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Solaraze

Side Effects & Drug Interactions
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SIDE EFFECTS

Of the 423 patients evaluable for safety in adequate and well-controlled trials, 211 were treated with Solaraze® drug product and 212 were treated with a vehicle gel. Eighty-seven percent (87%) of the Solaraze®-treated patients (183 patients) and 84% of the vehicle-treated patients (178 patients) experienced one or more adverse events (AEs) during the studies. The majority of these reactions were mild to moderate in severity and resolved upon discontinuation of therapy.

Of the 211 patients treated with Solaraze®, 172 (82%) experienced AEs involving skin and the application site compared to 160 (75%) vehicle-treated patients. Application site reactions (ASRs) were the most frequent AEs in both Solaraze®- and vehicle-treated groups. Of note, four reactions, contact dermatitis, rash, dry skin and exfoliation (scaling) were significantly more prevalent in the Solaraze® group than in the vehicle-treated patients.

Eighteen percent of Solaraze®-treated patients and 4% of vehicle-treated patients discontinued from the clinical trials due to adverse events (whether considered related to treatment or not). These discontinuations were main-ly due to skin irritation or related cutaneous adverse reactions.

Table 1 below presents the AEs reported at an incidence of >1% for patients treated with either Solaraze® Gel or vehicle (60- and 90-day treatment groups) during the phase 3 studies.

Table 1. Adverse events reported (>1% in any treatment group) during Solaraze® phase 3 clinical trials Incidences for 60-day and 90-day treatments
  60-day Treatment 90-day Treatment
  Solaraze® (%)
N=48
Gel Vehicle(%)
N=49
Solaraze® (%)
N=114
Gel Vehicle (%)
N=114
BODY AS A WHOLE 21 20 20 18
Abdominal Pain 2 0 1 0
Accidental Injury 0 0 4 2
Allergic Reaction 0 0 1 3
Asthenia 0 0 2 0
Back Pain 4 0 2 2
Chest Pain 2 0 1 0
Chills 0 2 0 0
Flu Syndrome 10 6 1 4
Headache 0 6 7 6
Infection 4 6 4 5
Neck Pain 0 0 2 0
Pain 2 0 2 2
CARDIOVASCULAR SYSTEM 2 4 3 1
Hypertension 2 0 1 0
Migraine 0 2 1 0
Phlebitis 0 2 0 0
DIGESTIVE SYSTEM 4 0 6 8
Constipation 0 0 0 2
Diarrhea 2 0 2 3
Dyspepsia 2 0 3 4
METABOLIC AND NUTRITIONAL DISORDERS 2 8 7 2
Creatine Phosphokinase Increased 0 0 4 1
Creatinine Increased 2 2 0 1
Edema 0 2 0 0
Hypercholesteremia 0 2 1 0
Hyperglycemia 0 2 1 0
SGOT Increased 0 0 3 0
SGPT Increased 0 0 2 0
MUSCULOSKELETAL SYSTEM 4 0 3 4
Arthralgia 2 0 0 2
Arthrosis 2 0 0 0
Myalgia 2 0 3 1
NERVOUS SYSTEM 2 2 2 5
Anxiety 0 2 0 1
Dizziness 0 0 0 4
Hypokinesia 2 0 0 0
RESPIRATORY SYSTEM 8 8 7 6
Asthma 2 0 0 0
Dyspnea 2 0 2 0
Pharyngitis 2 8 2 4
Pneumonia 2 0 0 1
Rhinitis 2 2 2 2
Sinusitis 0 0 2 0
SKIN AND APPENDAGES 75 86 86 71
Acne 0 2 0 1
Application Site Reaction 75 71 84 70
  Acne 0 4 1 0
   Alopecia 2 0 1 1
  Contact Dermatitis 19 4 33 4
  Dry Skin 27 12 25 17
  Edema 4 0 3 0
  Exfoliation 6 4 24 13
  Hyperesthesia 0 0 3 1
  Pain 15 22 26 30
  Paresthesia 8 4 20 20
  Photosensitivity Reaction 0 2 3 0
  Pruritus 31 59 52 45
  Rash 35 20 46 17
  Vesiculobullous Rash 0 0 4 1
Contact Dermatitis 2 0 0 0
Dry Skin 0 4 3 0
Herpes Simplex 0 2 0 0
Maculopapular Rash 0 2 0 0
Pain 2 2 1 0
Pruritus 4 6 4 1
Rash 2 10 4 0
Skin Carcinoma 0 6 2 2
Skin Nodule 0 2 0 0
Skin Ulcer 2 0 1 0
SPECIAL SENSES 2 0 4 2
Conjunctivitis 2 0 4 1
Eye Pain 0 2 2 0
UROGENITAL SYSTEM 0 0 4 5
Hematuria 0 0 2 1
OTHER 0 0 0 3
Procedure 0 0 0 3

Skin and Appendages Adverse Events Reported for Solaraze® at less than 1% Incidence in the phase 3 studies: skin hypertrophy, paresthesia, seborrhea, urticaria, application site reactions (skin carcinoma, hyperto-nia, skin hypertrophy lacrimation disorder, maculopapular rash, purpuric rash, vasodilation).

Adverse Reactions Reported for Oral Diclofenac Dosage Form (not topical Solaraze® Gel): *Incidence greater than 1% marked with asterisk.

Body as a Whole: abdominal pain or cramps*, headache*, fluid retention*, abdominal distention*, malaise, swelling of lips and tongue, photosensitivity, anaphylaxis, anaphylactoid reactions, chest pain.

Cardiovascular: hypertension, congestive heart failure, palpitations, flushing, tachycardia, premature ventricular contractions, myocardial infarction, hypotension.

Digestive: diarrhea*, indigestion*, nausea*, constipation*, flatulence*, liver test abnormalities*, PUB*, i.e., peptic ulcer, with or without bleeding and/or perforation, or bleeding without ulcer, vomiting, jaundice, melena, esophageal lesions, aphthous stomatitis, dry mouth and mucous membranes, bloody diarrhea, hepatitis, hepatic necrosis, cirrhosis, hepatorenal syndrome, appetite change, pancreatitis with or without concomitant hepatitis, colitis, intestinal perforation.

Hemic and Lymphatic: hemoglobin decrease, leukopenia, thrombocytopenia, eosinophilia, hemolytic anemia, aplastic anemia, agranulocytosis, purpura, allergic purpura, bruising.

Metabolic and Nutritional Disorders: azotemia, hypoglycemia, weight loss.

Nervous System: dizziness*, insomnia, drowsiness, depression, diplopia, anxiety, irritability, aseptic meningitis, convulsions, paresthesia, memory disturbance, nightmares, tremor, tic, abnormal coordination, disorientation, psychotic reaction.

Respiratory: epistaxis, asthma, laryngeal edema, dyspnea, hyperventilation, edema of pharynx.

Skin and Appendages: rash*, pruritus*, alopecia, urticaria, eczema, dermatitis, bullous eruption, erythema mul-tiforme major, angioedema, Stevens-Johnson syndrome, excess perspiration, exfoliative dermatitis.

Special Senses: tinnitus*, blurred vision, taste disorder, reversible and irreversible hearing loss, scotoma, vitre-ous floaters, night blindness, amblyopia.

Urogenital: nephrotic syndrome, proteinuria, oliguria, interstitial nephritis, papillary necrosis, acute renal failure, urinary frequency, nocturia, hematuria, impotence, vaginal bleeding.

DRUG INTERACTIONS

Although the systemic absorption of Solaraze® is low, concomitant oral administration of other NSAIDs such as aspirin at anti-inflammatory/analgesic doses should be minimized.

Brand Name: Solaraze
Generic Name: Diclofenac Sodium
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