This medicine is a topical nonsteroidal anti-inflammatory medicine (NSAID) used to treat minor aches, stiffness, and pain associated with osteoarthritis of the knee. This medicine works by blocking the enzyme in your body that makes prostaglandins. Decreasing prostaglandins helps to reduce pain and swelling. This medicine is not a cure for arthritis.
Follow the directions for using this medicine provided by your doctor. This medicine has a MEDICATION GUIDE approved by the U.S. Food and Drug Administration. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. This medicine is for use on the skin only. Before applying the medicine clean the knee area. DO NOT APPLY to areas of skin that are broken or irritated. Be sure to apply the medicine to the front, back, and sides of the knee or as directed by your doctor. Allow the medicine to dry before making contact with clothing or other material. Wash your hands after applying this medicine. DO NOT wrap, bandage, or apply heat to the treated area. DO NOT APPLY any suncreen, cosmetics, insect repellant, other topical medicine, or any other substance to the treated area until it is completely dry. DO NOT shower, bathe, or wash the treated area for at least 30 minutes after you use this medicine. STORE THIS MEDICINE at room temperature between 59 and 77 degrees F (15 and 25 degrees C), away from heat and light. DO NOT USE THIS MEDICINE after its expiration date. KEEP THIS MEDICINE out of the reach of children and away from pets. Use this medicine regularly to receive the most benefit from it. IF YOU MISS A DOSE OF THIS MEDICINE, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
WARNING: THIS MEDICINE IS A NONSTEROIDAL ANTI-INFLAMMATORY DRUG (NSAID). It may cause an increased risk of serious and sometimes fatal heart and blood vessel problems (eg, heart attack, stroke). The risk may be greater if you already have heart problems or if you use this medicine for a long time. DO NOT USE THIS MEDICINE right before or after bypass heart surgery. THIS MEDICINE 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. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are also taking disulfiram, or metronidazole. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking anticoagulants (eg, warfarin), aspirin, clopidogrel, corticosteroids (eg, prednisone), direct factor XA inhibitors (eg, rivaroxaban), heparin, prasugrel, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), azole antifungals (eg, itraconazole, voriconazole), bisphosphonates (eg, risedronate), probenecid, rifamycins (eg, rifampin), cyclosporine, lithium, methotrexate, oral NSAIDs (eg, ibuprofen), quinolones (eg, ciprofloxacin), tenofovir, angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), diuretics (eg, furosemide, hydrochlorothiazide), medicines that may harm the liver (eg, acetaminophen, ketoconazole, isoniazid, certain medicines for HIV infection, certain antibiotics or seizure medicines), or furazolidone. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor if you drink alcohol or if you have any other medical conditions including existing skin infection or irritated, broken skin on the knee area, poor health, dehydration or low fluid volume, low blood sodium levels, allergies (especially aspirin or NSAID allergy), pregnancy, or breast-feeding. Tell your doctor if you have a history of alcohol abuse, swelling or fluid buildup, asthma, nasal polyps (growths in the nose), mouth inflammation, autoimmune problems such as lupus, liver or kidney problems, eye disease, diabetes, stomach or bowel problems (eg, bleeding, perforation, ulcers). Tell your doctor if you have high blood pressure, a blood disorder (eg, porphyria), bone marrow problems, heart problems (eg, heart failure), blood vessel disease, bleeding or clotting problems, or if you are at risk for any of these conditions. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have severe kidney disease, you are in the last 3 months of pregnancy, or you have recently had or will be having bypass heart surgery. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.
SIDE EFFECTS that may go away during treatment include constipation, diarrhea, dry skin or mild irritation at the application site, gas, nausea, stomach upset. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if you experience 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. AN ALLERGIC REACTION to this medicine is unlikely but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose 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. This medicine may be harmful if swallowed.
IF YOUR SYMPTOMS DO NOT IMPROVE, or it they get worse, contact your doctor. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out. CHECK WITH YOUR PHARMACIST about how to dispose of unused medicine.