Radiation and safety
Diclofenac and Anti-Inflammatory Medicines
What diclofenac does, how the 50 mg dose and gel differ from tablets, how side effects are reported, and how paracetamol differs from an anti-inflammatory.
Diclofenac is a non-steroidal anti-inflammatory drug, one of a family of medicines that reduce pain and swelling by blocking part of the body's inflammatory response. In the Netherlands it is sold and prescribed in several forms, including tablets and topical gels, and the 50 mg figure refers to the amount of the active substance in a single tablet rather than to the strength of the effect. Paracetamol works differently: it lowers pain and fever but is not classed as an anti-inflammatory, so the two are not interchangeable for every problem.
The Dutch-language dossier on diclofenac and anti-inflammatory medicines sets out how the substance is described, how the 50 mg dose is explained, and how gel and tablet differ, alongside the practical questions people raise before seeing a doctor or pharmacist. That material is written for readers in the Netherlands, where the medicine is dispensed under local rules, and it treats the subject as general information rather than as a treatment plan for any individual.
What does an anti-inflammatory medicine actually do?
Inflammation is the body's response to injury or irritation: blood vessels widen, immune cells move into the tissue, and the area becomes warm, swollen and tender. Anti-inflammatory medicines act on part of that chain, reducing the production of prostaglandins, the signalling molecules that help generate pain and swelling. Diclofenac belongs to this group, as do ibuprofen and naproxen.
Paracetamol sits outside that group. It relieves pain and reduces fever, but its effect on inflammation is limited, which is why it is often described as an analgesic rather than an anti-inflammatory. The distinction matters when a person is choosing between products on a pharmacy shelf, because the two families are not equivalent for a swollen joint or a strained muscle.
What is the 50 mg dose of diclofenac?
The 50 mg figure describes how much diclofenac is contained in one tablet. It is a common strength for the immediate-release form, and it is not the same as a 50 mg dose of another medicine, nor the same as 50 mg of diclofenac delivered through the skin. The dose printed on a box is a quantity of substance, not a promise about how strong the effect will be for a particular person.
Diclofenac is available in the Netherlands both on prescription and, for some products and pack sizes, without one. The patient information leaflet inside the pack is the document that states the licensed dose, the maximum daily amount and the situations in which the medicine should not be used. A pharmacist can explain how a prescribed dose relates to the pack in front of the customer.
Gel against tablet: how do the two forms differ?
A gel delivers diclofenac through the skin to the tissue underneath, so the amount reaching the rest of the body is smaller than with a tablet. That is why a topical product and an oral product are not interchangeable at the same number of milligrams: 50 mg in a tablet and a gel containing diclofenac are different routes with different absorption.
A tablet is swallowed and passes through the digestive system before entering the bloodstream, which is why stomach protection and timing relative to food are part of the leaflet's instructions. A gel is applied to the skin over the painful area, usually in a measured amount, and hands are washed afterwards. The two forms are chosen for different situations, and the choice belongs with a prescriber or pharmacist rather than with a comparison of numbers on the packaging.
| Feature | Tablet | Gel |
|---|---|---|
| Route | Swallowed, acts through the bloodstream | Applied to the skin over the painful area |
| Amount reaching the whole body | Higher | Lower |
| Typical use described in the leaflet | Short-term pain and inflammation | Localised muscle and joint pain |
| Where the dose is stated | Patient information leaflet and prescription | Patient information leaflet and pack |
How are side effects reported in the UK and the Netherlands?
In the United Kingdom, suspected side effects from medicines are reported through the Yellow Card scheme, which is run by the Medicines and Healthcare products Regulatory Agency with the UK Health Security Agency; the UK Health Security Agency published its annual report on the scheme on 31 October 2023. Reports can be made by patients, carers and health professionals, and they feed into the safety monitoring that can lead to changes in a product's information.
In the Netherlands, the equivalent route runs through Lareb, the national centre that collects reports of adverse drug reactions. Both systems exist so that patterns can be detected after a medicine is in wide use, since clinical trials cannot capture every rare event. A report does not by itself prove that a medicine caused a symptom, but it adds to the evidence base.
How does paracetamol differ from an anti-inflammatory?
Paracetamol is used for pain and fever and is generally considered gentler on the stomach than anti-inflammatory medicines, which is one reason it appears in many over-the-counter combinations. It does not reduce inflammation in the way diclofenac or ibuprofen do, so for a sprained ankle or an inflamed joint it may relieve discomfort without addressing the swelling.
Anti-inflammatory medicines carry their own considerations, including effects on the stomach, kidneys and cardiovascular system, which is why the leaflets list conditions that require medical advice before use. NICE, in its clinical guideline on medicines associated with dependence or withdrawal symptoms published on 1 April 2022, sets out how certain medicines should be reviewed; the same principle of review applies to long-term use of any analgesic. The choice between paracetamol and an anti-inflammatory is therefore a clinical one, based on the problem, the person and the duration of use.
Checked against the source
- The Yellow Card scheme for reporting suspected side effects is operated by the Medicines and Healthcare products Regulatory Agency with the UK Health Security Agency, whose annual report on the scheme was published on 31 October 2023 (UK Health Security Agency).
- NICE published its guideline on medicines associated with dependence or withdrawal symptoms on 1 April 2022, covering how such medicines should be reviewed (NICE).
- The patient information leaflet supplied with a medicine is the document that states the licensed dose, the maximum daily amount and the situations in which the product should not be used (Medicines and Healthcare products Regulatory Agency).
- Suspected adverse drug reactions in the Netherlands are collected by Lareb, the national centre for drug safety reporting (Lareb).
- The General Pharmaceutical Council sets the standards for registered pharmacies in Great Britain, including the advice given when a medicine is supplied (General Pharmaceutical Council).
The number on the box and the dose in the body
A frequent confusion is to read 50 mg on a box of tablets and treat the same number on a tube of gel as if it described the same exposure. It does not. A tablet releases its content into the digestive tract and then into the bloodstream, while a gel releases diclofenac into the skin and the tissue beneath it, with only a fraction reaching the rest of the body.
The two products are also measured differently: a tablet is counted in units, a gel in a length of gel or a measured amount from the tube. Comparing the numbers without comparing the routes can lead to a mistaken idea of how much medicine is actually entering the body, which is why the leaflet and the pharmacist remain the reference points for any particular product.
Diclofenac sits in a different category from physiotherapy, yet both appear in discussions of how treatment is funded and recorded. The host page explains what diclofenac does, how the 50 mg dose and gel differ from tablets, how side effects are reported, and how paracetamol differs from an anti-inflammatory. A reader who wants to see how another European system sets out funding rules can turn to the Dutch physiotherapy cover, which describes what the Besluit zorgverzekering defines and why the decree prints no amounts. The two pages share a concern with how medicines and therapies are described in official texts.
Diclofenac belongs to the anti-inflammatory group, and its regulation sits within a wider pattern of rules that govern substances sold to the public. Readers who follow how such rules are written and applied may find a parallel case in France, where hemp and CBD products are classified by their THC content rather than by their intended use. That guide sets out the CBD food rules, the European case law behind them, and the position of food and animal products, offering a documented comparison for anyone interested in how thresholds and categories are decided.