Generic Name: diclofenac (dye-KLOE-fen-ak)
Brand Name: Pennsaid
Pennsaid solution is a nonsteroidal anti-inflammatory drug (NSAID). It may cause an increased risk of serious and sometimes fatal heart and blood vessel problems (eg, a heart attack, stroke). The risk may be greater if you already have heart problems or if you use Pennsaid solution for a long time. Do not use Pennsaid solution right before or after bypass heart surgery.
Pennsaid solution may cause an increased risk of serious and sometimes fatal stomach ulcers and bleeding. Elderly patients may be at greater risk. This may occur without warning signs.
Pennsaid solution is used for:
Treating pain in the knee joints caused by osteoarthritis. It may also be used for other conditions as determined by your doctor.
Pennsaid solution is an NSAID. Exactly how it works is not known. It may work by blocking certain substances in the body that are linked to inflammation. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.
Do NOT use Pennsaid solution if:
- you are allergic to any ingredient in Pennsaid solution
- you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or another NSAID (eg, celecoxib, ibuprofen)
- you have recently had or will be having bypass heart surgery
- you have severe kidney problems
- you are in the last 3 months of pregnancy
- you are taking disulfiram or metronidazole
Contact your doctor or health care provider right away if any of these apply to you.
Before using Pennsaid solution:
Some medical conditions may interact with Pennsaid solution. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a history of kidney or liver problems, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers)
- if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation
- if you have high blood pressure, blood disorders (eg, porphyria), bone marrow problems, bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or if you are at risk of any of these diseases
- if you have poor health, dehydration or low fluid volume, low blood sodium levels, you drink alcohol, or you have a history of alcohol abuse
Some MEDICINES MAY INTERACT with Pennsaid solution. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Anticoagulants (eg, warfarin), aspirin, clopidogrel, corticosteroids (eg, prednisone), direct factor Xa inhibitors (eg, rivaroxaban), heparin, prasugrel, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because the risk of bleeding, including stomach bleeding, may be increased
- Disulfiram, furazolidone, or metronidazole because a severe reaction that includes flushing, headache, fast or irregular heartbeat, trouble breathing, nausea, vomiting, and dizziness may occur
- Azole antifungals (eg, itraconazole, voriconazole), bisphosphonates (eg, risedronate), or probenecid because they may increase the risk of Pennsaid solution's side effects
- Rifamycins (eg, rifampin) because they may decrease Pennsaid solution's effectiveness
- Cyclosporine, lithium, methotrexate, oral NSAIDs (eg, ibuprofen), quinolones (eg, ciprofloxacin), or tenofovir because the risk of their side effects may be increased by Pennsaid solution
- Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril) or diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by Pennsaid solution
- Medicines that may harm the liver (eg, acetaminophen, ketoconazole, isoniazid, certain medicines for HIV infection, certain antibiotics or seizure medicines) because the risk of liver side effects may be increased. Ask your doctor if you are unsure if any of your medicines might harm the liver
This may not be a complete list of all interactions that may occur. Ask your health care provider if Pennsaid solution may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Pennsaid solution:
Use Pennsaid solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Pennsaid solution comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Pennsaid solution refilled.
- Do not apply Pennsaid solution to infected skin; open wounds; or red, swollen, or peeling skin.
- Wash your hands immediately before and after using Pennsaid solution.
- Wash the affected area and dry completely before using Pennsaid solution.
- To apply Pennsaid solution, dispense 10 drops at a time onto the knee or into your hand. Spread Pennsaid solution evenly around the front, back, and sides of the knee. Repeat until you have used the whole dose.
- Be sure that you cover your entire knee with your dose of Pennsaid solution. Do not use more than the recommended amount.
- Do not apply sunscreens, cosmetics, insect repellants, other topical medicines, or any other substance to the treated area until it is completely dry.
- Do not put on clothes over the treated area until it is completely dry.
- Do not wrap, bandage, or apply heat to the treated area.
- Let the treated skin dry before touching it or letting it touch anyone else's skin.
- Do not shower, bathe, or wash the treated area for at least 30 minutes after you use Pennsaid solution.
- If you miss a dose of Pennsaid solution, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Pennsaid solution.
Important safety information:
- Pennsaid solution may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Pennsaid solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Pennsaid solution is for external use only. Do not get it in your eyes, nose, or mouth. If you get it in any of these areas, rinse right away with cool water.
- Serious stomach ulcers or bleeding can occur with the use of Pennsaid solution. Taking it in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Pennsaid solution with food will NOT reduce the risk of these effects. Contact your doctor or emergency room at once if you develop severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling.
- Do NOT use more than the recommended dose or use for longer than prescribed without checking with your doctor.
- Pennsaid solution is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist.
- Do not take aspirin while you are using Pennsaid solution unless your doctor tells you to.
- Do not expose the treated area to the sun, sunlamps, or tanning booths.
- Pennsaid solution may cause harm if it is swallowed. If you may have taken it by mouth, contact your poison control center or emergency room right away.
- Lab tests, including kidney and liver function, blood electrolyte levels, complete blood cell counts, and blood pressure, may be performed while you use Pennsaid solution. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use Pennsaid solution with caution in the ELDERLY; they may be more sensitive to its effects, especially stomach bleeding and kidney problems.
- Pennsaid solution should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: Pennsaid solution may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Pennsaid solution while you are pregnant. It is not known if this medicine is found in breast milk after topical use. Do not breast-feed while taking Pennsaid solution.
Possible side effects of Pennsaid solution:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Constipation; diarrhea; dry skin or mild irritation at the application site; gas; nausea; stomach upset.
Severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; burning, numbness, or tingling of the skin; change in the amount of urine produced; chest pain; confusion; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent irritation at the application site; severe or persistent stomach pain or nausea; severe vomiting or diarrhea; shortness of breath; sudden or unexplained weight gain; swelling of the hands, legs, or feet; symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, yellowing of the skin or eyes, stomach pain, diarrhea); unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include decreased urination; loss of consciousness; seizures; severe dizziness or drowsiness; severe nausea, vomiting, or stomach pain; slow or troubled breathing; tremor; unusual bleeding or bruising; vomit that looks like coffee grounds.Proper storage of Pennsaid solution:
Store Pennsaid solution at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Pennsaid solution out of the reach of children and away from pets.
- If you have any questions about Pennsaid solution, please talk with your doctor, pharmacist, or other health care provider.
- Pennsaid solution is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take Pennsaid solution or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Pennsaid solution. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Pennsaid solution. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Pennsaid solution.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.