In November 2009, the FDA approved Pennsaid (diclofenac sodium 1.5% w/w), a non-steroidal antiinflammatory drug (NSAID) formulated as a topical solution for use in the treatment of osteoarthritis of the knee. Currently, there are two other topical diclofenac preparations on the market, Voltaren® gel and Flector® patches. These products are FDA approved for relief of osteoarthritis in joints and for acute pain due to minor injuries, respectively.  Like other diclofenac preparations, there is a risk of serious cardiovascular events with the use of this medication. Pennsaid should be applied to clean, dry skin. Apply 10 drops to each side of the knee (front, back and both sides) for a total of 40 drops, spreading evenly across the skin; rubbing in fully is not necessary. Application of the product may be repeated up to 4 times daily. Other topical products, like sunscreen, lotions and insect repellants can be applied on top of Pennsaid once it has dried completely. Most common adverse reactions include dry skin, itching and contact dermatitis. Pennsaid should not be applied to open wounds. To avoid contact of Pennsaid with eyes and mucous membranes, patients should be instructed to wash their hands after every application. Concurrent use of oral NSAID agents should be avoided.

 

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