PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (2022)

Table of Contents
TARGETED OA KNEE PAIN RELIEF1-3 Significantly greater reductions in pain scores for Pennsaid 2% versus vehicle-control at 4 weeks3* SELECT IMPORTANT SAFETY INFORMATION REDUCED SYSTEMIC EXPOSURE OF A TOPICAL2 93% REDUCTION IN SYSTEMIC EXPOSURE ENHANCED PENETRATION RIGHT AT THE SITE OF PAIN DMSO FACILITATES PENETRATION THROUGH THE SKIN 2X DAILY DOSING THAT’S EASY TO APPLY CONSISTENT ACCURATE DOSING WITH A METERED-DOSE PUMP CONVENIENT 2X DAILY DOSING1 SELECT IMPORTANT SAFETY INFORMATION TARGETED OA KNEE PAIN RELIEF + REDUCED SYSTEMIC EXPOSURE OF A TOPICAL PENNSAID 2% samples We’ll come to you Talk to someone now OTHER HORIZON INFLAMMATION CARE PRODUCT OPTIONS FOR YOUR PATIENTS PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) SELECT IMPORTANT SAFETY INFORMATION WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) INDICATIONS AND USAGE PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS WARNINGS AND PRECAUTIONS ADVERSE REACTIONS USE IN SPECIFIC POPULATIONS DUEXIS® (IBUPROFEN AND FAMOTIDINE) SELECT IMPORTANT SAFETY INFORMATION WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS Gastrointestinal Bleeding, Ulceration, and Perforation DUEXIS® (IBUPROFEN AND FAMOTIDINE) INDICATIONS AND USAGE DUEXIS® (IBUPROFEN AND FAMOTIDINE) IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS WARNINGS AND PRECAUTIONS ADVERSE REACTIONS USE IN SPECIFIC POPULATIONS RAYOS® (PREDNISONE) DELAYED-RELEASE TABLETS INDICATIONS AND USAGE RAYOS® (PREDNISONE) DELAYED-RELEASE TABLETS IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS WARNINGS AND PRECAUTIONS ADVERSE REACTIONS PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) SELECT IMPORTANT SAFETY INFORMATION WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) INDICATIONS AND USAGE PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS WARNINGS AND PRECAUTIONS ADVERSE REACTIONS USE IN SPECIFIC POPULATIONS DUEXIS® (IBUPROFEN AND FAMOTIDINE) SELECT IMPORTANT SAFETY INFORMATION WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS Gastrointestinal Bleeding, Ulceration, and Perforation DUEXIS® (IBUPROFEN AND FAMOTIDINE) INDICATIONS AND USAGE DUEXIS® (IBUPROFEN AND FAMOTIDINE) IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS WARNINGS AND PRECAUTIONS ADVERSE REACTIONS USE IN SPECIFIC POPULATIONS RAYOS® (PREDNISONE) DELAYED-RELEASE TABLETS INDICATIONS AND USAGE RAYOS® (PREDNISONE) DELAYED-RELEASE TABLETS IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS WARNINGS AND PRECAUTIONS ADVERSE REACTIONS REFERENCES FAQs Related content

PAIN RELIEF DATA

TARGETED OA KNEE PAIN RELIEF1-3

  • PENNSAID 2% provided 36.3% reduction in OA knee pain at baseline after 4 weeks (compared with 28.6% with vehicle control)1,3
    • Vehicle control contained dimethyl sulfoxide (DMSO) and all other inactive ingredients in PENNSAID 2%4
  • Relief measured as reduction of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale score from baseline at 4 weeks1,3

Significantly greater reductions in pain scores for Pennsaid 2% versus vehicle-control at 4 weeks3*

Solution with DMSO and all other inactive ingredients (n=129) PENNSAID 2% (n=130)

SELECT IMPORTANT SAFETY INFORMATION

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use
  • NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events

SYSTEMIC EXPOSURE DATA

REDUCED SYSTEMIC EXPOSURE OF A TOPICAL2

93% REDUCTION IN SYSTEMIC EXPOSURE

When compared with oral diclofenac sodium, PENNSAID 2% reduced systemic exposure by 93%.2

In a pharmacokinetic (PK) study of 22 healthy individuals, PENNSAID 2% demonstrated only 7% systemic absorption compared with oral diclofenac sodium, 75 mg twice daily.2

Oral diclofenac

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (1)

PENNSAID 2%

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (2)

93% reduction

PAIN TARGETING MECHANISM

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (3) PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (4) PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (5)

ENHANCED PENETRATION RIGHT AT THE SITE OF PAIN

DMSO FACILITATES PENETRATION THROUGH THE SKIN

DMSO facilitates penetration of diclofenac through the skin barrier.5 DMSO enhances the permeability of cell membranes, facilitating localized delivery of diclofenac sodium by driving it through the skin barrier directly to the site of pain.1,5

DOSING INSTRUCTIONS

2X DAILY DOSING THAT’S EASY TO APPLY

CONSISTENT ACCURATE DOSING WITH A METERED-DOSE PUMP

  • PENNSAID 2%: no measuring and little mess1
  • 2 pumps, 2 times daily1

CONVENIENT 2X DAILY DOSING1

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (6)

  • Another topical, Voltaren® Gel (diclofenac sodium topical gel), is applied 4x daily and requires patients to use a dosing card for accurate dosing6

For full application and dosing instructions see Instructions for Use.

SELECT IMPORTANT SAFETY INFORMATION

Patients should:

  • Wash and dry hands before and after use. Avoid contact of PENNSAID with the eyes and mucous membranes
  • Protect treated knee(s) from natural or artificial sunlight
  • Wait until the treated knee(s) is completely dry before applying sunscreen, insect repellent, lotion, moisturizer, cosmetics, or other topical medication
  • The most common adverse reactions to PENNSAID 1.5% or PENNSAID 2% in clinical trials were: application site reactions such as dryness, exfoliation, erythema, pruritus, pain, induration, rash, scabbing, contact dermatitis characterized by skin erythema and induration, contact dermatitis with vesicles; urinary tract infection; contusion; sinus congestion; nausea; dyspepsia; abdominal pain; flatulence; diarrhea; constipation; edema

TARGETED OA KNEE PAIN RELIEF + REDUCED SYSTEMIC EXPOSURE OF A TOPICAL

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (7)

Significant OA knee pain relief1,3

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (8)

93% reduction in systemic exposure compared to oral diclofenac2

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (9)

Targeted at the site of pain1,5

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (10)

2X daily dosing that’s easy to apply1

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (11)

Non-narcotic & non-addictive

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (12)

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (13)PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (14)PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (15)

PENNSAID 2% samples

Start your OA knee pain patients with samples of PENNSAID 2%.

REQUEST SAMPLES

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (16)PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (17)PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (18)

We’ll come to you

Get more information by having your PENNSAID 2% representative come to your practice.

REQUEST A REPRESENTATIVE

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (19)PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (20)PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (21)

Talk to someone now

Our support team is available to address
your questions and provide information
via phone (833) 736-6724.

833-PENNSAID

OTHER HORIZON INFLAMMATION CARE PRODUCT
OPTIONS FOR YOUR PATIENTS

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (22)

FOR YOUR OA OR RA PATIENTS

Powerful relief + built-in gastroprotection

REVIEW THE DATA

PENNSAID® (Diclofenac Sodium Topical Solution) 2% | For HCPs (23)

FOR YOUR PATIENTS WITH CERTAIN INFLAMMATORY CONDITIONS

The only delayed-release prednisone for the treatment of RA and other inflammatory conditions

SEE HOW IT WORKS

RA=rheumatoid arthritis.

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  • DUEXIS
  • PENNSAID 2%
  • RAYOS

PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) SELECT IMPORTANT SAFETY INFORMATION

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

Cardiovascular Thrombotic Events

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use.
  • PENNSAID is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Bleeding, Ulceration, and Perforation

  • NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) INDICATIONS AND USAGE

PENNSAID® (diclofenac sodium topical solution) 2% w/w (PENNSAID 2%) is a nonsteroidal anti-inflammatory drug indicated for the treatment of the pain of osteoarthritis of the knee(s).

PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • PENNSAID is contraindicated in patients with:
    • known hypersensitivity to diclofenac or any component of the drug product
    • a history of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs,
    • in the setting of CABG surgery.

WARNINGS AND PRECAUTIONS

  • Use the lowest effective dose of PENNSAID for the shortest duration consistent with individual patient treatment goals.
  • There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use. The concurrent use of aspirin and an NSAID, such as diclofenac, increases the risk of serious GI events. In the setting of concomitant use of low-dose aspirin for cardiac prophylaxis, monitor patients more closely for evidence of GI bleeding.
  • Elevation of one or more liver tests may occur during therapy with NSAIDs. PENNSAID should be discontinued immediately if clinical signs and symptoms consistent with liver disease develop. Measure transaminases at baseline and periodically in patients receiving long-term therapy with PENNSAID. PENNSAID should be discontinued immediately if abnormal liver tests persist or worsen or if clinical signs and/or symptoms consistent with liver disease develop.
  • Hypertension can occur with NSAID treatment. Monitor blood pressure closely.
  • Avoid use of PENNSAID in patients with severe heart failure unless benefits are expected to outweigh the risk.
  • Monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia. Avoid use of PENNSAID in patients with advanced renal disease unless benefits are expect to outweigh risk of worsening renal function.
  • Anaphylactic reactions may occur in patients with or without known hypersensitivity to diclofenac and in patients with aspirin-sensitive asthma.
  • NSAIDs, including diclofenac, can cause serious skin adverse reactions such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. Discontinue PENNSAID at first appearance of skin rash or any other sign of hypersensitivity.
  • Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) has been reported in patients taking NSAIDs such as PENNSAID. Some of these events have been fatal or life-threatening. If early symptoms of hypersensitivity appear, such as fever or lymphadenopathy with or without rash, discontinue PENNSAID and evaluate the patient immediately.
  • Limit use of NSAIDs, including PENNSAID between about 20 to 30 weeks in pregnancy due to the risk of oligohydramnios/fetal renal dysfunction. Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy due to the risks of premature closure of the fetal ductus arteriosus and oligohydramnios/fetal renal dysfunction.
  • Anemia has occurred in NSAID-treated patients. Monitor hemoglobin or hematocrit in patients with any signs or symptoms of anemia.
  • Concurrent use of PENNSAID with oral NSAIDs should be avoided unless benefit outweighs risk and periodic laboratory evaluations are conducted.
  • When applying PENNSAID, DO NOT: apply to open wounds, shower for at least 30 minutes after applying, wear clothing over the PENNSAID treated knee(s) until the treated knee(s) is dry. When applying PENNSAID, DO: wash and dry hands before and after use, avoid contact of PENNSAID with the eyes and mucous membranes, protect treated knee(s) from natural or artificial sunlight, wait until the treated knee(s) is completely dry before applying sunscreen, insect repellent, lotion, moisturizer, cosmetics, or other topical medication.
  • See full Prescribing Information for a list of clinically important drug interactions.

ADVERSE REACTIONS

  • The most common adverse reactions in the PENNSAID 1.5% or PENNSAID 2% clinical trials were: application site reactions such as dryness, exfoliation, erythema, pruritus, pain, induration, rash, scabbing, contact dermatitis characterized by skin erythema and induration, contact dermatitis with vesicles; urinary tract infection; contusion; sinus congestion; nausea; dyspepsia; abdominal pain; flatulence; diarrhea; constipation; and edema.

USE IN SPECIFIC POPULATIONS

  • Use of NSAIDs, including PENNSAID, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios. Limit dose and duration of use between about 20 and 30 weeks of gestation and avoid use at about 30 weeks of gestation and later in pregnancy. Consider withdrawal of NSAIDs in women who have difficulties conceiving or who are undergoing investigation of infertility.
  • Safety and efficacy of PENNSAID in pediatric patients has not been established.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

DUEXIS® (IBUPROFEN AND FAMOTIDINE) SELECT IMPORTANT SAFETY INFORMATION

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

Cardiovascular Thrombotic Events

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular (CV) thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use.
  • DUEXIS is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Bleeding, Ulceration, and Perforation

  • NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

DUEXIS® (IBUPROFEN AND FAMOTIDINE) INDICATIONS AND USAGE

DUEXIS® (ibuprofen and famotidine), a combination of the NSAID ibuprofen and the histamine H2-receptor antagonist famotidine, is indicated for the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis and to decrease the risk of developing upper gastrointestinal ulcers, which in the clinical trials was defined as a gastric and/or duodenal ulcer, in patients who are taking ibuprofen for those indications. The clinical trials primarily enrolled patients less than 65 years of age without a prior history of gastrointestinal ulcer. Controlled trials do not extend beyond 6 months.

DUEXIS® (IBUPROFEN AND FAMOTIDINE) IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • DUEXIS is contraindicated in patients:
    • With a known hypersensitivity to ibuprofen or famotidine or any components of the drug product or known hypersensitivity to other H2-receptor antagonists
    • Who have a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Fatal anaphylactic reactions to NSAIDs have been reported in such patients
    • In the setting of coronary artery bypass graft (CABG) surgery

WARNINGS AND PRECAUTIONS

  • Use ibuprofen at the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
  • There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use. The concurrent use of aspirin and an NSAID, such as DUEXIS, increases the risk of serious GI events.
  • Avoid use of DUEXIS in patients with a recent MI unless benefits are expected to outweigh the risk of recurrent CV thrombotic events. If DUEXIS is used in patients with a recent MI, monitor patients for signs of cardiac ischemia.
  • Discontinue DUEXIS if active and clinically significant bleeding from any source occurs.
  • Elevation of one or more liver tests may occur during therapy with NSAIDs. DUEXIS should be discontinued immediately if clinical signs and symptoms consistent with liver disease develop.
  • Hypertension can occur with NSAID treatment. Monitor blood pressure closely with DUEXIS treatment.
  • Avoid use of DUEXIS in patients with severe heart failure unless benefits are expected to outweigh the risk.
  • Monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia. Avoid use of DUEXIS in patients with advanced renal disease unless benefits are expected to outweigh risk of worsening renal function.
  • Anaphylactic reactions may occur in patients with or without known hypersensitivity to DUEXIS and in patients with aspirin-sensitive asthma.
  • DUEXIS can cause serious skin adverse reactions such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. Discontinue use at first appearance of skin rash or any other sign of hypersensitivity.
  • Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) has been reported in patients taking NSAIDs such as DUEXIS. Some of these events have been fatal or life-threatening. If early symptoms of hypersensitivity appear, such as fever or lymphadenopathy with or without rash, discontinue DUEXIS and evaluate the patient immediately.
  • Limit use of NSAIDs, including DUEXIS, between about 20 to 30 weeks in pregnancy due to the risk of oligohydramnios/fetal renal dysfunction. Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy due to the risks of oligohydramnios/fetal renal dysfunction and premature closure of the fetal ductus arteriosus.
  • Anemia has occurred in NSAID-treated patients. Monitor hemoglobin or hematocrit in patients with any signs or symptoms of anemia.
  • See full Prescribing Information for a list of clinically important drug interactions.

ADVERSE REACTIONS

  • The most common adverse reactions in clinical trials (≥1% and greater than ibuprofen alone) were nausea, diarrhea, constipation, upper abdominal pain, and headache.

USE IN SPECIFIC POPULATIONS

  • Use of NSAIDs, including DUEXIS, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios. Limit dose and duration of use between about 20 and 30 weeks of gestation and avoid use at about 30 weeks of gestation and later in pregnancy. Consider withdrawal of NSAIDs, including DUEXIS, in women who have difficulties conceiving or who are undergoing investigation of infertility.
  • Safety and efficacy of DUEXIS in pediatric patients has not been established.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

RAYOS® (PREDNISONE) DELAYED-RELEASE TABLETS INDICATIONS AND USAGE

RAYOS is a corticosteroid indicated:

  • As an anti-inflammatory or immunosuppressive agent for certain allergic, dermatologic, gastrointestinal, hematologic, ophthalmologic, nervous system, renal, respiratory, rheumatologic, specific infectious diseases or conditions and organ transplantation
  • For the treatment of certain endocrine conditions
  • For palliation of certain neoplastic conditions

RAYOS® (PREDNISONE) DELAYED-RELEASE TABLETS IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • Known hypersensitivity to prednisone or any excipients in the formulation

WARNINGS AND PRECAUTIONS

  • Corticosteroids can cause hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome and hyperglycemia. Monitor patients for these conditions with chronic use. Taper doses gradually for withdrawal after chronic use
  • RAYOS may increase susceptibility to new infection and increase risk of exacerbation, dissemination or reactivation of latent infection. RAYOS may mask signs and symptoms of infection. The rate of infectious complications increases with increasing doses of corticosteroids
  • Corticosteroids can cause elevated blood pressure, salt and water retention and hypokalemia. Monitor blood pressure and sodium, potassium serum levels. RAYOS should be used with caution in patients with a history of recent myocardial infarction, congestive heart failure, hypertension or renal insufficiency
  • There is an increased risk of gastrointestinal (GI) perforation in patients with certain GI disorders. RAYOS may mask signs and symptoms of GI perforation
  • Corticosteroid use may be associated with behavioral and mood disturbances, including euphoria, insomnia, mood swings, personality changes, severe depression and psychosis. Existing conditions may be aggravated
  • Corticosteroid use may lead to inhibition of bone growth in children and adolescents and the development of osteoporosis at any age. Give special consideration to patients at increased risk of osteoporosis (eg, postmenopausal women) before initiating corticosteroid therapy, and bone density should be monitored in patients on long-term corticosteroid therapy
  • Prolonged use of corticosteroids may result in cataracts, infections and glaucoma. Monitor intraocular pressure if corticosteroid therapy is continued for more than 6 weeks
  • Do not administer live or attenuated vaccines to patients receiving immunosuppressive doses of corticosteroids
  • Long‐term use of corticosteroids can have negative effects on growth and development in children. Monitor pediatric patients on long‐term corticosteroid therapy
  • Corticosteroids can cause fetal harm, including a small but inconsistent risk of orofacial clefts during the first trimester. Advise pregnant women of potential harm to the fetus
  • Prednisolone has been found in human milk following administration to lactating women; use the lowest dose in lactating women to achieve desired clinical effect

ADVERSE REACTIONS

  • Common adverse reactions for corticosteroids include fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetite and weight gain

Please see full Prescribing Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

  • DUEXIS
  • PENNSAID 2%
  • RAYOS

PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) SELECT IMPORTANT SAFETY INFORMATION

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

Cardiovascular Thrombotic Events

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use.
  • PENNSAID is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Bleeding, Ulceration, and Perforation

  • NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) INDICATIONS AND USAGE

PENNSAID® (diclofenac sodium topical solution) 2% w/w (PENNSAID 2%) is a nonsteroidal anti-inflammatory drug indicated for the treatment of the pain of osteoarthritis of the knee(s).

PENNSAID® (DICLOFENAC SODIUM TOPICAL SOLUTION) 2% W/W (PENNSAID 2%) IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • PENNSAID is contraindicated in patients with:
    • known hypersensitivity to diclofenac or any component of the drug product
    • a history of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs,
    • in the setting of CABG surgery.

WARNINGS AND PRECAUTIONS

  • Use the lowest effective dose of PENNSAID for the shortest duration consistent with individual patient treatment goals.
  • There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use. The concurrent use of aspirin and an NSAID, such as diclofenac, increases the risk of serious GI events. In the setting of concomitant use of low-dose aspirin for cardiac prophylaxis, monitor patients more closely for evidence of GI bleeding.
  • Elevation of one or more liver tests may occur during therapy with NSAIDs. PENNSAID should be discontinued immediately if clinical signs and symptoms consistent with liver disease develop. Measure transaminases at baseline and periodically in patients receiving long-term therapy with PENNSAID. PENNSAID should be discontinued immediately if abnormal liver tests persist or worsen or if clinical signs and/or symptoms consistent with liver disease develop.
  • Hypertension can occur with NSAID treatment. Monitor blood pressure closely.
  • Avoid use of PENNSAID in patients with severe heart failure unless benefits are expected to outweigh the risk.
  • Monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia. Avoid use of PENNSAID in patients with advanced renal disease unless benefits are expect to outweigh risk of worsening renal function.
  • Anaphylactic reactions may occur in patients with or without known hypersensitivity to diclofenac and in patients with aspirin-sensitive asthma.
  • NSAIDs, including diclofenac, can cause serious skin adverse reactions such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. Discontinue PENNSAID at first appearance of skin rash or any other sign of hypersensitivity.
  • Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) has been reported in patients taking NSAIDs such as PENNSAID. Some of these events have been fatal or life-threatening. If early symptoms of hypersensitivity appear, such as fever or lymphadenopathy with or without rash, discontinue PENNSAID and evaluate the patient immediately.
  • Limit use of NSAIDs, including PENNSAID between about 20 to 30 weeks in pregnancy due to the risk of oligohydramnios/fetal renal dysfunction. Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy due to the risks of premature closure of the fetal ductus arteriosus and oligohydramnios/fetal renal dysfunction.
  • Anemia has occurred in NSAID-treated patients. Monitor hemoglobin or hematocrit in patients with any signs or symptoms of anemia.
  • Concurrent use of PENNSAID with oral NSAIDs should be avoided unless benefit outweighs risk and periodic laboratory evaluations are conducted.
  • When applying PENNSAID, DO NOT: apply to open wounds, shower for at least 30 minutes after applying, wear clothing over the PENNSAID treated knee(s) until the treated knee(s) is dry. When applying PENNSAID, DO: wash and dry hands before and after use, avoid contact of PENNSAID with the eyes and mucous membranes, protect treated knee(s) from natural or artificial sunlight, wait until the treated knee(s) is completely dry before applying sunscreen, insect repellent, lotion, moisturizer, cosmetics, or other topical medication.
  • See full Prescribing Information for a list of clinically important drug interactions.

ADVERSE REACTIONS

  • The most common adverse reactions in the PENNSAID 1.5% or PENNSAID 2% clinical trials were: application site reactions such as dryness, exfoliation, erythema, pruritus, pain, induration, rash, scabbing, contact dermatitis characterized by skin erythema and induration, contact dermatitis with vesicles; urinary tract infection; contusion; sinus congestion; nausea; dyspepsia; abdominal pain; flatulence; diarrhea; constipation; and edema.

USE IN SPECIFIC POPULATIONS

  • Use of NSAIDs, including PENNSAID, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios. Limit dose and duration of use between about 20 and 30 weeks of gestation and avoid use at about 30 weeks of gestation and later in pregnancy. Consider withdrawal of NSAIDs in women who have difficulties conceiving or who are undergoing investigation of infertility.
  • Safety and efficacy of PENNSAID in pediatric patients has not been established.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

DUEXIS® (IBUPROFEN AND FAMOTIDINE) SELECT IMPORTANT SAFETY INFORMATION

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

Cardiovascular Thrombotic Events

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular (CV) thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use.
  • DUEXIS is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Bleeding, Ulceration, and Perforation

  • NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

DUEXIS® (IBUPROFEN AND FAMOTIDINE) INDICATIONS AND USAGE

DUEXIS® (ibuprofen and famotidine), a combination of the NSAID ibuprofen and the histamine H2-receptor antagonist famotidine, is indicated for the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis and to decrease the risk of developing upper gastrointestinal ulcers, which in the clinical trials was defined as a gastric and/or duodenal ulcer, in patients who are taking ibuprofen for those indications. The clinical trials primarily enrolled patients less than 65 years of age without a prior history of gastrointestinal ulcer. Controlled trials do not extend beyond 6 months.

DUEXIS® (IBUPROFEN AND FAMOTIDINE) IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • DUEXIS is contraindicated in patients:
    • With a known hypersensitivity to ibuprofen or famotidine or any components of the drug product or known hypersensitivity to other H2-receptor antagonists
    • Who have a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Fatal anaphylactic reactions to NSAIDs have been reported in such patients
    • In the setting of coronary artery bypass graft (CABG) surgery

WARNINGS AND PRECAUTIONS

  • Use ibuprofen at the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
  • There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use. The concurrent use of aspirin and an NSAID, such as DUEXIS, increases the risk of serious GI events.
  • Avoid use of DUEXIS in patients with a recent MI unless benefits are expected to outweigh the risk of recurrent CV thrombotic events. If DUEXIS is used in patients with a recent MI, monitor patients for signs of cardiac ischemia.
  • Discontinue DUEXIS if active and clinically significant bleeding from any source occurs.
  • Elevation of one or more liver tests may occur during therapy with NSAIDs. DUEXIS should be discontinued immediately if clinical signs and symptoms consistent with liver disease develop.
  • Hypertension can occur with NSAID treatment. Monitor blood pressure closely with DUEXIS treatment.
  • Avoid use of DUEXIS in patients with severe heart failure unless benefits are expected to outweigh the risk.
  • Monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia. Avoid use of DUEXIS in patients with advanced renal disease unless benefits are expected to outweigh risk of worsening renal function.
  • Anaphylactic reactions may occur in patients with or without known hypersensitivity to DUEXIS and in patients with aspirin-sensitive asthma.
  • DUEXIS can cause serious skin adverse reactions such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. Discontinue use at first appearance of skin rash or any other sign of hypersensitivity.
  • Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) has been reported in patients taking NSAIDs such as DUEXIS. Some of these events have been fatal or life-threatening. If early symptoms of hypersensitivity appear, such as fever or lymphadenopathy with or without rash, discontinue DUEXIS and evaluate the patient immediately.
  • Limit use of NSAIDs, including DUEXIS, between about 20 to 30 weeks in pregnancy due to the risk of oligohydramnios/fetal renal dysfunction. Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy due to the risks of oligohydramnios/fetal renal dysfunction and premature closure of the fetal ductus arteriosus.
  • Anemia has occurred in NSAID-treated patients. Monitor hemoglobin or hematocrit in patients with any signs or symptoms of anemia.
  • See full Prescribing Information for a list of clinically important drug interactions.

ADVERSE REACTIONS

  • The most common adverse reactions in clinical trials (≥1% and greater than ibuprofen alone) were nausea, diarrhea, constipation, upper abdominal pain, and headache.

USE IN SPECIFIC POPULATIONS

  • Use of NSAIDs, including DUEXIS, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios. Limit dose and duration of use between about 20 and 30 weeks of gestation and avoid use at about 30 weeks of gestation and later in pregnancy. Consider withdrawal of NSAIDs, including DUEXIS, in women who have difficulties conceiving or who are undergoing investigation of infertility.
  • Safety and efficacy of DUEXIS in pediatric patients has not been established.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

RAYOS® (PREDNISONE) DELAYED-RELEASE TABLETS INDICATIONS AND USAGE

RAYOS is a corticosteroid indicated:

  • As an anti-inflammatory or immunosuppressive agent for certain allergic, dermatologic, gastrointestinal, hematologic, ophthalmologic, nervous system, renal, respiratory, rheumatologic, specific infectious diseases or conditions and organ transplantation
  • For the treatment of certain endocrine conditions
  • For palliation of certain neoplastic conditions

RAYOS® (PREDNISONE) DELAYED-RELEASE TABLETS IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • Known hypersensitivity to prednisone or any excipients in the formulation

WARNINGS AND PRECAUTIONS

  • Corticosteroids can cause hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome and hyperglycemia. Monitor patients for these conditions with chronic use. Taper doses gradually for withdrawal after chronic use
  • RAYOS may increase susceptibility to new infection and increase risk of exacerbation, dissemination or reactivation of latent infection. RAYOS may mask signs and symptoms of infection. The rate of infectious complications increases with increasing doses of corticosteroids
  • Corticosteroids can cause elevated blood pressure, salt and water retention and hypokalemia. Monitor blood pressure and sodium, potassium serum levels. RAYOS should be used with caution in patients with a history of recent myocardial infarction, congestive heart failure, hypertension or renal insufficiency
  • There is an increased risk of gastrointestinal (GI) perforation in patients with certain GI disorders. RAYOS may mask signs and symptoms of GI perforation
  • Corticosteroid use may be associated with behavioral and mood disturbances, including euphoria, insomnia, mood swings, personality changes, severe depression and psychosis. Existing conditions may be aggravated
  • Corticosteroid use may lead to inhibition of bone growth in children and adolescents and the development of osteoporosis at any age. Give special consideration to patients at increased risk of osteoporosis (eg, postmenopausal women) before initiating corticosteroid therapy, and bone density should be monitored in patients on long-term corticosteroid therapy
  • Prolonged use of corticosteroids may result in cataracts, infections and glaucoma. Monitor intraocular pressure if corticosteroid therapy is continued for more than 6 weeks
  • Do not administer live or attenuated vaccines to patients receiving immunosuppressive doses of corticosteroids
  • Long‐term use of corticosteroids can have negative effects on growth and development in children. Monitor pediatric patients on long‐term corticosteroid therapy
  • Corticosteroids can cause fetal harm, including a small but inconsistent risk of orofacial clefts during the first trimester. Advise pregnant women of potential harm to the fetus
  • Prednisolone has been found in human milk following administration to lactating women; use the lowest dose in lactating women to achieve desired clinical effect

ADVERSE REACTIONS

  • Common adverse reactions for corticosteroids include fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetite and weight gain

Please see full Prescribing Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

REFERENCES

  • PENNSAID (diclofenac sodium topical solution) 2% [prescribing information] Horizon.
  • Holt RJ, Taiwo T, Kent JD. Bioequivalence of diclofenac sodium 2% and 1.5% topical solutions relative to oral diclofenac sodium in healthy volunteers. Postgrad Med. 2015;127(6):581-590.
  • Wadsworth LT, Kent JD, Holt RJ. Efficacy and safety of diclofenac sodium 2% topical solution for osteoarthritis of the knee: a randomized, double-blind, vehicle-controlled, 4 week study. Curr Med Res Opin. 2016;32(2):241-250.
  • Data on file. Horizon.
  • Marren K. Dimethyl sulfoxide: an effective penetration enhancer for topical administration of NSAIDs. Phys Sportsmed. 2011;39(3):75-82.
  • GSK. What is Voltaren? Voltaren gel website. https://www.voltarengel.com/what-is-voltaren. Accessed June 4, 2020.

FAQs

What is Pennsaid topical solution used for? ›

PENNSAID® (diclofenac sodium topical solution) 2% w/w is a nonsteroidal anti-inflammatory drug (NSAID) applied to the skin, used for treating the pain of osteoarthritis of the knee(s).

Do you need a prescription for Pennsaid? ›

Pennsaid is a prescription medicine used to treat the symptoms of Acute Pain, Arthritis Pain, Actinic Keratosis, and Osteoarthritis. Pennsaid may be used alone or with other medications. Pennsaid belongs to a class of drugs called Topical Skin Products.

Why does Pennsaid cost so much? ›

Patent law protection. Another reason why the price of Pennsaid is so expensive is because patent law protection provides the manufacturer of Pennsaid with exclusive rights to sell this drug until the patents expire. Typically, the patent will last for around 20 years from the date of the initial application.

Why is Pennsaid only used on knees? ›

Since OA of the knee affects the entire knee, applying PENNSAID 2% to just the top of your knee could lessen the pain relief you feel.

Does Pennsaid work immediately? ›

After application, the pain is gone or immensely diminished within 10 minutes.

Will Pennsaid help nerve pain? ›

The U.S. Food and Drug Administration (FDA) has approved Pennsaid to treat osteoarthritis (bone pain), but the FDA has not approved Pennsaid to treat neuropathic (nerve) pain.

How long can you use Pennsaid? ›

The topical solution (a lotion applied to the skin) is used to relieve symptoms such as pain associated with osteoarthritis of the knee. This medication should not be used for more than 3 months.

Can you take Tylenol with Pennsaid? ›

Interactions between your drugs

No interactions were found between Pennsaid and Tylenol.

Does Pennsaid make you sleepy? ›

headache, dizziness, drowsiness; stuffy nose; itching, increased sweating; increased blood pressure; or.

Is there a generic for Pennsaid 2%? ›

A generic version of Pennsaid 2% Pump (Diclofenac Sodium Topical Solution) has been approved by the FDA. Diclofenac Sodium Topical Solution is indicated for the treatment of arthritis of the knee. It reduces pain, swelling, and joint stiffness. Diclofenac is known as a nonsteroidal anti-inflammatory drug (NSAID).

Can I use Pennsaid on my hip? ›

Pennsaid is for use only on the knees and should not be used on other parts of the body.

What is equivalent to Pennsaid? ›

The generic equivalent of Pennsaid 1.5% (diclofenac sodium topical solution) has just been released, following FDA approval. Pennsaid is a non-steroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.

How effective is Pennsaid? ›

In a 12 week equivalence trial that used the WOMAC subscales to compare treatment response, Pennsaid was as effective as oral diclofenac, but was much better tolerated. Conclusion: Pennsaid is an effective topical NSAID in patients with OA of the knee.

When do you apply Pennsaid? ›

PENNSAID 2% is easy to use—apply twice a day to the front, back, and sides of the knee
  1. PENNSAID 2% has a convenient metered-dose pump that gives you the recommended dose of 40 mg (2 pumps) each time you use it.
  2. There's no messy measuring and a reduced dosing schedule.

What are the side effects of diclofenac? ›

Common side effects
  • feeling sick (nausea)
  • being sick (vomiting) or diarrhoea.
  • feeling dizzy or vertigo.
  • headaches.
  • stomach ache, wind or loss of appetite.
  • mild rash.

Does Pennsaid reduce swelling? ›

This medication is used to treat arthritis of the knee(s). It reduces pain and swelling, and helps improve your ability to move and flex the joint. Diclofenac is known as a nonsteroidal anti-inflammatory drug (NSAID).

Is Pennsaid good for bursitis? ›

Diclofenac topical (Voltaren Gel, Flector Transdermal Patch, Pennsaid topical solution) Since prepatellar bursitis is quite superficial, topical NSAIDs such as diclofenac topical gel (Voltaren Gel) can be very effective, with minimal systemic side effects.

Is Pennsaid and diclofenac the same? ›

What is Pennsaid? Pennsaid (diclofenac sodium topical solution) is a non-steroidal anti-inflammatory drug (NSAID) used to treat signs and symptoms of osteoarthritis of the knee(s).

Is diclofenac a muscle relaxer? ›

Diclofenac is used to relieve pain and swelling (inflammation) from various mild to moderate painful conditions. It is used to treat muscle aches, backaches, dental pain, menstrual cramps, and sports injuries. It also reduces pain, swelling, and joint stiffness caused by arthritis.

Who should not use diclofenac sodium topical gel? ›

tell your doctor if you are pregnant, plan to become pregnant; or are breast-feeding. Diclofenac may harm the fetus and cause problems with delivery if it is used around 20 weeks or later during pregnancy. Do not use diclofenac topical around or after 20 weeks of pregnancy, unless you are told to do so by your doctor.

Can diclofenac cause nerve damage? ›

Diclofenac induced severe nerve damage not only after direct injection in the sciatic nerve but also after injection in the area around the nerve. Thus, we recommend restricting the use of intramuscular gluteal injections of diclofenac. Intramuscular use of morphine and pethidine should also be overviewed.

What are side effects of Pennsaid? ›

Common side effects of Pennsaid include:
  • skin irritation (e.g., dryness, redness, stinging, itching, scaling, hives, swelling),
  • drowsiness,
  • dizziness,
  • nausea,
  • stomach pain,
  • upset stomach,
  • indigestion,
  • diarrhea,

Can Pennsaid be used on other joints? ›

It works by reducing substances in the body that cause pain and inflammation. Pennsaid (diclofenac topical 2% solution) is used to treat pain in the knees caused by osteoarthritis. Pennsaid is for use only on the knees and should not be used on other parts of the body.

Can I take Tylenol with Pennsaid? ›

Interactions between your drugs

No interactions were found between Pennsaid and Tylenol.

How long does it take for diclofenac gel to work? ›

If you're using diclofenac gel, plasters or patches on your skin, it usually takes 1 to 2 days to work. For arthritis, you may need to use the gel for up to 7 days on the painful joint to feel the full effect. Depending on why you're taking diclofenac, you may only need to take it for a short time.

Who should not use diclofenac sodium topical gel? ›

tell your doctor if you are pregnant, plan to become pregnant; or are breast-feeding. Diclofenac may harm the fetus and cause problems with delivery if it is used around 20 weeks or later during pregnancy. Do not use diclofenac topical around or after 20 weeks of pregnancy, unless you are told to do so by your doctor.

How effective is Pennsaid? ›

In a 12 week equivalence trial that used the WOMAC subscales to compare treatment response, Pennsaid was as effective as oral diclofenac, but was much better tolerated. Conclusion: Pennsaid is an effective topical NSAID in patients with OA of the knee.

When do you apply Pennsaid? ›

PENNSAID 2% is easy to use—apply twice a day to the front, back, and sides of the knee
  1. PENNSAID 2% has a convenient metered-dose pump that gives you the recommended dose of 40 mg (2 pumps) each time you use it.
  2. There's no messy measuring and a reduced dosing schedule.

Why do doctors not prescribe diclofenac? ›

The Feb. 12, 2013 study in PLoS Medicine (2013;10:e1001388) indicates that diclofenac use can increase the risk of heart attack or stroke in patients with pre-existing conditions such as diabetes, high cholesterol or other high risk factors for cardiovascular problems.

What fruits are good for arthritis? ›

Berries pack a double dose of anti-inflammatory properties. All fruits are high in antioxidants, which can help fight inflammation. Additionally, foods like blueberries, raspberries, strawberries and blackberries contain anthocyanins, which reduce inflammation.

Is diclofenac a strong painkiller? ›

Diclofenac is considered more potent than ibuprofen and needs to be taken two or three times per day. Ibuprofen often needs to be taken in higher doses to treat pain from arthritis.

Is it OK to take Tylenol every day for arthritis? ›

Can I take Tylenol Arthritis every day? Yes, but you should be cautious. Acetaminophen, the main ingredient in Tylenol Arthritis, can cause liver damage if taken in large doses.

What pain reliever can I take with diclofenac? ›

Can I take other painkillers with diclofenac? It's fine to take paracetamol with diclofenac. You can also take opioid-type painkillers such as codeine, co-codamol, tramadol or morphine alongside diclofenac.

Is there a generic form of Pennsaid? ›

A generic version of Pennsaid 2% Pump (Diclofenac Sodium Topical Solution) has been approved by the FDA. Diclofenac Sodium Topical Solution is indicated for the treatment of arthritis of the knee. It reduces pain, swelling, and joint stiffness. Diclofenac is known as a nonsteroidal anti-inflammatory drug (NSAID).

What is difference between arthritis and osteoarthritis? ›

The main difference between osteoarthritis and rheumatoid arthritis is the cause behind the joint symptoms. Osteoarthritis is caused by mechanical wear and tear on joints. Rheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the body's joints. It may begin any time in life.

Does diclofenac raise blood pressure? ›

We conclude that diclofenac and celecoxib increase systolic blood pressure at peak levels; however, these agents differ in their 24-hour effects.

Can diclofenac hurt your kidneys? ›

Diclofenac and other non-steroidal anti-inflammatory drugs (NSAID's) cause the kidney to lose the capacity to make these protective hormones and over time, can result in progressive kidney damage. This damage may take years in some people but in others can occur after a single dose.

PDR Drug Summaries are concise point-of-care prescribing, dosing and administering information to help phsyicans more efficiently and accurately prescribe in their practice PDR's drug summaries are available free of charge and serve as a great resource for US based MDs, DOs, NPs and PAs in patient practice

The manufacturer of clopidogrel advises that caution be used when used in combination with NSAIDs as an increase in occult GI blood loss occurred when clopidogrel was used concomitantly with naproxen Angiotensin II receptor antagonists: (Moderate) Monitor blood pressure and renal function periodically during concomitant angiotensin II blocker and nonsteroidal anti-inflammatory drug (NSAID) use.. The manufacturer of clopidogrel advises that caution be used when used in combination with NSAIDs as an increase in occult GI blood loss occurred when clopidogrel was used concomitantly with naproxen Citalopram: (Moderate) The combined use of selective serotonin reuptake inhibitors (SSRIs) and nonsteroidal antiinflammatory drugs (NSAIDs) may increase the risk of bleeding, including an upper GI bleed.. The manufacturer of clopidogrel advises that caution be used when used in combination with NSAIDs as an increase in occult GI blood loss occurred when clopidogrel was used concomitantly with naproxen Docetaxel: (Major) Due to the thrombocytopenic effects of docetaxel, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants, NSAIDs, platelet inhibitors (including aspirin), strontium-89 chloride, and thrombolytic agents.. The manufacturer of clopidogrel advises that caution be used when used in combination with NSAIDs as an increase in occult GI blood loss occurred when clopidogrel was used concomitantly with naproxen Prazosin: (Moderate) If nonsteroidal anti-inflammatory drugs (NSAIDs) and an antihypertensive drug are concurrently used, carefully monitor the patient for signs and symptoms of renal insufficiency and blood pressure control.. Warfarin: (Moderate) Monitor patients for signs or symptoms of bleeding during concurrent use of warfarin and nonsteroidal antiinflammatory drugs (NSAIDs).To minimize the potential for GI bleeding, use the lowest effective NSAID dose for the shortest possible duration.

Clinical trials of several COX-2 selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular (CV) thrombotic events, including myocardial infarction (MI), and stroke, which can be fatal. Based on available data, it is unclear that the risk for CV thrombotic events is similar for all NSAIDs. The relative increase in serious CV thrombotic events over baseline conferred by NSAID use appears to be similar in those with and without known CV disease or risk factors for CV disease. However, patients with known CV disease or risk factors had a higher absolute incidence of excess serious CV thrombotic events, due to their increased baseline rate. Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment. The increase in CV thrombotic risk has been observed most consistently at higher doses.

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction, and stroke, which can be fatal This risk may occur early in treatment and may increase with duration of use ( 5.1 ) PENNSAID is contraindicated in the setting of coronary artery bypass graft (CABG) surgery ( 4 , 5.1 ) NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal.. Monitor blood pressure ( 5.4 , 7 ) Heart Failure and Edema : Avoid use of PENNSAID in patients with severe heart failure unless benefits are expected to outweigh risk of worsening heart failure ( 5.5 ) Renal Toxicity : Monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia.. Avoid use of PENNSAID in patients with advanced renal disease unless benefits are expected to outweigh risk of worsening renal function ( 5.6 ) Anaphylactic Reactions : Seek emergency help if an anaphylactic reaction occurs ( 5.7 ) Exacerbation of Asthma Related to Aspirin Sensitivity : PENNSAID is contraindicated in patients with aspirin-sensitive asthma.. Table 1 lists all adverse reactions occurring in >1% of patients receiving PENNSAID, where the rate in the PENNSAID group exceeded vehicle, from a controlled study conducted in patients with osteoarthritis.. The data described below reflect exposure to PENNSAID 1.5% of 911 patients treated between 4 and 12 weeks (mean duration of 49 days) in seven Phase 3 controlled trials, as well as exposure of 793 patients treated in an open-label study, including 463 patients treated for at least 6 months, and 144 patients treated for at least 12 months.. Table 2 lists all adverse reactions occurring in ≥1% of patients receiving PENNSAID 1.5%, where the rate in the PENNSAID 1.5% group exceeded placebo, from seven controlled studies conducted in patients with osteoarthritis.. 14 CLINICAL STUDIES The use of PENNSAID for the treatment of pain of osteoarthritis of the knee was evaluated in a single double-blind controlled trial conducted in the US, involving patients treated with PENNSAID at a dose of 2 pumps twice a day for 4 weeks.. RxCUIRxNorm NAMERxTTY1 1487074 diclofenac sodium 2 % Topical SolutionPSN2 1487074 diclofenac sodium 20 MG/ML Topical SolutionSCD3 1487074 diclofenac sodium 2 % Topical SolutionSY4 1487076 PENNSAID 2 % Topical SolutionPSN5 1487076 diclofenac sodium 20 MG/ML Topical Solution [Pennsaid]SBD6 1487076 Pennsaid 20 MG/ML Topical SolutionSY7 1487076 Pennsaid 2 % Topical SolutionSY

A comprehensive guide to side effects including common and rare side effects when taking PENNSAID (Diclofenac Sodium Topical Solution) includes uses, warnings, and drug interactions.

Cardiovascular Thrombotic Events [see WARNINGS AND PRECAUTIONS ] GI Bleeding, Ulceration and Perforation [see WARNINGS AND PRECAUTIONS ] Hepatotoxicity [see WARNINGS AND PRECAUTIONS ] Hypertension [see WARNINGS AND PRECAUTIONS ] Heart Failure and Edema [see WARNINGS AND PRECAUTIONS ] Renal Toxicity and Hyperkalemia [see WARNINGS AND PRECAUTIONS ] Anaphylactic Reactions [see WARNINGS AND PRECAUTIONS ] Serious Skin Reactions [see WARNINGS AND PRECAUTIONS ] Hematologic Toxicity [see WARNINGS AND PRECAUTIONS ]. Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.. Other Common Adverse Reactions Table 1 lists all adverse reactions occurring in >1% of patients receiving PENNSAID, where the rate in the PENNSAID group exceeded vehicle, from a controlled study conducted in patients with osteoarthritis.. The data described below reflect exposure to PENNSAID 1.5% of 911 patients treated between 4 and 12 weeks (mean duration of 49 days) in seven Phase 3 controlled trials, as well as exposure of 793 patients treated in an open-label study, including 463 patients treated for at least 6 months, and 144 patients treated for at least 12 months.. Other Common Adverse Reactions In controlled trials, subjects treated with PENNSAID 1.5% experienced some adverse events associated with the NSAID class more frequently than subjects using placebo (constipation, diarrhea, dyspepsia, nausea, flatulence, abdominal pain, edema; see Table 2).. Table 2 lists all adverse reactions occurring in ≥1% of patients receiving PENNSAID 1.5%, where the rate in the PENNSAID 1.5% group exceeded placebo, from seven controlled studies conducted in patients with osteoarthritis.. Treatment Group:PENNSAID 1.5%. N=911Topical Placebo. N=332Adverse ReactionN (%)N (%)Dry Skin (Application Site)292 (32)17 (5)Contact Dermatitis (Application Site)83 (9)6 (2)Dyspepsia72 (8)13 (4)Abdominal Pain54 (6)10 (3)Flatulence35 (4)1 (<1)Pruritus (Application Site)34 (4)7 (2)Diarrhea33 (4)7 (2)Nausea33 (4)3 (1)Pharyngitis40 (4)13 (4)Constipation29 (3)1 (<1)Edema26 (3)0Rash (Non-Application Site)25 (3)5 (2)Infection25 (3)8 (2)Ecchymosis19 (2)1 (<1)Dry Skin (Non-Application Site)19 (2)1 (<1)Contact Dermatitis, vesicles (Application Site)18 (2)0Paresthesia (Non-Application Site)14 (2)3 (<1)Accidental Injury22 (2)7 (2)Pruritus (Non-Application Site)15 (2)2 (<1)Sinusitis10 (1)2 (<1)Halitosis11 (1)1 (<1)Application Site Reaction (not otherwise specified)11 (1)3 (<1) Postmarketing Experience In postmarketing surveillance, the following adverse reactions have been reported during post-approval use of PENNSAID 1.5%.. Intervention: Monitor patients with concomitant use of PENNSAID with anticoagulants (e.g., warfarin), antiplatelet agents (e.g., aspirin), selective serotonin reuptake inhibitors (SSRIs), and serotonin norepinephrine reuptake inhibitors (SNRIs) for signs of bleeding [see WARNINGS AND PRECAUTIONS ] Aspirin Clinical Impact: Controlled clinical studies showed that the concomitant use of NSAIDs and analgesic doses of aspirin does not produce any greater therapeutic effect than the use of NSAIDs alone.. In a clinical study, the concomitant use of an NSAID and aspirin was associated with a significantly increased incidence of GI adverse reactions as compared to use of the NSAID alone [see WARNINGS AND PRECAUTIONS ] Intervention: Concomitant use of PENNSAID and analgesic doses of aspirin is not generally recommended because of the increased risk of bleeding [see WARNINGS AND PRECAUTIONS ].. During concomitant use of PENNSAID and ACE-inhibitors or ARBs in patients who are elderly, volume-depleted, or have impaired renal function, monitor for signs of worsening renal function [see WARNINGS AND PRECAUTIONS ].. Intervention: During concomitant use of PENNSAID with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see WARNINGS AND PRECAUTIONS ].. Methotrexate Clinical Impact: Concomitant use of NSAIDs and methotrexate may increase the risk for methotrexate toxicity (e.g., neutropenia, thrombocytopenia, renal dysfunction) Intervention: During concomitant use of PENNSAID and methotrexate, monitor patients for methotrexate toxicity.. NSAIDs and Salicylates Clinical Impact: Concomitant use of diclofenac with other NSAIDs or salicylates (e.g., diflunisal, salsalate) increases the risk of GI toxicity, with little or no increase in efficacy [see WARNINGS AND PRECAUTIONS ] Concomitant use of oral NSAIDs with PENNSAID has been evaluated in one Phase 3 controlled trial and in combination with oral diclofenac, compared to oral diclofenac alone, resulted in a higher rate of rectal hemorrhage (3% vs. less than 1%), and more frequent abnormal creatinine (12% vs. 7%), urea (20% vs. 12%) and hemoglobin (13% vs. 9%).. Intervention: During concomitant use of PENNSAID and pemetrexed, in patients with renal impairment whose creatinine clearance ranges from 45 to 79 mL/min, monitor for myelosuppression, renal and GI toxicity.

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

Therefore, do not use combination therapy with diclofenac sodium topical solution and an oral NSAID unless the benefit outweighs the risk and conduct periodic laboratory evaluations.Concomitant use of oral NSAIDs with diclofenac sodium topical solution resulted in a higher rate of rectal hemorrhage, more frequent abnormal creatinine, urea and hemoglobin.. The following adverse reactions are discussed in greater detail in other sections of the labeling:. Cardiovascular Thrombotic Events [see Warnings and Precautions (5.1)]. GI Bleeding, Ulceration and Perforation [see Warnings and Precautions (5.2)]. Hepatotoxicity [see Warnings and Precautions (5.3)]. Hypertension [see Warnings and Precautions (5.4)]. Heart Failure and Edema [see Warnings and Precautions (5.5)]. Renal Toxicity and Hyperkalemia [see Warnings and Precautions (5.6)]. Anaphylactic Reactions [see Warnings and Precautions (5.7)]. Serious Skin Reactions [see Warnings and Precautions (5.9)]. Hematologic Toxicity [see Warnings and Precautions (5.11)]. 6.1 Clinical Trials Experience. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.. The data described below reflect exposure to diclofenac sodium topical solution of 911 patients treated between 4 and 12 weeks (mean duration of 49 days) in seven Phase 3 controlled trials, as well as exposure of 793 patients treated in an open-label study, including 463 patients treated for at least 6 months, and 144 patients treated for at least 12 months.. Table 1 lists all adverse reactions occurring in ≥1% of patients receiving diclofenac sodium topical solution, where the rate in the diclofenac sodium topical solution group exceeded placebo, from seven controlled studies conducted in patients with osteoarthritis.. Treatment Group: Diclofenac Sodium Topical Solution. N=911 Topical Placebo. N=332. Adverse Reaction† N (%) N (%). Dry Skin (Application Site) 292 (32) 17 (5). Contact Dermatitis (Application Site) 83 (9) 6 (2). Dyspepsia 72 (8) 13 (4). Abdominal Pain 54 (6) 10 (3). Flatulence 35 (4) 1 (<1). Pruritus (Application Site) 34 (4) 7 (2). Diarrhea 33 (4) 7 (2). Nausea 33 (4) 3 (1). Pharyngitis 40 (4) 13 (4). Constipation 29 (3) 1 (<1). Edema 26 (3) 0. Rash (Non-Application Site) 25 (3) 5 (2). Infection 25 (3) 8 (2). Ecchymosis 19 (2) 1 (<1). Dry Skin (Non-Application Site) 19 (2) 1 (<1). Contact Dermatitis, vesicles (Application Site) 18 (2) 0. Paresthesia (Non-Application Site) 14 (2) 3 (<1). Accidental Injury 22 (2) 7 (2). Pruritus (Non-Application Site) 15 (2) 2 (<1). Sinusitis 10 (1) 2 (<1). Halitosis 11 (1) 1 (<1). Application Site Reaction (not otherwise specified) 11 (1) 3 (<1). †Preferred Term according to COSTART. 6.2 Postmarketing Experience. In non-U.S. postmarketing surveillance, the following adverse reactions have been reported during post-approval use of diclofenac sodium topical solution.. Intervention Monitor patients with concomitant use of diclofenac sodium topical solution with anticoagulants (e.g., warfarin), antiplatelet agents (e.g., aspirin), selective serotonin reuptake inhibitors (SSRIs), and serotonin norepinephrine reuptake inhibitors (SNRIs) for signs of bleeding [see Warnings and Precautions (5.11)]. Aspirin. Clinical Impact: Controlled clinical studies showed that the concomitant use of NSAIDs and analgesic doses of aspirin does not produce any greater therapeutic effect than the use of NSAIDs alone.. In a clinical study, the concomitant use of an NSAID and aspirin was associated with a significantly increased incidence of GI adverse reactions as compared to use of NSAID alone [see Warnings and Precautions (5.2)]. Intervention Concomitant use of diclofenac sodium topical solution and analgesic doses of aspirin is not generally recommended because of the increased risk of bleeding [see Warnings and Precautions (5.11)].. Concomitant use of oral NSAIDs with diclofenac sodium topical solution has been evaluated in one Phase 3 controlled trial and in combination with oral diclofenac, compared to oral diclofenac alone, resulted in a higher rate of rectal hemorrhage (3% vs. less than 1%), and more frequent abnormal creatinine (12% vs. 7%), urea (20% vs. 12%) and hemoglobin (13% vs. 9%).. Table 3: Single-Dose (80 drops) and Multiple Dose (80 drops four times daily for 7 days) Diclofenac Sodium Topical Solution Pharmacokinetic Parameters. Pharmacokinetic Parameters Diclofenac sodium. Normal Adults [N=18]. (Age: 18-55 years) Normal Adults [N=19]. (Age: 18-55 years). Single Dose Multiple Dose. Four times daily for 7 days. AUC0-t 177.5 ± 72.6 ng.h/mL 695.4 ± 348.9 ng.h/mL. AUC0-inf 196.3 ± 68.5 ng.h/mL 745.2 ± 374.7 ng.h/mL. Plasma Cmax 8.1 ± 5.9 ng/mL 19.4 ± 9.3 ng/mL. Plasma Tmax (h) 11.0 ± 6.4 4.0 ± 6.5. Plasma t1/2 (h) 36.7 ± 20.8 79.0 ± 38.1. Kel (h-1) 0.024 ± 0.010 0.011 ± 0.004. CL/F (L/h) 244.7 ± 84.71 --. 1Apparent total body clearance. Absorption. Diclofenac systemic exposure from diclofenac sodium topical solution application (4 times daily for 1 week) was approximately 1/3 of the diclofenac systemic exposure from the Solaraze (diclofenac topical gel) application (twice daily for 4 weeks).. In a dermal carcinogenicity study conducted in albino mice, daily topical applications of diclofenac sodium for two years at concentrations up to 0.035% diclofenac sodium (a 43-fold lower diclofenac sodium concentration than present in diclofenac sodium topical solution) did not increase neoplasm incidence.. In a photococarcinogenicity study conducted in hairless mice, topical application of diclofenac sodium at doses up to 0.035% diclofenac sodium (a 43-fold lower diclofenac sodium concentration than present in diclofenac sodium topical solution) resulted in an earlier median time of onset of tumors.. 14.1 Studies in Osteoarthritis of the Knee. The use of diclofenac sodium topical solution for the treatment of the signs and symptoms of osteoarthritis of the knee was evaluated in two double-blind controlled trials conducted in the US and Canada, involving patients treated with diclofenac sodium topical solution at a dose of 40 drops four times a day for 12 weeks.. Table 4: Change in treatment outcomes after 12 weeks of treatment in one study of efficacy of diclofenac sodium topical solution. Efficacy Variable Study I. Mean baseline score and mean change in efficacy variables after 12 weeks of treatment. Mean Baseline score Diclofenac Sodium. Topical Solution. N=154 Topical placebo1. N=155 Topical vehicle2. N=161. WOMAC pain score(Likert 3.1, 0–20) 13 -6.0 -4.7 -4.7. WOMAC physicalfunction (Likert 3.1, 0–68) 42 -15.7 -12.3 -12.1. POHA (0–4) 2.3 -1.0 -0.4 -0.6. 1placebo formulation included 2.3% DMSO. 2 vehicle formulation included 45.5% DMSO. Table 5: Change in treatment outcomes after 12 weeks of treatment in one study of efficacy of diclofenac sodium topical solution. Efficacy Variable Study II. Mean baseline score and mean change in efficacy variables after 12 weeks of treatment. Mean Baseline score Diclofenac Sodium. Topical Solution. N=164 Topical vehicle1. N=162. WOMAC pain score (Likert 3.1, 0–20) 13 -5.9 -4.4. WOMAC physical function (Likert 3.1, 0–68) 42 -15.3 -10.3. PGA (0–4) 3.1 -1.3 -1.0. 1vehicle formulation included 45.5% DMSO. Avoid Concomitant Use of NSAIDs. Inform patients that the concomitant use of diclofenac sodium topical solution with other NSAIDs or salicylates (e.g., diflunisal, salsalate) is not recommended due to the increased risk of gastrointestinal toxicity, and little or no increase in efficacy [see Warnings and Precautions (5.2) and Drug Interactions (7)].. DICLOFENAC SODIUM diclofenac sodium solutionProduct InformationProduct TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:61919-343(NDC:60505-0399)Route of AdministrationTOPICALActive Ingredient/Active MoietyIngredient NameBasis of StrengthStrength DICLOFENAC SODIUM (UNII: QTG126297Q) (DICLOFENAC - UNII:144O8QL0L1) DICLOFENAC SODIUM16.05 mg in 1 mLInactive IngredientsIngredient NameStrength PROPYLENE GLYCOL (UNII: 6DC9Q167V3) WATER (UNII: 059QF0KO0R) GLYCERIN (UNII: PDC6A3C0OX) ALCOHOL (UNII: 3K9958V90M) DIMETHYL SULFOXIDE (UNII: YOW8V9698H) Packaging#Item CodePackage DescriptionMarketing Start DateMarketing End Date1NDC:61919-343-05150 mL in 1 CARTON; Type 0: Not a Combination Product10/31/2017Marketing InformationMarketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End DateANDAANDA20202710/31/2017Labeler - DIRECT RX. (079254320). Registrant - DIRECT RX (079254320)EstablishmentNameAddressID/FEIBusiness OperationsDIRECT RX079254320repack(61919-343)

Diclofenac Potassium 50 mg Tablets - Summary of Product Characteristics (SmPC) by Accord-UK Ltd

Since cardiovascular risks with diclofenac may increase with dose and duration of exposure, the lowest effective daily dose should be used and for the shortest duration possible (see section 4.4 Special warnings and precautions for use).. Caution is advised when administering Diclofenac Potassium Tablets to patients with mild to moderate renal impairment (see section 4.4 Special warnings and precautions for use).. Caution is advised when administering Diclofenac Potassium Tablets to patients with mild to moderate hepatic impairment (see section 4.4 Special warnings and precautions for use).. As with all NSAIDs, including diclofenac , close medical surveillance is imperative and particular caution should be exercised when prescribing diclofenac in patients with symptoms indicative of gastrointestinal disorders, or with a history suggestive of gastric or intestinal ulceration, bleeding or perforation(see section 4.8 Undesirable effects).The risk of GI bleeding, ulceration or perforation is higher with increasing NSAID doses including diclofenac, and in patients with a history of ulcer, particularly if complicated with haemorrhage or perforation.. As fluid retention and oedema have been reported in association with NSAIDs therapy, including diclofenac, particular caution is called for in patients with impaired cardiac or renal function, history of hypertension, the elderly, patients receiving concomitant treatment with diuretics or medicinal products that can significantly impact renal function, and those patients with substantial extracellular volume depletion from any cause, e.g. before or after major surgery (see section 4.3 Contraindications).. Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported very rarely in association with the use of NSAIDs, including diclofenac (see section 4.8 Undesirable effects).. Although clinical investigations do not appear to indicate that diclofenac has an influence on the effect of anticoagulants, there are reports of an increased risk of haemorrhage in patients receiving diclofenac and anticoagulant concomitantly (see section 4.4 Special warnings and precautions for use).. Other NSAIDs including cyclooxygenase-2 selective inhibitors and corticosteroids: Co-administration of diclofenac with other systemic NSAIDs or corticosteroids may increase the risk of gastrointestinal bleeding or ulceration.. Potent CYP2C9 inhibitors: Caution is recommended when co-prescribing diclofenac with potent CYP2C9 inhibitors (such as voriconazole), which could result in a significant increase in peak plasma concentrations and exposure to diclofenac due to inhibition of diclofenac metabolism.

Pennsaid cutaneous solution contains the active ingredient diclofenac sodium, which is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are used to relieve pain and inflammation.

Pennsaid cutaneous solution contains the active ingredient diclofenac sodium, which is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID).. When diclofenac is applied to the skin (topical application) it is absorbed through the skin into the underlying tissues, where it reduces pain and inflammation in the local area.. Do not apply to areas of skin that have been affected by skin diseases such as psoriasis, unless advised by your doctor.. When diclofenac is applied to the skin it is absorbed into the bloodstream to a far lesser degree than diclofenac taken by mouth.. Consult your doctor immediately if you experience side effects such as stomach pain, indigestion, heartburn or signs of bleeding in the stomach or intestines, eg blood in the stools, while using this medicine.. As it decreases pain and inflammation this medicine may mask the signs and symptoms of skin infections in the area that you apply it to.. For this reason you should tell your doctor if you get a skin infection in the area that you are using this medicine.. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.. If applied to large areas of skin for long periods of time there is a possibility that side effects associated with oral diclofenac may be experienced.. The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.. You should not apply any other medicines to the affected joint at the same time as Pennsaid solution.. When it is used on unbroken skin this medicine is unlikely to be absorbed in sufficient amounts to affect other medicines that are being taken by mouth.. However, you should tell your doctor or pharmacist what medicines you are already using, including those bought without a prescription and herbal medicines, before using this medicine.

Diclofenac (Solaraze, Voltaren) topical gel is a prescription medication used to treat osteoarthritis pain and actinic keratoses. Learn about side effects, warnings, dosage, and more.

Diclofenac topical gel is available as a brand-name drug and a generic drug.. Diclofenac is a prescription drug.. Diclofenac topical gel is available as the brand-name drugs Solaraze and Voltaren .. For more information on the possible side effects of Diclofenac, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.. the type and severity of the condition you’re using Diclofenac to treat your age the form of Diclofenac you take other medical conditions you may have. Ask your doctor if diclofenac is the right drug for you.. This list does not contain all drugs that may interact with Diclofenac.. Before taking Diclofenac, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take.. Diclofenac may decrease the blood pressure-lowering effects of some drugs used to control blood pressure.. Using the cancer drug pemetrexed with diclofenac may increase the effects of pemetrexed.. Taking diclofenac with other drugs that affect the flow of blood through your body can increase your risk of bleeding.. Taking cyclosporine , a drug that weakens your immune system, with diclofenac may increase your risk for kidney problems.. Taking digoxin with diclofenac can lead to increased levels of digoxin in your body and increased side effects.. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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