Patient Medication Information: uses, side effects, how to take - Pennsaid

What is PENNSAID used for?

PENNSAID is used in adults to treat the signs and symptoms of osteoarthritis in the knee(s). It helps relieve pain, swelling and stiffness.

How does PENNSAID work?

PENNSAID belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). It is used topically (on the skin) to reduce the chemicals produced by your body which cause pain and swelling.
PENNSAID only treats the symptoms and relieves pain and inflammation as long as you use it. PENNSAID does not cure your arthritis or stop it from getting worse.

Serious Warnings and Precautions

Risk of Heart and Blood Vessel Problems:

Using non-steroidal anti-inflammatory drugs (NSAIDs), like PENNSAID, can cause heart and blood vessel problems like heart attack, stroke, blood clots, high blood pressure and heart failure. These can lead to death.
The risk of having heart problems is higher if you use PENNSAID for longer periods of time and/or in people who have heart disease.
Tell your healthcare professional if you have heart problems, high blood pressure or diabetes.

Risk of Stomach and Intestine (Gastrointestinal) Problems:

Using NSAIDs, like PENNSAID, can cause stomach and intestine problems like ulcers, inflammation, bleeding, holes/perforation, blockage or pain.

Talk to your healthcare professional about any medical conditions you have and any drugs you are taking.

Pregnancy:

Do NOT use PENNSAID if you are pregnant.
Medicines like PENNSAID may cause harm to your unborn baby.
Tell your healthcare professional right away if you become pregnant, think you may be pregnant or want to get pregnant while you are using PENNSAID.

What are the ingredients in PENNSAID?

Medicinal ingredients: diclofenac sodium

Non-medicinal ingredients: dimethyl sulfoxide, ethanol, glycerine, propylene glycol, purified water

PENNSAID comes in the following dosage forms:

Topical solution: 1.5% w/w

Do not use PENNSAID if you:

are planning to have or have recently had heart bypass surgery
have severe, uncontrolled heart failure
have active stomach or intestinal ulcers
have inflammatory bowel disease (Crohn’s disease or Ulcerative Colitis)
are allergic to diclofenac sodium, or to any of the non-medicinal ingredients in PENNSAID or component of the container (see What are the ingredients in PENNSAID?)
have a history of asthma, hives, growths in your nose, sinus swelling or symptoms of an allergic reaction after taking acetylsalicylic acid (ASA) or other NSAIDs
have liver disease (active or severe)
have kidney disease (severe or worsening)
have high levels of potassium in your blood
are using other NSAIDs
are under 18 years of age
have been prescribed PENNSAID for longer than 3 months, PENNSAID cannot be used longer than 3 months
are pregnant or breastfeeding

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take PENNSAID. Talk about any health conditions or problems you may have, including if you:

have or have had a heart attack, chest pain, heart disease, stroke or heart failure
have asthma
have a stomach infection
have a history of ulcer or bleeding from the stomach or gut (small or large intestines)
have other bleeding or blood problems
have liver or kidney problems, urine problems or are dehydrated
have high blood pressure, high cholesterol or diabetes
have poor blood flow to your extremities (like your hands and feet)
smoke or used to smoke
drink a lot of alcohol
are planning on becoming pregnant. PENNSAID cannot be used if you are pregnant
are planning to breastfeed, PENNSAID cannot be used if you are breastfeeding • have immune system problems

Other warnings you should know about:

Serious Skin Reactions: In rare cases, serious or life-threatening skin reactions listed below have been reported with some NSAIDs, such as PENNSAID.

drug reaction with eosinophilia and systemic symptoms (DRESS),
Stevens-Johnson syndrome (SJS),
toxic epidermal necrolysis (TEN),
exfoliative dermatitis and
erythema multiforme

You may be at a greater risk of experiencing a serious skin reaction during the first month of treatment.

See the Serious side effects and what to do about them table, below, for more information on these and other serious side effects.

PENNSAID might cause you to become more sensitive to sunlight. Sunlight or sunlamps may cause sunburn, skin blisters, skin rashes, redness, itching and discoloration or vision changes. If you have a reaction from the sun, talk to your healthcare professional.

Check-ups and Testing: You should have regular visits with your healthcare professional while you are using PENNSAID to monitor your health. They should:

Check your blood pressure.
Check your eyes. PENNSAID can cause blurred or reduced vision.
Do blood and urine tests to check your liver, kidney and blood health.

Surgery: Tell any doctor, dentist, pharmacist or healthcare professional that you see, that you are using this medicine. This is especially important if you are planning to have heart surgery.

Driving and Using Machines: Be careful about driving or doing activities that require you to be alert, as PENNSAID may affect your vision or nervous system. If you become drowsy, dizzy or light-headed after using PENNSAID, do NOT drive or operate machinery.

Adults (65 years or older): Side effects like gastrointestinal problems may happen more often. Your healthcare professional might have you start with a lower dose of PENNSAID. They will monitor your health during and after treatment.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

The following may interact with PENNSAID:

acetylsalicylic acid (ASA) or other NSAIDs, used to treat pain, fever and inflammation, such as celecoxib, diclofenac, ibuprofen, naproxen
digoxin, used for heart problems
medicines used as blood thinners or to prevent blood clots, such as heparin, warfarin, ASA, clopidogrel • oral medicines used to treat diabetes
medicines used to lower extra fluid levels (diuretics), such as furosemide, hydrochlorothiazide
medicines used to lower blood pressure
corticosteroids used as an anti-inflammatory, such as glucocorticoids, like prednisone
methotrexate, used to treat some cancers or arthritis
acetaminophen, used to treat pain and fevers
cyclosporine, used to lower the risk of organ rejection
lithium, used to treat bipolar disorder
medicines used to treat gout, such as probenecid and sulfinpyrazone
antibiotics used to treat bacterial infections, such as quinolone
phenytoin, used to treat seizures
voriconazole, used to treat infections
alcohol

How to take PENNSAID:

Use PENNSAID exactly how your healthcare professional has told you to. Talk to your healthcare professional if you are unsure.
Do not stop using PENNSAID or change your dose without talking to your healthcare professional.
PENNSAID is for external use only. Avoid contact with your eyes and mucous membranes.
Apply PENNSAID to clean, dry skin.
Do not use PENNSAID under bandages or dressings.
Do not apply PENNSAID to open, broken or infected skin.
Do not apply any other medication to the treated area
Do not use PENNSAID for longer than 3 months.

Usual dose:

Adults 18 years and older: Apply 40 drops to affected knee only, 4 times a day, or 50 drops, 3 times a day.

How to Apply PENNSAID:

Use the plastic dropper to dispense 10 drops of PENNSAID into your hand, or directly onto your affected knee.
Spread PENNSAID evenly around the front, back and sides of your knee.
Repeat these steps until you have applied the prescribed amount of PENNSAID (either 40 or 50 drops) and your knee is completely covered.
If you are using PENNSAID on both your knees, repeat the above steps to treat your other knee.
Wash your hands when you are finished using PENNSAID.
Allow several minutes for PENNSAID to dry.

Overdose:

If you think you, or a person you are caring for, have taken too much PENNSAID, contact a healthcare professional, hospital emergency department, regional poison control centre or Health Canada’s toll-free number, 1-844 POISON-X (1-844-764-7669) immediately, even if there are no signs or symptoms.

Missed Dose:

If you miss applying a dose of PENNSAID, skip the missed dose. Then continue with your next dose at the usual time. Do not double the next dose to make up for a missed dose.

What are possible side effects from using PENNSAID?

These are not all the possible side effects you may have when taking PENNSAID. If you experience any side effects not listed here, tell your healthcare professional.

Side effects may include:

confusion, dizziness, light-headedness, spinning
diarrhea, constipation
feeling gassy
feeling of burning/prickliness/numbing
hair loss
hard to concentrate or think
headache
heartburn, indigestion
- irritation on the skin where you apply PENNSAID including rash, itchiness, dryness, tingling
- mouth sores
- muscle pain
- nervousness
- skin rash
- sore throat
- stomach upset/abdominal pain
- taste disorder, thirst, dry mouth
- vomiting, nausea

Serious side effects and what to do about them

Symptom / effect	Talk to your healthcare professional		Stop taking drug and get immediate medical help
Symptom / effect	Only if severe	In all cases
RARE

Serious Skin Reactions: fever, severe rash, swollen lymph glands, flu-like feeling, blisters and peeling skin that may start in and around the mouth, nose, eyes and genitals and spread to other areas of the body, swelling of face and/or legs, yellow skin or eyes, shortness of breath, dry cough, chest pain or discomfort,


				✓
Symptom / effect	Talk to your healthcare professional		Stop taking drug and get immediate medical help
Symptom / effect	Only if severe	In all cases

feeling thirsty, urinating less often, less urine or dark urine.

UNKNOWN
Allergic Reaction: rash, hives, swelling of the face, lips, tongue or throat, difficulty swallowing or breathing							✓
Aseptic Meningitis (Inflammation of the protective lining of the brain that is not caused by infection): headaches, stiff neck, nausea, vomiting, fever, clouding of consciousness					✓
Blood Clots: In the leg or arm: pain, redness and swelling, skin is warm to the touch In the lung: chest pain, usually worse with breathing, shortness of breath, cough that may contain blood, dizziness, loss of consciousness							✓
Blood Problems (low white and/or red blood cell or platelet count): feeling tired or weak, pale skin, bruising or bleeding for longer than usual if you hurt yourself, fever, chills					✓
Congestive Heart Failure (heart does not pump blood as well as it should): shortness of breath, fatigue and weakness, swelling in ankles, legs and feet, cough, fluid retention, lack of appetite, nausea, rapid or irregular heartbeat, reduced ability to exercise							✓
Depression (sad mood that will not go away): difficulty sleeping or					✓
	Serious side effects and what to do about them
Symptom / effect		Talk to your healthcare professional				Stop taking drug and get immediate medical help
Symptom / effect		Only if severe		In all cases
sleeping too much, changes in appetite or weight, reduced sex drive and thoughts of death or suicide
Gastrointestinal (GI) Problems (bleeding, blockage, holes, ulcers or inflammation in your GI tract): blood in vomit, black tarry or bloody stool, dizziness, stomach pain, bloating, loss of appetite, weight loss, nausea, vomiting, constipation or diarrhea, chills or fever					✓
Hypertension (high blood pressure): fatigue, dizziness or fainting, chest pain			✓
Liver Problems: yellowing of the skin or eyes (jaundice), right upper stomach pain or swelling, nausea or vomiting, unusual dark urine, unusual tiredness					✓
Lung Problems, Asthma: increased shortness of breath, wheezing, difficulty breathing, cough and chest tightness, irregular heartbeat							✓
Myocardial Infarction (heart attack): pressure or squeezing pain between the shoulder blades, in the chest, jaw, left arm or upper abdomen, shortness of breath, dizziness, fatigue, light-headedness, clammy skin, sweating, indigestion, anxiety, feeling faint, possible irregular heartbeat							✓
Stroke (bleeding or blood clot in the brain): sudden numbness, weakness or tingling of the face,							✓
	Serious side effects and what to do about them
Symptom / effect		Talk to your healthcare professional				Stop taking drug and get immediate medical help
Symptom / effect		Only if severe		In all cases
arm or leg, particularly on one side of the body, sudden headache, blurry vision, difficulty swallowing or speaking, lethargy, dizziness, fainting, vomiting, trouble understanding, trouble with walking, loss of balance

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.

Reporting Side Effects

You can report any suspected side effects associated with the use of health products to Health Canada by:

Visiting the Web page on Adverse Reaction Reporting (canada.ca/drug-device-reporting) for information on how to report online, by mail or by fax; or
Calling toll-free at 1-866-234-2345.

NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

Storage:

•

Store at room temperature (15-25 °C).

•

Do not keep outdated medicine or medicine no longer needed.

•

Keep out of reach and sight of children.

If you want more information about PENNSAID:

•

Talk to your healthcare professional

•

Find the full product monograph that is prepared for healthcare professionals and
includes this Patient Medication Information by visiting the Health Canada website: (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website
(https://knighttx.com), by emailing medinfo@knighttx.com, or by calling 1-844-483-5636.

Rx or OTC	Prescription (Rx)?
DIN	02247265
Schedule(s)	PRESCRIPTION
Active ingredient(s)	Diclofenac sodium 1.5 %
Dosage form(s)	Solution
Route(s) of administration	Topical
Drug class (WHO ATC)	M Musculo-skeletal system drugs M02 Topical products for joint and muscular pain M02A Topical products for joint and muscular pain M02AA Antiinflammatory preparations, non-steroids for topical use M02AA15 Diclofenac
Company	KNIGHT THERAPEUTICS INC.
Current status	Marketed
Current status date	November 21, 2025

Pennsaid: Uses, Side Effects and Dosage