Medication Guide

Medication Guide For Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

(See the end of this Medication Guide for a list of prescription NSAID medicines.)

What is the most important information I should know about medicines called Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?

NSAID medicines may increase the chance of a heart attack or stroke that can lead to death.

This chance increases:

• with longer use of NSAID medicines
• in people who have heart disease

NSAID medicines should never be used right before or after a heart surgery called a "coronary artery bypass graft (CABG)."

NSAID medicines can cause ulcers and bleeding in the stomach and intestines at any time during treatment. Ulcers and bleeding:

• can happen without warning symptoms
• may cause death

The chance of a person getting an ulcer or bleeding increases with:

• taking medicines called "corticosteroids" and "anticoagulants"
• longer use
• smoking
• drinking alcohol
• older age
• having poor health

NSAID medicines should only be used:

• exactly as prescribed
• at the lowest dose possible for your treatment
• for the shortest time needed

What are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?

NSAID medicines are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as:

• different types of arthritis
• menstrual cramps and other types of short-term pain

Who should not take a Non-Steroidal Anti-Inflammatory Drug (NSAID)?

Do not take an NSAID medicine:

• if you had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAID medicine
• for pain right before or after heart bypass surgery

Tell your healthcare provider:

• about all of your medical conditions.
• about all of the medicines you take. NSAIDs and some other medicines can interact with each other and cause serious side effects. Keep a list of your medicines to show to your healthcare provider and pharmacist.
• if you are pregnant. NSAID medicines should not be used by pregnant women late in their pregnancy.
• if you are breastfeeding. Talk to your doctor.

What are the possible side effects of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?

Get emergency help right away if you have any of the following symptoms:

• shortness of breath or trouble breathing
• chest pain
• slurred speech
• weakness in one part or side of your body
• swelling of the face or throat

Stop your NSAID medicine and call your healthcare provider right away if you have any of the following symptoms:

• nausea
• more tired or weaker than usual
• itching
• your skin or eyes look yellow
• stomach pain
• flu-like symptoms
• vomit blood
• there is blood in your bowel movement or it is black and sticky like tar
• unusual weight gain
• skin rash or blisters with fever
• swelling of the arms and legs, hands and feet

These are not all the side effects with NSAID medicines. Talk to your healthcare provider or pharmacist for more information about NSAID medicines.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other information about Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):

• Aspirin is an NSAID medicine but it does not increase the chance of a heart attack. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.
• • Some of these NSAID medicines are sold in lower doses without a prescription (over-the-counter). Talk to your healthcare provider before using over-the-counter NSAIDs for more than 10 days.

NSAID medicines that need a prescription

This Medication Guide has been approved by the U.S. Food and Drug Administration.

Patient Instructions for Use

PENNSAID
[pen/sed]
(diclofenac sodium topical solution)

Your doctor has prescribed PENNSAID (diclofenac sodium topical solution) ® to treat your pain from osteoarthritis in your knee(s) and help you manage your daily activities better.

Before you use PENNSAID (diclofenac sodium topical solution) ®:

• • Apply PENNSAID (diclofenac sodium topical solution) ® exactly as your doctor tells you. Do not apply PENNSAID (diclofenac sodium topical solution) ® anywhere on your body other than where your doctor tells you.
• Apply PENNSAID (diclofenac sodium topical solution) ® on clean, dry skin that does not have any cuts, infections or rashes.
• Use PENNSAID (diclofenac sodium topical solution) ® 4 times each day on your knee(s).
• Do not get PENNSAID (diclofenac sodium topical solution) ® in your eyes, nose or mouth. Only use PENNSAID (diclofenac sodium topical solution) ® on your skin (topical use). If you get PENNSAID (diclofenac sodium topical solution) ® in your eyes, rinse your eyes right away with water or saline. Call your doctor if your eyes are irritated for more than one hour.

Steps for using PENNSAID (diclofenac sodium topical solution) ^®:

Step 1. Wash your hands with soap and water before and after applying PENNSAID (diclofenac sodium topical solution) ®.

Step 2. Your total dose for each knee is 40 drops of PENNSAID (diclofenac sodium topical solution) ®. You will use 10 drops at a time. Put 10 drops of PENNSAID (diclofenac sodium topical solution) ® either on your hand or directly on your knee.

Figure 1. Dispense 10 drops of PENNSAID (diclofenac sodium topical solution) ® at a time

Step 3. Spread PENNSAID (diclofenac sodium topical solution) ® evenly on the front, back and sides of your knee.

Repeat this step 4 times so that your knee is completely covered with a total of 40 drops of PENNSAID (diclofenac sodium topical solution) ®.

Figure 2. Spread PENNSAID (diclofenac sodium topical solution) evenly on the front, and sides of your knee

Figure 3. Spread PENNSAID (diclofenac sodium topical solution) evenly on the back of your knee

Step 4. Repeat steps 2 and 3 for the other knee if needed.

After you use PENNSAID (diclofenac sodium topical solution) ^®:

Do not

• cover your knee with clothing until your knee is completely dry
• put sunscreen, insect repellant, lotion, moisturizer, cosmetics, or other topical medicines on your knee until it is completely dry
• take a shower or a bath for at least 30 minutes after you put PENNSAID (diclofenac sodium topical solution) ® on your knee(s)
• use heating pads or apply bandages to the skin where you have applied PENNSAID (diclofenac sodium topical solution) ®
• expose your skin to sunlight or artificial light (tanning booths) where you have put PENNSAID (diclofenac sodium topical solution) ®

How should I store PENNSAID (diclofenac sodium topical solution) ®?

• Store PENNSAID (diclofenac sodium topical solution) ® between 59°F to 86°F (15°C to 30°C).

Keep PENNSAID (diclofenac sodium topical solution) ® and all medicines out of the reach of children.

Last reviewed on RxList: 1/24/2011
This monograph has been modified to include the generic and brand name in many instances.