Diclofenac Epolamine (dye-KLOE-fen-ak e-POLE-a-meen)
Treats pain caused by minor strains, sprains, and contusions (bruises). This is a nonsteroidal anti-inflammatory drug (NSAID).
There may be other brand names for this medicine.
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to diclofenac. You should not use this medicine if aspirin or other NSAIDs (such as ibuprofen, naproxen, Advil®, Aleve®, Bextra®, Celebrex®, Ecotrin®, Motrin®, or Voltaren®) have ever caused you to have breathing problems (such as asthma attacks), hives, or other allergic-type reactions. Do not use this medicine if you have aspirin-sensitive asthma. Do not use this medicine to relieve pain right before or right after a type of heart surgery called coronary artery bypass graft (CABG). Do not use this medicine on damaged or non-intact skin caused by skin diseases (such as dermatitis, eczema, infections), burns, or wounds.
How to Use This Medicine
- Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to.
- This medicine is not for long-term use.
- This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.
- Wash your hands with soap and water before and after applying a patch.
- Leave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident.
- If any of this medicine gets in your eyes, mouth, or nose, rinse the medicine off right away with water or saline. If eye irritation persists for more than one hour, call your doctor.
- Do not put the patch over burns, cuts, or irritated skin.
- If the patch begins to peel off, the edges of the patch may be taped down. Put on a new patch if the old one has fallen off and cannot be reapplied.
- If the patch still peels off, it may be used with a mesh netting sleeve (such as Curad® Hold Tite?, Surgilast® Tubular Elastic Dressing) to hold the patch applied to the ankles, knees, or elbows. The mesh netting sleeve must not be occlusive and must allow air to pass through.
- Do not wear the patch when bathing or showering.
- To help you remember to use your medicine, try to get into the habit of using it at regular times. Try to change the skin patch at the same time and day of the week.
If a dose is missed:
- If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.
- Fold the used patch in half with the sticky sides together. Throw any used patch away so that children or pets cannot get to it. You will also need to throw away old patches after the expiration date has passed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are using acetaminophen (Tylenol®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), lithium (Eskalith®, Lithobid®), methotrexate (Rheumatrex®, Trexall®), other pain or arthritis medicine (such as aspirin, ibuprofen, naproxen, Advil®, Aleve®, Bextra®, Celebrex®, Ecotrin®, Motrin®, or Voltaren®), blood pressure medicine (such as enalapril, lisinopril, Accupril®, Lotrel®, or Zestril®), a diuretic or "water pill" (such as furosemide, hydrochlorothiazide [HCTZ], torsemide, Demadex®, or Lasix®), a blood thinner (such as warfarin, Coumadin®), or a steroid medicine (such as dexamethasone, prednisolone, prednisone, or Medrol®).
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant or breastfeeding. Do not use this medicine during the last part of a pregnancy unless your doctor tells you to.
- Make sure your doctor knows if you have a history of ulcers or other stomach problems. Tell your doctor if you have kidney disease, liver disease, anemia, asthma, bleeding problems, congestive heart failure (CHF), high blood pressure, or other heart or circulation problems.
- This medicine may increase your risk of having a heart attack or stroke. This is more likely in people who already have heart disease. People who use this medicine for a long time might also have a higher risk.
- This medicine may cause bleeding in your stomach or intestines. This is more likely if you have had a stomach ulcer or bleeding in the past, if you smoke or drink alcohol regularly, if you are over 60 years of age, are in poor health, or using certain other medicines (such as a steroid medicine or a blood thinner).
- Stop using this medicine and check with your doctor right away if you have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.
- This medicine may also cause a serious type of allergic reaction called anaphylaxis. This may occur more often in patients who are allergic to aspirin or other nonsteroidal anti-inflammatory drugs. Anaphylaxis can be life-threatening and requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in color of the skin of the face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; and puffiness or swelling of the eyelids or around the eyes. If these effects occur, get emergency help at once.
- Serious skin reactions can occur during treatment with this medicine. Stop using this medicine and check with your doctor right away if you have blistering, peeling, or loosening of the skin; red skin lesions; severe acne or skin rash; sores or ulcers on the skin; or fever or chills while you are using this medicine.
- Tell your doctor if you have unexplained weight gain or edema (fluid retention or body swelling) with this medicine.
- Before having any kind of surgery or medical tests, tell your doctor that you are using this medicine. It may be necessary for you to stop treatment for awhile, or to change to a different nonsteroidal antiinflammatory drug before your procedure.
- If your symptoms do not improve or if they get worse, call your doctor.
- Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Blistering, peeling, or red skin rash.
- Bloody or black, tarry stools.
- Change in how much or how often you urinate.
- Chest pain, shortness of breath, or coughing up blood.
- Cold sweats and bluish-colored skin.
- Dark-colored urine or pale stools.
- Fever, chills, cough, sore throat, and body aches.
- Nausea, vomiting, loss of appetite, or pain in your upper stomach.
- Numbness or weakness in your arm or leg, or on one side of your body.
- Pain in your lower leg (calf).
- Rapid weight gain.
- Severe stomach pain.
- Slow, fast, or irregular heartbeat.
- Sores or white patches on your lips, mouth, or throat.
- Sudden or severe headache, or problems with vision, speech, or walking.
- Swelling in your hands, ankles, or feet.
- Unusual bleeding or bruising.
- Unusual tiredness or weakness.
- Yellowing of your skin or the whites of your eyes.
If you notice these less serious side effects, talk with your doctor:
- Burning, itching, or swelling where the patch is applied.
- Dry mouth.
- Mild headache, dizziness, or drowsiness.
- Mild nausea, vomiting, constipation, diarrhea, or upset stomach.
- Mild skin rash.
- Unusual or bad taste in your mouth.
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
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