diclofenac and menthol topical

What is the most important information I should know about diclofenac and menthol topical?

Diclofenac and menthol can increase your risk of fatal heart attack or stroke. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Diclofenac and menthol may also cause stomach or intestinal bleeding, which can be fatal.

What is diclofenac and menthol topical?

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). Menthol provides a cooling sensation when applied to the skin.

Diclofenac and menthol topical (for the skin) is a combination medicine used to treat osteoarthritis of the knee.

Diclofenac and menthol topical may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using diclofenac and menthol topical?

Tell your doctor if you have ever had:

• heart problems, high blood pressure, or if you smoke;
• a heart attack, stroke, or blood clot;
• stomach ulcers, bleeding in your stomach or intestines;
• fluid retention;
• asthma; or
• kidney disease.

Diclofenac can affect ovulation and it may be harder to get pregnant while you are using this medicine.

If you are pregnant, you should not use diclofenac and menthol topical unless your doctor tells you to. Using an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.

How should I use diclofenac and menthol topical?

Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

After applying the medicine, wash and dry your hands. Wait until the medicine is completely dry before you cover the knee with clothing. Avoid showering/bathing the treated knee for at least 30 minutes after applying diclofenac and menthol topical.

Wait until the treated skin is completely dry before you apply sunscreen, insect repellant, lotion, or other skin products. Do not allow anyone else to touch the treated skin until it is completely dry.

Do not cover treated skin with a bandage or expose it to heat from a hot tub, heating pad, or sauna. Heat or bandaging can increase the amount of drug absorbed through your skin and may cause harmful effects.

If you use this medicine long-term, your blood pressure will need to be checked often. Your kidney and liver function may also need to be checked.

What happens if I miss a dose?

Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not apply two doses at one time.

What happens if I overdose?

Overdose symptoms may include drowsiness, lack of energy, nausea, vomiting, or stomach pain.

What should I avoid while using diclofenac and menthol topical?

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to diclofenac (such as aspirin, ibuprofen, ketoprofen, or naproxen).

If you are also taking low-dose aspirin to prevent heart attack or stroke, do not stop taking it or change your dose without your doctor's advice. Aspirin should be used for cardiovascular conditions only under the supervision of a doctor.

What are the possible side effects of diclofenac and menthol topical?

• a skin rash, no matter how mild;
• signs of stomach bleeding --bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath;
• liver problems --nausea, diarrhea, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
• low red blood cells (anemia) --pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Serious side effects may be more likely in older adults.

Common side effects may include:

• skin dryness, redness, itching, or rash;
• blistering or hardening of the treated skin;
• numbness, tingling, burning pain;
• acne;
• flushing (sudden warmth, redness, or tingly feeling);
• stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting; or
• dizziness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect diclofenac and menthol topical?

Tell your doctor about all your other medicines, especially:

• cyclosporine;
• digoxin;
• lithium;
• methotrexate;
• pemetrexed;
• a blood thinner (warfarin, Coumadin, Jantoven);
• aspirin or other NSAIDs (ibuprofen, naproxen, Advil, Motrin, Aleve, celecoxib, indomethacin, meloxicam, and others;
• heart or blood pressure medication, including a diuretic or "water pill"; or
• steroid medicine (prednisone and others).

This list is not complete. Other drugs may affect diclofenac and menthol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about diclofenac and menthol topical.