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This medicine is nonsteroidal anti-inflammatory drug (NSAID) used to treat pain in certain joints (such as in the knees or hands) caused by osteoarthritis. It may also be used to treat other conditions as determined by your doctor.

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. DO NOT APPLY THIS MEDICINE TO INFECTED SKIN; OPEN WOUNDS; OR RED, SWOLLEN, OR PEELING SKIN. USE THE PROVIDED DOSING CARD TO MEASURE YOUR DOSE OF THIS MEDICINE. Ask your pharmacist if you have any questions about how to use the dosing card or this medicine. Gently massage this medicine into the skin of the affected area. Allow the medicine to dry for at least 10 minutes before you wear clothes or gloves over the treated area. After using the dosing card, fold it in half (with the used side inside) and throw it away out of the reach of children and pets. Wash your hands immediately after using this medicine unless your hands are part of the treated area. Do not wrap, bandage, or apply heat to the treated area. Do not shower, bathe, or wash the treated area for at least 1 hour after you use this medicine. STORE THIS MEDICINE AT ROOM TEMPERATURE between 59 and 86 degrees F (15 and 30 degrees C) away from heat and light. IF YOU MISS A DOSE OF THIS MEDICINE, skip the missed dose. Go back to your regular dosing schedule. Do not use 2 doses at once.

WARNING: THIS MEDICINE IS A NONSTEROIDAL ANTIINFLAMMATORY 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. 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, other NSAIDs (eg, ibuprofen), quinolones (eg, ciprofloxacin), tenofovir, angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), diuretics (eg, furosemide, hydrochlorothiazide), or medicines that may harm the liver (eg, acetaminophen, ketoconazole, isoniazid, certain medicines for HIV infection, certain antibiotics or seizure medicines). DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions, including a history of kidney or liver problems, diabetes, stomach or bowel problems (eg, bleeding, perforation, or ulcers), swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation. Tell your doctor if you have high blood pressure, blood disorders (eg, porphyria), bleeding or clotting problems, heart problems (eg, heart failure), blood vessel disease, or if you are at risk for any of these diseases. Inform your doctor if you drink alcohol, have a history of alcohol abuse, or if you have any other medical conditions including poor health; dehydration or low fluid volume; low blood sodium levels; any allergies (especially to aspirin or aspirin-like medicines); pregnancy; or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have severe kidney problems, if you have recently had or will be having bypass heart surgery, or if you are in the last 3 months of pregnancy. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

SIDE EFFECTS that may occur while using this medicine include mild irritation at the application site. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience fever, chills, or persistent sore throat; ringing in the ears; severe or persistent irritation at the application site; or unusual tiredness or weakness. CONTACT YOUR DOCTOR IMMEDIATELY if you experience bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; depression; fainting; fast or irregular heartbeat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting or diarrhea; shortness of breath; sudden or unexplained weight gain; swelling of hands, legs, or feet; symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, yellowing of skin or eyes); unusual bruising or bleeding; unusual joint or muscle pain; vision or speech changes; or 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; or swelling of the mouth, face, lips, or tongue. 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. This medicine may be harmful if swallowed. 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, or vomit that looks like coffee grounds.

DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children and pets. CHECK WITH YOUR PHARMACIST about how to dispose of unused medicine.


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