Fenoprofen

Generic Name: fenoprofen (FEN-oh-PROE-fen)
Brand Name: Generic only. No brands available.

Overview
Fenoprofen is a nonsteroidal anti-inflammatory drug (NSAID). It may cause an increased risk of serious and sometimes fatal heart and blood vessel problems (eg, heart attack, stroke). The risk may be greater if you already have heart problems or if you take fenoprofen for a long time. Do not use fenoprofen right before or after bypass heart surgery.
Fenoprofen may cause an increased risk of serious and sometimes fatal stomach ulcers and bleeding. Elderly patients may be at greater risk. This may occur without warning signs.

Use For

Treating rheumatoid arthritis, osteoarthritis, or mild to moderate pain. It may also be used for other conditions as determined by your doctor.

Fenoprofen is an NSAID. Exactly how it works is not known. It may block certain substances in the body that are linked to inflammation. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

Do Not Use If

• you are allergic to any ingredient in fenoprofen
• you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or an NSAID (eg, ibuprofen, celecoxib)
• you have recently had or will be having bypass heart surgery
• you have severe kidney problems
• you are in the last 3 months of pregnancy

Contact your doctor or health care provider right away if any of these apply to you.

Before Use

Some medical conditions may interact with fenoprofen. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal product, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of kidney or liver disease, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers)
• if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation
• if you have high blood pressure, blood disorders, bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or if you are at risk for any of these diseases
• if you have hearing problems, poor health, dehydration or low fluid volume, or low blood sodium levels, you drink alcohol, or you have a history of alcohol abuse

Some MEDICINES MAY INTERACT with fenoprofen. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anticoagulants (eg, warfarin), aspirin, corticosteroids (eg, prednisone), heparin, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because risk of stomach bleeding may be increased
• Probenecid because it may increase the risk of fenoprofen's side effects
• Phenobarbital because it may decrease fenoprofen's effectiveness
• Cyclosporine, hydantoins (eg, phenytoin), lithium, methotrexate, quinolones (eg, ciprofloxacin), sulfonamides (eg, sulfamethoxazole), or sulfonylureas (eg, glipizide) because the risk of their side effects may be increased by fenoprofen
• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril) or diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by fenoprofen

This may not be a complete list of all interactions that may occur. Ask your health care provider if fenoprofen may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Dosage

Usual Adult Dose for Osteoarthritis

300 to 600 mg orally 3 to 4 times a day.

Usual Adult Dose for Rheumatoid Arthritis

300 to 600 mg orally 3 to 4 times a day.

Usual Adult Dose for Pain

200 mg orally every 4 to 6 hours as needed.

Usual Adult Dose for Acute Gout

800 mg orally one time. This should be followed by 400 to 800 mg orally every 6 to 8 hours until the acute gouty attack has resolved, usually 2 to 3 days.

Renal Dose Adjustments

Fenoprofen is contraindicated in patients with significantly impaired renal function.

Liver Dose Adjustments

Data not available

Dose Adjustments

Titrate dose based on patient response to and tolerance of fenoprofen. Patients with rheumatoid arthritis generally seem to require larger doses than do those with osteoarthritis. The smallest dose that yields acceptable control should be employed.

Precautions

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Etodolac

 Etodolac

 

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), cidofovir, corticosteroids (such as prednisone), lithium, "water pills" (diuretics such as furosemide).
This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.
Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to etodolac and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.
This medication may affect certain laboratory tests, possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Uses

Etodolac is used to relieve pain from various conditions. It also reduces pain, swelling, and joint stiffness from arthritis. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation.
If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain. See also Warning section.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication may also be used to treat gout attacks.

How to use etodolac

Read the Medication Guide provided by your pharmacist before you start using etodolac and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.
The dosage is based on your medical condition and response to treatment. To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose or take it more often than directed. For ongoing conditions such as arthritis, continue taking this medication as directed by your doctor.
If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.
Tell your doctor if your condition does not improve or if it worsens.

Precautions

Before taking etodolac, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before taking this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), blood disorders (such as anemia, bleeding/clotting problems), growths in the nose (nasal polyps), heart disease (such as previous heart attack), high blood pressure, liver disease, stroke, throat/stomach/intestinal problems (such as bleeding, heartburn, ulcers).
Kidney problems can sometimes occur with the use of NSAID medications, including etodolac. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have any unusual change in the amount of urine.
This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.
This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.
This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, or sunlamps. Use a sunscreen and wear protective clothing when outdoors.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially stomach/intestinal bleeding, kidney problems, and worsening heart problems.
Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.
It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Side Effects

See also Warning section.
Upset stomach, nausea, diarrhea, drowsiness, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.
Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, difficult/painful swallowing, hearing changes (such as ringing in the ears), mental/mood changes, swelling of the ankles/feet/hands, sudden/unexplained weight gain, change in the amount of urine, unexplained stiff neck, vision changes, unusual tiredness.
This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: dark urine, persistent nausea/vomiting/loss of appetite, stomach/abdominal pain, yellowing eyes/skin.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Diflunisal

Diflunisal

Generic Name: diflunisal (dye-FLOO-ni-sal)
Brand Name: Dolobid

Indication

Diflunisal is a nonsteroidal anti-inflammatory drug (NSAID). It may cause an increased risk of serious and sometimes fatal heart and blood vessel problems (eg, heart attack, stroke). The risk may be greater if you already have heart problems or if you take diflunisal for a long time. Do not use diflunisal right before or after bypass heart surgery.
Diflunisal may cause an increased risk of serious and sometimes fatal stomach ulcers and bleeding. Elderly patients may be at greater risk. This may occur without warning signs.

Use For

Treating rheumatoid arthritis, osteoarthritis, or mild to moderate pain. It may also be used for other conditions as determined by your doctor.

Diflunisal is an NSAID. Exactly how it works is not known. It may block certain substances in the body that are linked to inflammation. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

Do Not Use If

• you are allergic to any ingredient in diflunisal
• you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or an NSAID (eg, ibuprofen, celecoxib)
• you have recently had or will be having bypass heart surgery
• you are also taking another NSAID (eg, ibuprofen)
• you are in the last 3 months of pregnancy

Contact your doctor or health care provider right away if any of these apply to you.

Before Using

Some medical conditions may interact with diflunisal. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal product, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of kidney or liver disease, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers)
• if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation
• if you have high blood pressure, blood disorders, bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or if you are at risk for any of these diseases
• if you have chickenpox, the flu, poor health, dehydration or low fluid volume, or low blood sodium levels, you drink alcohol, or you have a history of alcohol abuse

Some MEDICINES MAY INTERACT with diflunisal. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anticoagulants (eg, warfarin), aspirin, corticosteroids (eg, prednisone), heparin, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because risk of stomach bleeding may be increased
• Antacids, other NSAIDs (eg, ibuprofen), or probenecid because they may increase the risk of diflunisal's side effects
• Acetaminophen, cyclosporine, lithium, methotrexate, quinolones (eg, ciprofloxacin), or sulfonylureas (eg, glipizide) because the risk of their side effects may be increased by diflunisal
• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), angiotensin receptor blockers (eg, losartan), or diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by diflunisal

This may not be a complete list of all interactions that may occur. Ask your health care provider if diflunisal may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Dosage

Usual Adult Dose for Pain

Initial: 1000 mg orally one time.

Maintenance: 500 mg orally every 12 hours. Some patients may require 500 mg every 8 hours.

Usual Adult Dose for Osteoarthritis

250 to 500 mg orally twice a day.
The dosage may be increased or decreased according to patient response. Maintenance doses higher than 1500 mg/day are not recommended

Usual Adult Dose for Rheumatoid Arthritis

250 to 500 mg orally twice a day.
The dosage may be increased or decreased according to patient response. Maintenance doses higher than 1500 mg/day are not recommended

 Side Effect
In addition to its needed effects, some unwanted effects may be caused by diflunisal. In the event that any of these side effects do occur, they may require medical attention.
You should check with your doctor immediately if any of these side effects occur when taking diflunisal:
More common

• Stomach cramps or pain

Less common

• Back or leg pains
• bleeding gums
• blistering, peeling, loosening of skin
• bloody or black, tarry stools
• bloody or cloudy urine
• blurred or loss of vision
• burning feeling in chest or stomach
• burning while urinating
• clay-colored stools
• constipation
• cough or hoarseness
• cracks in the skin
• dark-colored urine
• diarrhea
• difficult or painful urination
• difficulty breathing
• difficulty swallowing
• disturbed color perception
• dizziness
• double vision
• facial swelling
• fast heartbeat
• feeling of warmth
• fever with or without chills
• flu-like symptoms
• general body swelling
• general feeling of tiredness or weakness
• greatly decreased frequency of urination or amount of urine
• halos around lights
• headache
• hives
• increased blood pressure
• increased thirst
• indigestion
• itching
• joint or muscle pain
• large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
• light-colored stools
• liver function abnormalities
• loss of appetite
• loss of heat from the body
• lower back or side pain
• muscle aches, pains, or weakness
• nausea or vomiting
• night blindness
• noisy breathing
• nosebleeds
• overbright appearance of lights
• pale skin
• pinpoint red spots on skin
• puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
• red, irritated eyes
• redness of the face, neck, arms and occasionally, upper chest
• red skin lesions, often with a purple center
• red, swollen skin
• scaly skin
• severe or continuing stomach pain
• shortness of breath
• skin rash
• sores, ulcers, or white spots in mouth or on lips
• sore throat
• stomach upset
• swelling of face, fingers, feet or lower legs
• swollen lymph nodes
• tenderness in stomach area
• tightness in chest
• troubled breathing
• tunnel vision
• unpleasant breath odor
• unusual bleeding or bruising
• unusual tiredness or weakness
• upper right abdominal pain
• vomiting of blood or material that looks like coffee grounds
• weight gain
• wheezing
• yellow eyes or skin

Symptoms of overdose

• Change in consciousness
• confusion about identity, place, and time
• continuing ringing or buzzing or other unexplained noise in ears
• decreased awareness or responsiveness
• deep or fast breathing with dizziness
• fast, pounding, or irregular heartbeat or pulse
• hearing loss
• loss of consciousness
• numbness of feet, hands, and around mouth
• severe sleepiness
• sweating

Some of the side effects that can occur with diflunisal may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
More common

• Acid or sour stomach
• belching
• heartburn
• indigestion
• stomach discomfort or upset

Less common

• Bloated, full feeling
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• discouragement
• dry mucous membranes
• excess air or gas in stomach or intestines
• feeling of constant movement of self or surroundings
• feeling sad or empty
• increased sensitivity of skin to sunlight
• irritability
• lack or loss of strength
• lightheadedness
• loss of interest or pleasure
• mood or mental changes
• nervousness
• passing gas
• seeing, hearing, or feeling things that are not there
• sensation of spinning
• severe sunburn
• sleeplessness
• swelling or inflammation of the mouth
• tiredness
• trouble concentrating
• trouble sleeping
• unable to sleep
• weight loss

Diclofenac

Voltaren (diclofenac)

Indication

Carefully consider the potential benefits and risks of Voltaren® (diclofenac sodium enteric-coated tablets) and other treatment options before deciding to use Voltaren (diclofenac sodium) . Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals (see WARNINGS).
Voltaren (diclofenac sodium) is indicated:

• For relief of the signs and symptoms of osteoarthritis
• For relief of the signs and symptoms of rheumatoid arthritis
• For acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis

Drugs Description

Voltaren® (diclofenac sodium enteric-coated tablets) is a benzene-acetic acid derivative. Voltaren (diclofenac sodium) is available as delayed-release (enteric-coated) tablets of 75 mg (light pink) for oral administration. The chemical name is 2-[(2,6-dichlorophenyl)amino] benzeneacetic acid, monosodium salt. The molecular weight is 318.14. Its molecular formula is C₁₄H₁₀Cl₂NNaO₂, and it has the following structural formula

The inactive ingredients in Voltaren (diclofenac sodium) include: hydroxypropyl methylcellulose, iron oxide, lactose, magnesium stearate, methacrylic acid copolymer, microcrystalline cellulose, polyethylene glycol, povidone, propylene glycol, sodium hydroxide, sodium starch glycolate, talc, titanium dioxide.

Dosage

Carefully consider the potential benefits and risks of Voltaren® (diclofenac sodium) (diclofenac sodium enteric-coated tablets) and other treatment options before deciding to use Voltaren (diclofenac sodium) . Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals (see WARNINGS).
After observing the response to initial therapy with Voltaren (diclofenac sodium) , the dose and frequency should be adjusted to suit an individual patient's needs.
For the relief of osteoarthritis, the recommended dosage is 100-150 mg/day in divided doses (50 mg b.i.d. or t.i.d., or 75 mg b.i.d.).
For the relief of rheumatoid arthritis, the recommended dosage is 150-200 mg/day in divided doses (50 mg t.i.d. or q.i.d., or 75 mg b.i.d.).
For the relief of ankylosing spondylitis, the recommended dosage is 100-125 mg/day, administered as 25 mg q.i.d., with an extra 25-mg dose at bedtime if necessary.
Different formulations of diclofenac [Voltaren® (diclofenac sodium enteric-coated tablets); Voltaren®-XR (diclofenac sodium extended-release tablets); Cataflam® (diclofenac potassium immediate-release tablets)] are not necessarily bioequivalent even if the milligram strength is the same.

Side Effect

Voltaren (diclofenac) is an oral nonsteroidal anti-inflammatory drug (NSAID) used for the treatment of pain, fever, and inflammation by reducing the production of prostaglandins. Voltaren is used primarily for the treatment of inflammation and pain caused by conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Most common side effects of Voltaren are upset stomach, heartburn, stomach pain, diarrhea, constipation, bloating, gas, ulcers, dizziness, headache, nervousness, skin itching or rash, blurred vision, or ringing in the ears.
Voltaren should be taken with food to reduce stomach upset. Potential drug interactions include lithium (Eskalith, Lithobid), blood pressure medications, methotrexate (Rheumatrex, Trexall), certain antibiotics, and anticoagulants. Like other NSAIDs, Voltaren is generally avoided during pregnancy because it may affect the cardiovascular system of the fetus. It is not known whether Voltaren is excreted in breast milk.
Our Voltaren Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to

Patient Information Side Effect
Voltaren (diclofenac) is an oral nonsteroidal anti-inflammatory drug (NSAID) used for the treatment of pain, fever, and inflammation by reducing the production of prostaglandins. Voltaren is used primarily for the treatment of inflammation and pain caused by conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Most common side effects of Voltaren are upset stomach, heartburn, stomach pain, diarrhea, constipation, bloating, gas, ulcers, dizziness, headache, nervousness, skin itching or rash, blurred vision, or ringing in the ears.
Voltaren should be taken with food to reduce stomach upset. Potential drug interactions include lithium (Eskalith, Lithobid), blood pressure medications, methotrexate (Rheumatrex, Trexall), certain antibiotics, and anticoagulants. Like other NSAIDs, Voltaren is generally avoided during pregnancy because it may affect the cardiovascular system of the fetus. It is not known whether Voltaren is excreted in breast milk.
Our Voltaren Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to

Bromfenac

Bromfenac

Generic Name: bromfenac (BROME-fen-ak)
Brand Name: Examples include Bromday and Xibrom

Used For

Treating eye pain and swelling in patients who have recently had surgery to remove cataracts. It may also be used for other conditions as determined by your doctor.

Bromfenac is a nonsteroidal anti-inflammatory drug (NSAID) eye drop. It works by blocking the production of prostaglandin, a substance that causes inflammation (eg, redness, swelling, irritation).

Do Not Use If

• you are allergic to any ingredient in bromfenac
• you are in late pregnancy

Contact your doctor or health care provider right away if any of these apply to you.

Before Using

Some medical conditions may interact with bromfenac. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to sulfites, aspirin or any medicine containing aspirin, an NSAID (eg, ibuprofen), or a phenylacetic acid derivative
• if you have asthma, diabetes, bleeding problems, or rheumatoid arthritis
• if you have other eye problems (eg, dry eye syndrome, cornea problems), have had complicated eye surgery, or have had repeated eye surgeries within a short period of time

Some MEDICINES MAY INTERACT with bromfenac. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anticoagulants (eg, warfarin) or heparin because the risk of bleeding may be increased
• Corticosteroids (eg, prednisolone) because healing may be slowed or delayed

This may not be a complete list of all interactions that may occur. Ask your health care provider if bromfenac may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

 Dosage

Usual Adult Dose for Postoperative Ocular Inflammation

For the treatment of postoperative inflammation and reduction of ocular pain in patients who have undergone cataract surgery:
Bromday (bromfenac ophthalmic solution 0.09%) and Prolensa (bromfenac ophthalmic solution 0.07%) :
- one drop applied to the affected eye(s) once daily beginning 1 day prior to cataract surgery, continued on the day of surgery, and through the first 14 days of the postoperative period.

Bromfenac ophthalmic, like most topical nonsteroidal anti-inflammatory agents may increase the risk for the occurrence and severity of corneal adverse events if instilled more than 24 hours prior to and longer than 2 weeks following cataract surgery.

Side Effect
Applies to bromfenac ophthalmic: ophthalmic solution
In addition to its needed effects, some unwanted effects may be caused by bromfenac ophthalmic. In the event that any of these side effects do occur, they may require medical attention.
You should check with your doctor immediately if any of these side effects occur when taking bromfenac ophthalmic:
More common

• Blurred vision
• change in color vision
• decreased vision or other changes in vision
• difficulty seeing at night
• eye pain
• red, sore eyes
• sensitivity to light
• tearing

Some of the side effects that can occur with bromfenac ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
More common

• Abnormal sensation in the eye
• burning or stinging of the eye
• feeling of having something in the eye
• headache
• itching of the eyes

Type of pain

Types of pain

Acute pain - this can be intense and short-lived, in which case we call it acute pain. Acute pain may be an indication of an injury. When the injury heals the pain usually goes away.

Chronic pain - this sensation lasts much longer than acute pain. Chronic pain can be mild or intense (severe).

How do we classify pain?

Pain can be nociceptive, non-nociveptive, somatic, visceral, neuropathic, or sympathetic:

• Nociceptive Pain
  - Somatic
  - Visceral


• Non-Nociceptive
  - Neuropathic
  - Sympathetic

Nociceptive Pain - specific pain receptors are stimulated. These receptors sense temperature (hot/cold), vibration, stretch, and chemicals released from damaged cells.

Somatic Pain - a type of nociceptive pain. Pain felt on the skin, muscle, joints, bones and ligaments is called somatic pain. The term musculo-skeletal pain means somatic pain. The pain receptors are sensitive to temperature (hot/cold), vibration, and stretch (in the muscles). They are also sensitive to inflammation, as would happen if you cut yourself, sprain something that causes tissue damage.

Pain as a result of lack of oxygen, as in ischemic muscle cramps, are a type of nociceptive pain. Somatic pain is generally sharp and well localized - if you touch it or move the affected area the pain will worsen.

Visceral Pain - a type of nociceptive pain. It is felt in the internal organs and main body cavities. The cavities are divided into the thorax (lungs and heart), abdomen (bowels, spleen, liver and kidneys), and the pelvis (ovaries, bladder, and the womb). The pain receptors - nociceptors - sense inflammation, stretch and ischemia (oxygen starvation).
to be a vague deep ache. Colicky and cramping sensations are generally types of visceral pain. Visceral pain commonly refers to some type of back pain - pelvic pain generally refers to the lower back, abdominal pain to the mid-back, and thoracic pain to the upper back (see below for the meaning of referred pain).

Nerve Pain or Neuropathic Pain

Nerve pain is also known as neuropathic pain. It is a type of non-nociceptive pain. It comes from within the nervous system itself. People often refer to it as pinched nerve, or trapped nerve. The pain can originate from the nerves between the tissues and the spinal cord (peripheral nervous system) and the nerves between the spinal cord and the brain (central nervous system, or CNS).

Neuropathic pain can be caused by nerve degeneration, as might be the case in a stroke, multiple-sclerosis, or oxygen starvation. It could be due to a trapped nerve, meaning there is pressure on the nerve. A torn or slipped disc will cause nerve inflammation, which will trigger neuropathic pain. Nerve infection, such as shingles, can also cause neuropathic pain.

Pain that comes from the nervous system is called non-nociceptive because there are no specific pain receptors. Nociceptive in this text means responding to pain. When a nerve is injured it becomes unstable and its signaling system becomes muddled and haphazard. The brain interprets these abnormal signals as pain. This randomness can also cause other sensations, such as numbness, pins and needles, tingling, and hypersensitivity to temperature, vibration and touch. The pain can sometimes be unpredictable because of this.

Sympathetic Pain

The sympathetic nervous system controls our blood flow to our skin and muscles, perspiration (sweating) by the skin, and how quickly the peripheral nervous system works.

Sympathetic pain occurs generally after a fracture or a soft tissue injury of the limbs. This pain is non-nociceptive - there are no specific pain receptors. As with neuropathic pain, the nerve is injured, becomes unstable and fires off random, chaotic, abnormal signals to the brain, which interprets them as pain.

Generally with this kind of pain the skin and the area around the injury become extremely sensitive. The pain often becomes so intense that the sufferer daren't use the affected arm or leg. Lack of limb use after a time can cause other problems, such as muscle wasting, osteoporosis, and stiffness in the joints. 

pain

PAIN 

 What is pain?

 In medicine pain relates to a sensation that hurts. If you feel pain it hurts, you feel discomfort, distress and perhaps agony, depending on the severity of it. Pain can be steady and constant, in which case it may be an ache. It might be a throbbing pain - a pulsating pain. The pain could have a pinching sensation, or a stabbing one.
The English word 'pain' probably comes from Old French (peine), Latin (poena - meaning punishment pain), or Ancient Greek (poine - a word more related to penalty), or a combination of all three.

Only the person who is experiencing the pain can describe it properly. Pain is a very individual experience.

The NIH (National Institutes of Health) National Pain Consortium estimates that the public health burden of pain affects one third of America's population at a cost of between $560 billion and $635 billion each year.

The British Pain Society quoted England's Chief Medical Officer, who said that annually more than five million people in the UK develop chronic pain. Unfortunately, one third of them do not recover. 11% of adults and 8% of children in the UK suffer severe pain.