Pennsaid

Generic Name: diclofenac topical (dye KLOE fen ak TOP ik al)
Brand Names: Pennsaid, Solaraze, Voltaren Topical

What is Pennsaid?

Pennsaid topical solution contains diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.

Pennsaid is used to treat pain in the knees caused by osteoarthritis. This medication may not be effective in treating arthritis pain elsewhere in the body.

Pennsaid may also be used for other purposes not listed in this medication guide.

Important information about Pennsaid

Do not use Pennsaid if you have ever had asthma or a severe allergic reaction caused by aspirin, diclofenac (Cataflam, Voltaren), or another non-steroidal anti-inflammatory drug (NSAID). Do not use Pennsaid just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Before using Pennsaid, tell your doctor if you have heart disease, congestive heart failure, high blood pressure, a history of heart attack or stroke, a history of stomach ulcer or bleeding, liver or kidney disease, a blood clotting disorder, asthma, or nasal polyps.

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While the risk of absorbing diclofenac into your bloodstream is low, an NSAID may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.

Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

Pennsaid may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are using Pennsaid, especially in older adults.

Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Before using Pennsaid

While the risk of absorbing diclofenac topical into your bloodstream is low, an NSAID can cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.

This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are using Pennsaid, especially in older adults.

Do not use Pennsaid if you have ever had asthma or a severe allergic reaction caused by aspirin, diclofenac (Cataflam, Voltaren), or another NSAID. Do not use Pennsaid just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

To make sure you can safely use Pennsaid, tell your doctor if you have any of these other conditions;

• a history of drug allergies;

• a history of heart attack, stroke, or blood clot;

• heart disease, congestive heart failure, high blood pressure;

• a history of stomach ulcer or bleeding;

• liver or kidney disease;

• a bleeding or blood clotting disorder; or

• asthma, or polyps in your nose.

Pennsaid may be harmful to an unborn baby. If you are pregnant, ask your doctor if it is safe for you to use Pennsaid. Tell your doctor if you become pregnant during treatment. Diclofenac can pass into breast milk and may harm a nursing baby. You should not breast-feed while using Pennsaid.

How should I use Pennsaid?

Use Pennsaid exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. When treating osteoarthritis, keep using any oral medications your doctor has prescribed.

Do not use Pennsaid on an open skin wound, or on areas of eczema, infection, skin rash, or burn injury. Do not cover the treated skin with a bandage or expose it to heat from a hot tub, heating pad, sauna, or heated water bed. Heat or bandaging can increase the amount of drug you absorb through your skin and may cause harmful effects. Wash your hands after applying Pennsaid.

To treat osteoarthritis knee pain (with Pennsaid): Apply the solution only to clean, dry skin. Place 10 drops at a time into your hand and spread the solution over the front, back, and sides of the knee. Apply a total of 40 drops to each affected knee, 4 times per day. You may also drop the medicine directly onto the knee, spreading after every 10 drops.

Wait until the Pennsaid solution is completely dry before covering treated skin with clothing or applying any other skin products, including sunscreen.

Store Pennsaid at room temperature away from moisture and heat. Do not freeze.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Pennsaid?

Avoid drinking alcohol. It may increase your risk of stomach bleeding. Do not use cosmetics, sunscreen, lotions, insect repellant, or other medicated skin products on the same area you treat with Pennsaid. Avoid getting Pennsaid in your mouth, nose, or eyes. If this does happen, rinse with water. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds) while you are using Pennsaid.

Avoid taking aspirin, oral (pill form) diclofenac (Cataflam, Voltaren), or other NSAIDs without your doctor's advice. This includes ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others.

Ask a doctor or pharmacist before using any cold, allergy, or pain medicine. Aspirin and other medicines similar to diclofenac are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

Pennsaid side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Pennsaid: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Although the risk of serious side effects is low when diclofenac is applied to the skin, you should be aware of side effects that can occur if the medication is absorbed into your bloodstream.

Stop using this medicine and call your doctor at once if you have a serious side effect such as:

• chest pain, slurred speech, problems with vision or balance, and feeling weak or short of breath;

• bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

• pale or yellowed skin, dark colored urine, confusion;

• swelling or rapid weight gain, urinating less than usual or not at all;

• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• bruising, severe tingling, numbness, pain, muscle weakness;

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or

• the first sign of any skin rash, no matter how mild.

Less serious Pennsaid side effects may include:

• mild nausea, stomach pain, upset stomach;

• diarrhea, gas; or

• mild itching, dryness, redness, scaling, or other skin irritation where the medicine was applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Pennsaid side effects (in more detail)

What other drugs will affect Pennsaid?

Tell your doctor about all other medicines you use, especially:

• a blood thinner such as warfarin (Coumadin, Jantoven);

• cyclosporine (Gengraf, Neoral, Sandimmune);

• lithium (Eskalith, Lithobid);

• methotrexate (Rheumatrex, Trexall);

• a diuretic (water pill);

• steroids (prednisone and others); or

• heart or blood pressure medication such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others.

It is not likely that other drugs you take orally or inject will have an effect on topically applied diclofenac. But many drugs can interact with each other. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Pennsaid.