DERMACINRX LEXITRAL

Diclofenac Sodium 1.5%, Topical solution

Alcohol

· Severity: Major

· Notes for Consumers: Side effects from this drug may get worse if you drink alcohol-containing drinks. If you have persistent stomach upset, vomit blood or what looks like coffee grounds, or have black, tarry stools, contact your health care provider immediately. It is best to limit or avoid alcohol containing drinks while taking this drug, even with short term use. Many non-prescription products for headaches, pain, arthritis, or sinus pain contain drugs that may cause stomach problems along with alcohol; closely read labels before taking any medicines with alcohol-containing drinks.

· Notes for Professionals: Concomitant ingestion of ethanol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Ethanol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of ethanol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and ethanol should be avoided. Chronic alcoholism is often associated with hypoprothrombinemia and this condition increases the risk of bleeding. Systemic exposure of NSAIDs that are primary substrates for CYP2C9, such as diclofenac, may be increased during use of ethanol, which is a dose-dependent inhibitor of CYP2C9. The effects of ethanol may also be substrate-dependent, since in vitro data have shown varying inhibitory effects on 2C9 substrates.The manufacturer of diclofenac; misoprostol recommends that the total daily dose of diclofenac not exceed 100 mg in patients receiving a CYP2C9 inhibitor. Patients should be warned regarding the potential for increased risk of GI bleeding if alcohol-containing beverages are taken concurrently with NSAIDs.

Diclofenac Sodium 1.5%, Topical solution

Marijuana

· Severity: Moderate

· Notes for Consumers: The effects of marijuana may be decreased if combined with this medicine. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice slurred speech, confusion, severe drowsiness, increased heart rate, or any other new or unusual side effects.

· Notes for Professionals: Administering nonsteroidal antiinflammatory drugs (NSAIDs) concurrently with marijuana may limit some of marijuana's pharmacologic activities. Certain actions of marijuana require prostaglandin-mediated processes to occur; NSAIDs may interfere with these processes thereby decreasing marijuana's effect. Coadministration of indomethacin with marijuana has been shown to significantly decrease euphoria, tachycardia, and the intraocular pressure lowering activity of marijuana.

Diclofenac Sodium 1.5%, Topical solution

Tobacco

· Severity: Moderate

· Notes for Consumers: Tobacco-smoking may increase the risk for ulcers and gastrointestinal problems with these drugs. Ask your health care provider about a plan to stop smoking. If you have persistent stomach upset, vomit blood or what looks like coffee grounds, or have black, tarry stools, contact your health care provider immediately.

· Notes for Professionals: Concomitant use of nonsteroidal antiinflammatory drugs (NSAIDs) with tobacco smoking may enhance the risk of gastrointestinal (GI) side effects. Tobacco smoking may independently increase the risk of peptic ulcer and GI bleeding, and thus may increase the risk with NSAID usage. Patients using tobacco and NSAIDs concurrently should be monitored closely for GI adverse reactions.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>