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

What is Pennsaid?

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

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

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

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Diclofenac may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Pennsaid, especially in older adults.

Before taking this medicine

Diclofenac can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while using Pennsaid.

Do not use Pennsaid just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

You should not use Pennsaid if you are allergic to diclofenac (Voltaren, Cataflam, Flector, and others), or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

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

  • heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;

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

  • a history of stomach ulcers or bleeding;

  • asthma;

  • liver or kidney disease;

  • fluid retention.

Using Pennsaid during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether diclofenac topical passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using Pennsaid.

Pennsaid is not approved for use by anyone younger than 18 years old.

How should I use Pennsaid?

Use Pennsaid exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use Pennsaid in larger amounts or for longer than recommended. Use the lowest dose that is effective in treating your condition.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Wash your hands after applying Pennsaid, unless you are treating the skin on your hands. Wait at least 10 minutes before dressing or wearing gloves. Wait at least 1 hour before you bathe or shower.

Do not apply Pennsaid to an open skin wound, or on areas of infection, rash, or burn. Do not cover treated skin with a bandage or expose it to heat from a hot tub, heating pad, or sauna. Heat or bandaging can increase the amount of diclofenac you absorb through your skin.

To treat osteoarthritis knee pain with Pennsaid: Apply the solution only to clean, dry skin. Spread the solution over the front, back, and sides of the knee. Wait until the 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. Store Pennsaid in an upright position.

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?

Do not use cosmetics, sunscreen, lotions, insect repellant, or other medicated skin products on the same area you treat with Pennsaid.

Avoid exposing treated skin to heat, sunlight, or tanning beds.

Avoid getting Pennsaid near your eyes, nose, or mouth. If this does happen, rinse with water. Call your doctor if you have eye irritation that lasts longer than 1 hour.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin or other NSAIDs while you are using Pennsaid.

Ask a doctor or pharmacist before using any cold, allergy, or pain medication. Many medicines available over the counter contain aspirin or other medicines similar to Pennsaid. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen.

Pennsaid side effects

Although the risk of serious side effects is low when diclofenac is applied to the skin, this medicine can be absorbed through the skin, which may cause steroid side effects throughout the body.

Get emergency medical help if you have signs of an allergic reaction to Pennsaid: sneezing, runny or stuffy nose; wheezing or trouble breathing; hives; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.

Stop using Pennsaid and call your doctor at once if you have:

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

  • shortness of breath (even with mild exertion);

  • swelling or rapid weight gain;

  • signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

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

  • kidney problems - little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;

  • high blood pressure - severe headache, pounding in your neck or ears, nosebleed, anxiety, confusion;

  • low red blood cells (anemia) - pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

  • severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Pennsaid side effects may include:

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

  • diarrhea, constipation;

  • headache, dizziness, drowsiness;

  • stuffy nose;

  • itching, increased sweating;

  • increased blood pressure; or

  • swelling or pain in your arms or legs.

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?

Ask your doctor before using Pennsaid if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • cyclosporine;

  • lithium;

  • methotrexate;

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

  • heart or blood pressure medication, including a diuretic or "water pill"; or

  • steroid medicine (prednisone and others).

This list is not complete. Other drugs may interact with diclofenac topical, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

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 by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. 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. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2015 Cerner Multum, Inc. Version: 9.04. Revision Date: 2015-09-02, 12:07:45 PM.