When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to papain or urea.

How to Use This Medicine:
Spray, Ointment, Liquid Under Pressure

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Use this medicine only on your skin. Rinse it off right away if it gets on a cut or scrape. Do not get the medicine in your eyes, nose, or mouth.
• Wash your hands with soap and water before and after you use this medicine.
• Clean your skin wound with saline or other cleanser recommended by your doctor.
• Before using a new spray bottle, prime the pump by holding the spray upright directly over the wound, and pumping 10 to 14 times.
• To use the spray form of this medicine, hold the bottle about 1 to 2 inches from your wound. Use even, firm, and equal pressure each time you pump the bottle to spray the medicine onto your wound. Completely cover the wound with this medicine. After applying the medicine, cover the skin area with a bandage or other dressing recommended by your doctor.
• To use the ointment form of this medicine, apply it directly to the skin wound. After applying the medicine, cover the skin area with a bandage or other dressing recommended by your doctor.
• For best results, cleanse or irrigate your skin wound each time you change your bandages, even if you do not apply papain/urea each time.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use hydrogen peroxide to clean your skin ulcer or wound. Hydrogen peroxide can keep papain/urea from working properly.
• Avoid using any other medicines that contain lead, silver, or mercury. These metals can keep papain/urea from working properly.
• Do not put cosmetics or skin care products on the treated skin.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding.
• Do not use this medicine to treat a skin problem your doctor has not examined.
• Call your doctor if your symptoms do not improve or if they get worse.

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

If you notice these less serious side effects, talk with your doctor:

• Burning or stinging when you apply the medicine.

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