Gastrointestinal Bleeding, Ulceration, and Perforation VOLTAREN GEL is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.This risk may occur early in treatment and may increase with duration of use. Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS Digoxin: Concomitant use with VOLTAREN GEL can increase serum concentration and prolong half-life of digoxin.Monitor patients to assure diuretic efficacy including antihypertensive effects ( 7) Diuretics: NSAIDs can reduce natriuretic effect of furosemide and thiazide diuretics.In such high risk patients, monitor for signs of worsening renal function ( 7) ACE Inhibitors and ARBs: Concomitant use with VOLTAREN GEL in elderly, volume depleted, or those with renal impairment may result in deterioration of renal function.ACE Inhibitors, Angiotensin Receptor Blockers (ARB), or Beta-Blockers: Concomitant use with VOLTAREN GEL may diminish the antihypertensive effect of these drugs.Concomitant use of VOLTAREN GEL and analgesic doses of aspirin is not generally recommended ( 7) warfarin, aspirin, SSRIs/SNRIs): Monitor patients for bleeding who are concomitantly using VOLTAREN GEL with drugs that interfere with hemostasis. ![]() Drugs that Interfere with Hemostasis (e.g.Hematologic Toxicity: Monitor hemoglobin or hematocrit in patients with any signs or symptoms of anemia ( 5.11, 7).Premature Closure of Fetal Ductus Arteriosus: Avoid use in pregnant women starting at 30 weeks gestation.Serious Skin Reactions: Discontinue VOLTAREN GEL at first appearance of rash or other signs of hypersensitivity ( 5.9).Monitor patients with preexisting asthma (without aspirin sensitivity) ( 5.8) ![]()
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