by mouth. Topical medicines are for use solely on your skin. Do not apply it to the skin with open wounds or irritation. Rinse the area with water if this medication is absorbed into your mouth or eyes.

Be sure to read and adhere to any instructions for use that are included with your medicine. Consult your physician or pharmacist if you don't understand these directions.

Don't apply this medicine to a wound in your skin that is open or to areas that are prone to inflammation, burning, rash, and peeling skin.

After applying the medication, clean and dry the hands. Make sure the medication is fully dry prior to covering the knee in clothing. Do not shower or bathe the knee for a minimum of 30 minutes following the application of DicloStream.

You must wait until the skin is dry before you use sunscreen, insect repellant lotion, or any other skin products. Do not permit anyone else to get on the treated skin until it's completely dry.

Do not cover your area with a wrap or expose it to the heat of a hot tub or heating pad sauna. The heat or the bandaging process can boost the quantity of medication that is absorbed by your skin and can cause negative consequences.

If you take this medication for a long time, your blood pressure will have to be monitored regularly. The function of your liver and kidneys might also require examination. Keep at room temperature and away from heat and moisture. Close the bottle when not being used.

What happens if I miss the dose?

Apply the medicine as fast as you are able, but do not take the dose you missed if it is close to time for the next dose. Don't apply two doses at the same time.

What happens if I overdose?

Get medical attention in an emergency or contact the poison help line at 1-800-222-1222.

The signs of an overdose could include tiredness and fatigue, nausea, vomiting, or stomach discomfort.

What should be avoided?

Do not get DicloStream in your eye. If contact occurs, wash your eyes with water. Consult your doctor if you are experiencing eye irritation that lasts more than one hour. Beware of exposing your skin to the sun, heat, and tanning beds.

Consult a physician or pharmacist before taking other medicines to treat swelling, fever, pain, or flu symptoms. They could contain ingredients like diclofenac (such as aspirin, ibuprofen, ketoprofen, and naproxen). Do not drink alcohol. This can increase your chance of sustaining damage to your liver. Do not smoke, as it may increase the chance of bleeding from your stomach. If you're also taking low-dose aspirin to protect yourself from stroke or heart attack, do not take it off or change your dosage without a physician's guidance. Aspirin should only be used to treat heart conditions under the guidance of a physician.

Interaction with other drug

Consult your physician before taking diclofenac or menthol if you are taking any antidepressants. Taking certain antidepressants along with an NSAID could cause bleeding or bruises easily. Inform your doctor about all other medicines you take, particularly:

  • Cyclosporine;
  • Digoxin;
  • Lithium;
  • Methotrexate;
  • Pemetrexed;
  • A blood thinner (warfarin, coumadin, jantoven);
  • Aspirin and other nsaids (ibuprofen, naproxen, advil, motrin, aleve aspirin, celecoxib, indomethacin, meloxicam, and many others);
  • Blood pressure or heart-related medication, such as diuretics (also known as a "water pill"); or
  • Steroid medication (prednisone and others)

This list is not exhaustive. Other drugs can interact with diclofenac or menthol, such as prescription drugs and Ove