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Combining oral NAC with topical diclofenac for knee tendinopathy – dosing schedule?

Posted by trevor_recovery in Protocols & Stacks - 1 points, 3 comments.

I’ve been dealing with chronic patellar tendon pain for about a year now. In the last 3 months I tried oral NAC (600 mg twice a day) to boost glutathione and reduce any low‑grade inflammation, and I also started using diclofenac gel (4 g per knee, 3x daily) after each physio session. The idea was to support systemic antioxidant capacity while delivering a local NSAID effect without the GI load of oral ibuprofen.

For the NAC I reconstituted 600 mg capsules in 30 ml sterile water and took 10 ml each morning and evening, mixing with water. The diclofenac gel I apply after shower, spreading the full 4 g patch over the tendon area, then wait 30 min before any compress.

In my experience the pain rating dropped from 6/10 to about 3/10 after two weeks, and I felt a little less stiffness during the night. I haven’t noticed any skin irritation from the gel, but the NAC sometimes gives a mild sulfur taste.

I’m wondering if anyone has tried a similar combo, especially regarding timing – should the NAC be taken further from the gel application, or does it matter? Also, any thoughts on adjusting the NAC dose (maybe 900 mg total) or adding a small glycine portion like in GlyNAC for extra glutathione support? Ngl, I’m open to suggestions before I extend the cycle beyond 8 weeks. No one wants to run into unexpected side effects. Thanks.

Comments

  • practical_optimizer: I’ve tried a rough version of that combo on my own runner’s knee last winter. I stuck with 600 mg NAC twice daily in capsule form (no water reconstitution) and put 2 g diclofenac gel on the tendon after my night shower, usually about an hour after the NAC dose. The timing didn’t seem to matter much – the gel works locally anyway – but I found it easier to keep the oral stuff away from the shower so the taste didn’t linger. I never cranked NAC above 600 mg; adding glycine made the mix taste even
  • trevor_recovery: I’ve been on 600 mg twice daily for about 10 weeks now, reconstituted in water as I described. I noticed the same 4 g gel dose worked best for me – 2 g feels a bit light, especially after three applications a day. I also apply it directly after shower, just like you, and then wait 30 min before compressing. Ngl, did you find any difference in pain relief between the 2 g and 4 g amounts? And how long after the NAC salariés did you wait before the gel, or did you just do it simultaneously?
  • trevor_recovery: I’ve only been at 900 mg for about six weeks now, started after hitting a plateau at 600 mg. I split it 450 mg twice a day, still in capsules, and keep the gel application same as yours. Pain’s dropped a bit more, but I can’t tell if it’s the extra NAC or just time. How long did you stay at 600 mg before tweaking?

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