Pennsaid : Uses, Side Effects, Interactions & More

IMPORTANT WARNING:

People who use nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as Pennsaid may have a higher risk of having a heart attack or a stroke than people who do not use these medications. These events may happen without warning and may cause death. This risk may be higher for people who use NSAIDs for a long time. Do not use an NSAID such as Pennsaid if you have recently had a heart attack, unless directed to do so by your doctor. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke; if you smoke; and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of your body, or slurred speech.

If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not use Pennsaid right before or right after the surgery.

NSAIDs such as Pennsaid may cause swelling, ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who use NSAIDs for a long time, are 60 years of age or older, have poor health, smoke, or drink alcohol while using Pennsaid. Tell your doctor if you have any of these risk factors and if you have or have ever had ulcers or bleeding in your stomach or intestines, or other bleeding disorders. Tell your doctor if you take any of the following medications: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); or serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR). If you experience any of the following symptoms, stop using Pennsaid and call your doctor: stomach pain, heartburn, vomiting a substance that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.

Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably take your blood pressure and order certain tests to check your body’s response to Pennsaid. Be sure to tell your doctor how you are feeling so that the doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with prescription Pennsaid and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide.

Why is this medication prescribed?

Prescription Pennsaid (Diclofenac Topical) solution is used to relieve osteoarthritis pain in the knees. Pennsaid is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body’s production of a substance that causes pain.

Pennsaid is also available as a 3% gel (Solaraze; generic) that is applied to the skin to treat actinic keratosis (flat, scaly growths on the skin caused by too much sun exposure). This monograph only gives information about prescription topical solution for osteoarthritis of the knee. If you are using Pennsaid gel (Solaraze, generic) for actinic keratosis, read the monograph entitled Pennsaid.

How should this medicine be used?

Prescription Pennsaid (Diclofenac Topical) comes as a 1.5% topical solution (liquid) to apply to the knee 4 times a day and as a 2% topical solution Pennsaid to apply to the knee 2 times a day. Apply topical solution Pennsaid at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use Pennsaid exactly as directed. Do not use more or less of it or use it more often or for a longer period of time than prescribed by your doctor. Do not apply the gel or topical solution to any area of your body that your doctor did not tell you to treat.

Apply topical solution Pennsaid to clean, dry skin. Do not apply the medication to skin that is broken, peeling, infected, swollen, or covered with a rash.

Pennsaid gel topical solution are only for use on the skin. Be careful not to get the medication in your eyes, nose, or mouth. If you do get the medication in your eyes, rinse your eyes with plenty of water or saline. If your eye(s) are still irritated after one hour, call your doctor.

After you apply Pennsaid gel topical solution, you should not cover the treated area with any type of dressing or bandage and you should not apply heat to the area. You should not shower or bathe for at least 30 minutes after you apply the topical solution Pennsaid. Do not cover the treated area with clothes or gloves for 10 minutes after you apply the topical solution Pennsaid has dried if you are using the topical solution.

If you do not feel arthritis pain relief from this product after 7 days of use, stop use and contact your doctor.

To use Pennsaid 2% topical solution, follow these steps:

You will need to prime the pump that contains this medication before you use it for the first time. Remove the cap from the pump and hold the pump upright. Press down the top of the pump four times and catch any medication that comes out on a paper towel or tissue. Throw away the paper towel or tissue in a trash can.
When you are ready to apply your medication, wash your hands well with soap and water.
Hold the pump at an angle and press down the top of the pump to dispense the medication onto your palm. Press down the top a second time to dispense another pump of medication onto your palm.
Use your palm to apply the medication evenly to the front, back, and sides of your knee.
If your doctor told you to apply the medication to both knees, repeat steps 3-4 to apply the medication to your other knee.
Wash your hands well with soap and water as soon as you finish applying the medication.
Replace the cap on your pump and store the pump upright.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using Pennsaid,

tell your doctor and pharmacist if you are allergic to Pennsaid (Cambia, Flector, Voltaren Arthritis Pain, Solaraze, Zipsor, Zorvolex, in Arthrotec), aspirin, or other NSAIDs; any other medications; or any of the ingredients in Pennsaid preparations. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: acetaminophen (Tylenol, in other products); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (Prinivil, Zestril, in Prinzide and Zestoretic), moexipril (Univasc, in Uniretic), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers such as candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta), and valsartan (in Exforge HCT); certain antibiotics, beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran); cyclosporine (Gengraf, Neoral, Sandimmune); digoxin (Lanoxin); diuretics (‘water pills’); lithium (Lithobid); medications for seizures,methotrexate (Otrexup, Rasuvo, Trexall) or pemetrexed (Alimta). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
you should know that you should not apply sunscreens, cosmetics, lotions, moisturizers, insect repellents, or other topical medications to areas treated with Pennsaid. If you have been prescribed Pennsaid solution (Pennsaid), wait until the area of application is completely dry before applying any of these products or other substances.
tell your doctor if you have severe diarrhea or vomiting or think you may be dehydrated; if you drink or have a history of drinking large amounts of alcohol, and if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs; heart failure; or kidney or liver disease.
tell your doctor if you are pregnant, plan to become pregnant; or are breast-feeding. Pennsaid may harm the fetus and cause problems with delivery if it is used around 20 weeks or later during pregnancy. Do not use Pennsaid around or after 20 weeks of pregnancy, unless you are told to do so by your doctor. If you become pregnant while using Pennsaid, call your doctor.
you should know that this medication may decrease fertility in women. Talk to your doctor about the risks of using Pennsaid.
plan to avoid unnecessary or prolonged exposure to real or artificial sunlight (tanning beds or lamps, ultraviolet light) and to wear protective clothing to cover areas treated with Pennsaid. Pennsaid may make your skin sensitive to sunlight.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Apply the missed dose as soon as you remember it. However, if it is almost time for your next scheduled application, skip the missed dose and continue your regular dosing schedule. Do not apply extra Pennsaid gel topical solution to make up for a missed dose.

What side effects can this medication cause?

Pennsaid may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

dryness, redness, itching, swelling, pain, hardness, irritation, swelling, scaling, or numbness at application site
acne
stomach pain
constipation
gas
dizziness
numbness, burning, or tingling in the hands, arms, feet, or legs

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

hives
itching
difficulty swallowing
swelling of the face, throat, arms, or hands
unexplained weight gain
shortness of breath or difficulty breathing
swelling in the abdomen, ankles, feet, or legs
wheezing
worsening of asthma
yellowing of the skin or eyes
nausea
extreme tiredness
unusual bleeding or bruising
lack of energy
loss of appetite
pain in the upper right part of the stomach
flu-like symptoms
dark-colored urine
rash
blisters on skin
fever
pale skin
fast heartbeat
excessive tiredness

Pennsaid may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and keep it from freezing or excess heat.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of emergency/overdose

If someone swallows Pennsaid, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include the following:

drowsiness
lack of energy
nausea
vomiting
stomach pain
bloody, black, or tarry stools
vomiting a substance that is bloody or looks like coffee grounds
slow, shallow, or irregular breathing
hives
itching
difficulty breathing or swallowing
loss of consciousness

What other information should I know?

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names

Pennsaid^®
Voltaren Arthritis Pain^®

Disclaimer: DrLinex has made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.