There are simple treatment options available for symptoms of knee OA. Among the most commonly used medications are NonSteroidal Anti-Inflammatory Drugs, or NSAIDs.

NSAIDs are a class of medicines that treat the pain and inflammation of some medical conditions

YOU HAVE A CHOICE IN TREATMENT.

Some NSAIDs are taken orally and others are applied topically.

Oral medications are generally released in the stomach and then go into your bloodstream
As a result, a larger amount of the medicine goes through your whole body than it would with a topical medicine.
A topical medication is applied to the skin
Topical treatments allow you to apply the medication directly to your knee

All NSAIDs, including oral, topical, and even nonprescription versions, such as ibuprofen, or naproxen,
pose serious risk of cardiovascular and gastrointestinal side effects.

Studies suggest that topical NSAIDs may offer safety benefits for the stomach and intestines compared to oral NSAIDs in some patients

Localized Treatment for Knee OA

ASK YOUR DOCTOR IF PENNSAID® TOPICAL NSAID SOLUTION IS RIGHT FOR YOU.

Tell your doctor about all of your symptoms and if your knee OA pain interferes with everyday activities. Only you and your doctor can decide if PENNSAID is right for you.

Altman RD. Practical considerations for the pharmacologic management of osteoarthritis. Am J Manag Care. 2009;15:S236-S243. Arthritis Foundation. All about Osteoarthritis. http://www.arthritistoday.org. Accessed January 6, 2011. Arthritis Foundation. NSAIDs. Arthritis Today Drug Guide. http://www.arthritistoday.org/treatments/drug‑guide/types‑of‑drugs/drug‑guide‑nsaids.php. Accessed January 6, 2011. Arthritis Foundation. NSAIDs. Who gets osteoarthritis. http://www.arthritis.org/who‑gets‑osteoarthritis.php. Accessed January 6, 2011. Arthrotec (diclofenac sodium/misoprostol) Tablets USP [prescribing information]. New York, NY: G.D. Searle LLC, Division of Pfizer. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833-1840. Diclofenac sodium delayed release tablets USP [prescribing information]. Corona, CA: Watson Laboratories, Inc. Evans JMM, McMahon AD, McGilchrist MM, et al. Topical non-steroidal anti-inflammatory drugs and admission to hospital for upper gastrointestinal bleeding and perforation: a record linkage case-control study. Br Med J. 1995;311:22-26. Heyneman CW, Lawless-Liday C, Wall GC. Oral versus topical NSAIDs in rheumatic diseases: a comparison. Drugs. 2000;60:555-574. Notman R, Noro M, O’Malley B, Anwar J. Molecular basis for dimethylsulfoxide (DMSO) action on lipid membranes. J Am Chem Soc. 2006;128:13982-13983. PENNSAID [package insert]. Mississauga, Ontario:Nuvo Research, Inc.; 2010.

INDICATION
PENNSAID® is a nonsteroidal anti-inflammatory drug (NSAID) used for treating the signs and symptoms of osteoarthritis of the knee(s).

IMPORTANT RISK INFORMATION

WARNING: CARDIOVASCULAR (CV) AND GASTROINTESTINAL (GI) RISK

Nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of serious blood clots in the heart, or cause a heart attack or stroke. These risks can cause death. The risk may increase the longer NSAIDs are used. Patients who have heart disease or are at risk for heart disease may be at greater risk
Do not use PENNSAID in patients who are in the hospital for heart bypass surgery grafts

NSAIDs cause an increased risk of serious stomach problems or problems in the intestines. Patients could bleed or develop a hole in their stomach or intestines. All of these problems can cause death. These problems can happen at any time with no warning when using NSAIDs. Older patients are at greater risk for these problems

Tell your doctor if you have:
• High blood pressure, heart failure, or had any heart surgeries
• A history of ulcers or bleeding in the stomach or intestines
• Kidney or liver problems

The most common side effects of PENNSAID occur where it is put on the skin such as dry skin (32%), red and firm skin rash, skin rash with blisters, and itching. Other common side effects include: upset stomach, stomach pain, gas, diarrhea, and nausea.

Serious reactions can occur even if you never used PENNSAID before. NSAIDs can cause bad skin reactions that can be fatal.

A rise in liver tests can occur with NSAID therapy. Stop PENNSAID if this occurs and does not go away or if it gets worse.

Using NSAIDs for a long time can hurt the kidneys. Use PENNSAID carefully in the elderly, those with damaged kidneys, bad hearts, bad livers, and those taking water pills or ACE inhibitors. Do not take other NSAIDS unless your physician says it is OK.

Do not use PENNSAID if you are pregnant or breast-feeding. Do not use PENNSAID on children.

Avoid exposing treated knee to the sun or tanning lamps. Wash and dry hands before and after use. Avoid contact of PENNSAID with the eyes, the mouth and the nose. Do not apply to open wounds. Do not apply heat or binding items to the treated knee.

You are encouraged to report negative side effects of prescription drugs to the Food and Drug Administration (FDA). Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For more important risk information about PENNSAID, please read the PENNSAID Medication Guide and Full Prescribing Information and discuss any questions you have with your doctor.

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PENNSAID is a registered trademark of Nuvo Research Inc. Other brands are trademarks of their respective owners. © 2011 Covidien