With topically applied Pennsaid®, the most common adverse reaction has been mild dryness or irritation at the application site. A recent equivalence study has also shown that Pennsaid® works as well as the maximum daily dose of oral diclofenac, without provoking serious side effects.
Are there any other precautions or warnings for this medication?
Hepatic porphyria: People with hepatic porphyria should use this medication with caution, as it may trigger an attack.
Infection: This medication may mask some of the signs of infection.
Kidney function: People with reduced kidney function may need lower doses and more frequent medical check-ups while using this medication.
Occupational hazards: Some people have reported headache, dizziness, lightheadedness, and confusion while taking this medication. Avoid operating motor vehicles and doing other potentially hazardous activities until you have determined the effect this medication has on you.
Stomach: Stomach ulcers and bleeding from the stomach have been known to occur when diclofenac is taken by mouth. These complications can occur at any time and are sometimes severe enough to require immediate medical attention. Although these reactions have not been seen with diclofenac topical solution, you should seek medical attention right away if you notice any signs of bleeding (such as dark, tarry stools, blood in the stools, or vomiting of material that looks like coffee grounds).
Vision: Other medications in the same family as diclofenac may cause vision changes such as blurred or decreased vision. If you notice vision changes, stop using the medication and check with your doctor.
Pregnancy: This medication is not recommended for use during pregnancy, as its safety has not been established.
Breast-feeding: This medication should not be used by nursing mothers.
Children: Diclofenac is not recommended for children. The safety, effectiveness, and dosage of this medication for this age group have not been established.
Seniors: Seniors may have a higher risk of side effects with this medication. Seniors may need lower doses of this medication and more frequent medical check-ups.
What other drugs could interact with this medication?
The following medications may affect the way that diclofenac works or increase the risk of side effects:
corticosteroids (e.g., prednisone)
other NSAIDs (e.g., naproxen, indomethacin)
quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, gatifloxacin)
Diclofenac may affect the way that the following medications work or increase the risk of side effects:
beta-adrenergic blockers (e.g., metoprolol, atenolol)
diuretics (water pills; e.g., spironolactone)
medications for diabetes (e.g., glyburide, metformin)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.