When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to diclofenac, or if you have an allergy to aspirin or similar medicines.

How to Use This Medicine:
Patch

• 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 should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Do not put the patch over burns, cuts, or irritated skin. Do not use this medicine on skin injuries that are caused by diseases (such as dermatitis, eczema, infections) or wounds.
• If any of this medicine gets in your eyes, mouth, or nose, rinse it off with water right away. Call your doctor if eye irritation lasts for more than 1 hour.
• Do not wear the patch when bathing or showering.
• Missed dose: 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.
• 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.

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 this medicine together with other NSAID medicines (including aspirin, diflunisal, ibuprofen, naproxen, salsalate), unless your doctor says it is okay.
• Some foods and medicines can affect how the diclofenac patch works. Tell your doctor if you are using any of the following:
  
  • Acetaminophen, cyclosporine, digoxin, lithium, methotrexate, or pemetrexed
  • Blood thinner (including warfarin)
  • Blood pressure medicine
  • Diuretic (water pill)
  • Medicine to treat depression
  • Steroid medicine (including dexamethasone, hydrocortisone, prednisolone, prednisone)

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding. Do not use this medicine during the later part of pregnancy unless your doctor tells you to.
• Tell your doctor if you have kidney disease, liver disease, anemia, asthma, bleeding problems, high blood pressure, heart failure or other heart problems, a recent heat attack, or a history of stomach ulcers or stroke. Tell your doctor if you drink alcohol regularly.
• This medicine may cause the following problems:
  
  • High risk of blood clots, heart failure, heart attack, or stroke
  • Stomach or bowel bleeding
  • Liver problems
  • High blood pressure
  • Kidney problems and high potassium levels
  • Serious skin reactions
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Call your doctor if your symptoms do not improve or if they get worse.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

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
• Change in how much or how often you urinate
• Chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, nausea, unusual sweating, faintness
• Confusion, weakness, uneven heartbeat, trouble breathing, numbness or tingling in your hands, feet, or lips
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Fast, slow, or uneven heartbeat
• Rapid weight gain, swelling in your hands, ankles, or feet
• Severe stomach pain, red or black stools
• Unusual bleeding, bruising, or weakness
• Vomiting blood or material that looks like coffee grounds

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

• Burning, itching, or swelling where the patch is applied

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