Flector patch for cancer pain

M Levin, MD — Fri, 08 Mar 2013 12:51:21 +0000

Flector Patch is a topical non-steroidal(NSAID) drug diclofenac. Diclofenac has antiinflammatory, analgesic, and anti-fever effects. Each FLECTOR® Patch measures approximately 4 inches by 5.5 inches and contains 180-mg of diclofenac. The recommended dose of FLECTOR® Patch is one patch to the most painful area twice a day (12 hours at a time). FLECTOR® Patch should be applied to intact or non-damaged skin. Some physicians feel that these patches can be cut into smaller portions but this has not been formally studied.

A meta-analysis in 2004 showed that drugs of this class applied through skin are effective and safe in treating acute painful conditions for 1 week. Whether this is also true of this patc is not known. Flector patch had also been studied for ostearthritis and localized pain of rheumatic conditions.

Flector has not been adequately studied for pain of metastatic cancer. The oral version, Voltaren, allows the morphien dose to be decreased. However, it can cause liver damage. How well it works as a patch for painful metastases has not been studied. It is not a completely innocuous drug, especially for a cancer patient who is on chemotherapy and more susceptible to side effects, or with possible liver metastases.

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Flector patch for painful metastases – pro

M Levin, MD — Fri, 08 Mar 2013 12:43:04 +0000

Flector Patch(diclofenac) is a topical non-steroidal(NSAID) drug diclofenac. Diclofenac has anti-inflammatory, analgesic, and antipyretic properties by inhibiting the enzyme cyclooxegenase (COX) and decreasing the formation of prostaglandins, thromboxanes, and prostacyclin. The oral version is Voltaren. Each FLECTOR® Patch measures approximately 4 inches by 5.5 inches and contains 180-mg of diclofenac epolamine. The recommended dose of FLECTOR® Patch is one patch to the most painful area twice a day (12 hours at a time). FLECTOR® Patch should be applied to intact or non-damaged skin.

A meta-analysis in 2004 by Mason et al. showed topical NSAIDs to be effective and safe in treating acute painful conditions for 1 week. Whether this is also true of the patch is not known. This systemic review of 26 double-blind, placebo-controlled trials showed clinically significant efficacy in 19 of 26 trials, with a pooled relative benefit of 1.6 and number needed to treat of 3.8 vs. placebo to achieve an outcome of approximately 50% reduction in pain at 7 days. It is also well studied for ostearthritis and localized pain of rheumatic conditions.

Flector has not been adequately studied for pain of metastatic cancer. Oral doclofenac has a morphine sparing effect, as do other NSAID. It can cause liver damage. How well it works locally has not been studied. It is not a completely benign drug, especially for a debilitated cancer patient susceptible to side effects of NSAID or ir with known or undiagnosed liver metastases.

Flector® Patch (diclofenac epolamine 1.3%). Prescribing information. August 2011. King Pharmaceuticals, Inc.
Bristol, TN 37620. www.flectorpatch.com.

The Medical Letter on Drugs and Therapeutics, 1277a January 14, 2008(50): 1-2

Mason L, Moore RA, Edwards JE, Derry S, McQuay HJ. Topical NSAIDs for acute pain: a meta-analysis. BMC Fam Pract. 2004;5:10–9.

R. Björkman, A. Ullman, J. Hedne Morphine-sparing effect of diclofenac in cancer pain European Journal of Clinical Pharmacology January 1993, Volume 44, Issue 1, pp 1-5
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Flector patch for cancer pain

Flector patch for painful metastases – pro