Version July 2025
| Topical analgesic | Usual dose (adult) |
| Topical nonsteroidal anti-inflammatory drugs (NSAIDs)* | |
| Diclofenac topical gel (1%) | Knees: rub in 4 g of gel to affected knee(s) 3 to 4 times daily Hands: rub in 2 g of gel to affected joint(s) 3 to 4 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 4 times daily |
| Diclofenac topical solution pump (2%) | Knees: rub in 2 pump actions to affected knee(s) up to 2 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 4 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 2 to 4 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) 1 to 4 times daily; the preparation most often studied in osteoarthritis was 0.025% cream |
| Capsaicin topical patches (0.025 to 0.05%) | Apply 1 patch to affected area for up to 8 hours (maximum 4 patches per day) |
| Combination therapies | |
| Diclofenac-lidocaine gel (diclofenac 1% and lidocaine 4.5%) | Rub into affected joint(s) up to 4 times daily |
| Diclofenac-lidocaine patch (diclofenac 1.25% and lidocaine 4.5%) | Apply 1 patch to affected area for up to 12 hours (maximum 2 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 4 weeks. Topical capsaicin should not come in contact with mucous membranes, abraded skin, eyes, or genital areas.
