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

What is Pennsaid?

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

Pennsaid (diclofenac topical 1.5% solution) 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 purposes not listed in this medication guide.

Important information

You should not use Pennsaid if you have ever had asthma or a severe allergic reaction caused by aspirin, diclofenac (Cataflam, Voltaren), or another nonsteroidal-steroidal anti-inflammatory drug (NSAID).

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NSAIDs may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use Pennsaid just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

NSAIDs may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Pennsaid.

Before taking this medicine

You should not use Pennsaid if you have ever had asthma or a severe allergic reaction caused by aspirin, diclofenac (Cataflam, Voltaren), or another NSAID.

While the risk of absorbing diclofenac into your bloodstream is low, an NSAID may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use Pennsaid just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

An NSAID may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Pennsaid, especially if:

  • you are in poor health;

  • you smoke or drink alcohol;

  • you are an older adult;

  • you use Pennsaid long-term; or

  • you take a blood thinner (warfarin, Coumadin) or steroid medicine (prednisone, dexamethasone, and others).

To make sure Pennsaid is safe for you, tell your doctor if you have:

  • 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.

FDA pregnancy category D. Do not use Pennsaid if you are pregnant, especially during the last 10 weeks of pregnancy. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment with Pennsaid .

See also: Pregnancy and breastfeeding warnings (in more detail)

Diclofenac topical 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. Follow all directions on your prescription label. Keep using any oral medications your doctor has prescribed.

Wash your hands after applying this medication, unless you are treating the skin on your hands.

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.

Before you use Pennsaid for the first time, you will need to prime the pump. To prime the pump, remove the cap and fully press the top of the pump all the way down 4 times while holding the bottle in an upright position. Dispense this portion of the medicine into a tissue or paper towel and throw it away in a trash can. The pump is now ready to use. You should not need to prime the pump again.

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.

Avoid showering/bathing for at least 30 minutes after the application.

Wait until the treated area is dry before covering treated skin with clothing or applying sunscreen, insect repellant, lotion, moisturizer, cosmetics, or other topical medication to the same knee you have just treated with Pennsaid.

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 this medication 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), celecoxib, diclofenac, indomethacin, meloxicam, 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, Pennsaid can be absorbed through the skin, which may cause steroid side effects throughout the body.

Stop using Pennsaid and get emergency medical help if you have heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; or signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.

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.

Also call your doctor at once if you have:

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

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • shortness of breath (even with mild exertion), swelling, rapid weight gain;

  • little or no urinating;

  • dangerously high blood pressure--severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, uneven heartbeats, seizure; or

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

Common Pennsaid side effects may include:

  • nausea, vomiting, stomach pain, heartburn, gas;

  • diarrhea, constipation; or

  • dizziness.

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: Side effects (in more detail)

What other drugs will affect Pennsaid?

It is not likely that other drugs you take orally or inject will have an effect on topically applied Pennsaid. But many drugs can interact with each other. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Where can I get more information?

  • Your pharmacist can provide more information about Pennsaid.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Pennsaid only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2014 Cerner Multum, Inc. Version: 9.02. Revision Date: 2014-02-12, 8:49:12 AM.

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