How does it work?

Pennsaid cutaneous solution contains the active ingredient diclofenac sodium, which is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are used to relieve pain and inflammation.

Diclofenac works by blocking the action of a substance in the body called cyclo-oxygenase (COX). Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced by the body in response to injury and certain diseases and conditions, and cause pain, swelling and inflammation. Diclofenac blocks the production of these prostaglandins and is therefore effective at reducing inflammation and pain.

When diclofenac is applied to the skin (topical application) it is absorbed through the skin into the underlying tissues, where it reduces pain and inflammation in the local area.

Pennsaid solution is used to relieve pain associated with osteoarthritis in superficial joints that are close to the skin surface, such as the wrist or knee. There is no data on the use of Pennsaid for large, deep joints covered by layers of muscle or other soft tissues, such as the hip or spine.

The skin over the painful joint should be washed and dried before applying the solution. The number of drops recommended by your doctor should then be applied to the skin and spread evenly over the joint. The diclofenac will be absorbed into the underlying tissues of the joint where it will relieve pain.

What is it used for?

• Pain due to osteoarthritis in joints that are close to the skin surface, such as the wrist or knee.

Warning!

• Pennsaid solution should not be taken by mouth. It is for application to the skin only.
• Do not apply the solution to broken, damaged or infected skin. Do not apply to areas of skin that have been affected by skin diseases such as psoriasis, unless advised by your doctor.
• Avoid getting the solution in contact with the eyes and mucous membranes, such as the inside of the nose or mouth.
• Wash your hands after applying the solution, unless the hands are the area being treated.
• You should not cover the area being treated with airtight dressings such as bandages or other dressings, as these will enhance the absorption of the medicine into the body and may increase the risk of adverse effects.
• When diclofenac is applied to the skin it is absorbed into the bloodstream to a far lesser degree than diclofenac taken by mouth. This means it is much less likely to cause side effects on the gut than oral diclofenac. However, it is important that people with a history of disorders affecting the stomach or intestines are closely monitored by a doctor while using this medicine, particularly if elderly. Consult your doctor immediately if you experience side effects such as stomach pain, indigestion, heartburn or signs of bleeding in the stomach or intestines, eg blood in the stools, while using this medicine.
• As it decreases pain and inflammation this medicine may mask the signs and symptoms of skin infections in the area that you apply it to. This may make you think mistakenly that an infection is getting better when it isn't, or that an infection is less serious than it is. For this reason you should tell your doctor if you get a skin infection in the area that you are using this medicine.

Use with caution in

• Decreased kidney function.
• Decreased liver function.
• A type of life long inherited blood disease caused by a defect in the liver (hepatic porphyria).
• History of peptic ulcer or bleeding in the stomach or intestines.
• Inflammatory bowel disease such as Crohn's disease or ulcerative colitis.

Not to be used in

• Pregnancy.
• Breastfeeding.
• People in whom aspirin or other NSAIDs, eg ibuprofen, cause allergic reactions such as asthma attacks, itchy rash (urticaria), nasal inflammation (rhinitis) or swelling of the lips, tongue and throat (angioedema).
• History of allergy or skin sensitivity to dimethyl sulphoxide (DMSO).
• This medicine is not recommended for use in children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• The manufacturer states that this medicine should not be used during pregnancy. Diclofenac should not be used in the third trimester of pregnancy because it may delay labour, increase the length of labour and cause complications in the newborn baby. It is not recommended for use in the first and second trimesters of pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
• When diclofenac is taken by mouth it passes into breast milk in very small amounts that are unlikely to be harmful to a nursing infant. The manufacturer has not studied the safety of using Pennsaid when breastfeeding, but it is unlikely to be absorbed sufficiently to have any effect on a nursing infant. However, the manufacturer recommends it is not used by women who are breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

• Dry skin at application site.
• Rash at application site.
• If applied to large areas of skin for long periods of time there is a possibility that side effects associated with oral diclofenac may be experienced. You can read about these in the factsheets linked below.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

You should not apply any other medicines to the affected joint at the same time as Pennsaid solution.

When it is used on unbroken skin this medicine is unlikely to be absorbed in sufficient amounts to affect other medicines that are being taken by mouth. However, you should tell your doctor or pharmacist what medicines you are already using, including those bought without a prescription and herbal medicines, before using this medicine. Similarly, check with your doctor or pharmacist before using any new medicines while using this one, to ensure that the combination is safe.

Other medicines containing the same active ingredient

Diclofenac enteric-coated tablets, sustained-release tablets, suppositories and injection are also available without brand names, ie as the generic medicine.