Panamor 1,292 g/100 g Gel

PANAMOR GEL belongs to a group of medicines called non - steroidal anti - inflammatory drugs. PANAMOR GEL has anti - inflammatory and analgesic properties. PANAMOR GEL is used to relieve pain and reduce swelling in painful conditions affecting joints and muscles, for example sprains, strains and bruises.

Do not use PANAMOR GEL :

• if you are hypersensitive (allergic) to diclofenac and other non - steroidal anti - inflammatory medicines or any of the other ingredients of PANAMOR GEL (listed in section 6).
• if you are using other NSAIDSs e.g. aspirin or other medicines containing diclofenac.
• if you have a condition called porphyria.
• if you have heart failure, established heart disease and/or cerebrovascular disease, e.g. if you have had a heart attack or stroke.
• if you have now, or have ever had, a stomach (gastric) or duodenal (peptic) ulcer, or bleeding in the digestive tract (this can include vomiting blood, bleeding when emptying bowels, fresh blood in faeces or black, tarry faeces).
• if you have asthma and experience attacks of asthma after taking acetylsalicylic acid or other NSAIDs.
• if you are pregnant and or breastfeeding your baby (see Pregnancy, breastfeeding and fertility).

Always apply PANAMOR GEL exactly as your healthcare provider has instructed you. Check with your doctor or pharmacist if you are unsure. Do not share medicines prescribed for you with any other person. Confine the use of PANAMOR GEL to adults and adolescents over 14 years of age only as the safety and efficacy has not yet been established in children. Use the lowest effective dose for the shortest possible duration of treatment.

Apply PANAMOR GEL depending on the size of the affected area. Apply 2 g to 4 g PANAMOR GEL (1 to 2 fingertips) 3 to 4 times daily. The gel should then be rubbed in gently or massaged into the skin in the case of muscular pain. After application, the hands should be washed, unless they are the area being treated. If you have the impression that the effect of PANAMOR GEL is too strong or too weak, tell your doctor or pharmacist. You should consult your doctor if your condition does not improve or worsens within 7 days of starting treatment. The duration of treatment depends on the indication and the response obtained. It is recommended that treatment be reviewed after 2 weeks.

If you use more PANAMOR GEL than you should In the event of overdosage, consult your doctor or pharmacist. If neither is available, contact the nearest hospital or poison control centre. If you forget to use PANAMOR GEL Do not use a double dose to make up for forgotten individual doses.

PANAMOR GEL can have side effects. Not all side effects reported for PANAMOR GEL are included in this leaflet. Should your general health worsen or if you experience any untoward effects while using PANAMOR GEL, please consult your healthcare provider for advice.

If any of the following happens, stop using PANAMOR GEL and tell your doctor immediately or go to the casualty department at your nearest hospital :

• swelling of the hands, feet, ankles, face, lips, mouth or throat, which may cause difficulty in swallowing or breathing,
• rash or itching,
• fainting,
• blistering of the skin, mouth, eyes and genitals, as these may be due to a serious allergic reaction known as Stevens - Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN).

These are all very serious side effects. If you have them, you may have had a serious allergic reaction to PANAMOR GEL. You may need urgent medical attention or hospitalisation.

Tell your doctor immediately or go to the casualty department at your nearest hospital if you notice any of the following:

• fever, chills, swelling, sore throat, fatigue, which may be signs of an infection due to low white blood cell count (leucopenia, agranulocytosis, neutropenia),
• decreased number of new red blood cells which can make the skin pale and cause weakness or breathlessness (aplastic anaemia),
• rapid or irregular heartbeat, reduced ability to exercise, wheezing, a cough that doesn't go away or a cough that brings up white or pink mucus with spots of blood (heart failure),
• any sign of ulcers or bleeding in the stomach or intestine, for example, when emptying your bowels, vomiting of blood or black, tarry feces,
• worsening of colitis and Crohn’s disease,
• fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light - colored stools, joint pain (hepatitis), yellowing of skin and the whites of your eyes, also called jaundice,
• kidney disease or failure,
• extensive changes in the skin with the appearance of redness, scaling, and large bubbles (bullous dermatitis),
• swelling around eyes, ankles and feet, foamy urine, weight gain (nephrotic syndrome).

These are all serious side effects. You may need urgent medical attention.

Tell your doctor if you notice any of the following:

Frequent side effects:

• vomiting (being sick), passing of wind (flatulence),
• constipation (irregular and infrequent or difficult evacuation of the bowels),
• dyspepsia (painful, difficult, or disturbed digestion), stomach pain,
• ulcerative stomatitis (characterised by swollen spongy gums, ulcers, and loose teeth),
• itchiness, dry skin, rash, redness of the skin (eczema).

Less frequent side effects:

• headache, dizziness,
• high blood pressure, accumulation of fluid in the leg (peripheral oedema),
• increased sensitivity of the skin to sunlight,
• difficulty in breathing, chest tightness or pain, wheezing (symptoms of asthma).

Frequency unknown:

• the oral ejection of gas or air from the stomach known as belching (eructation), diarrhoea,
• burning sensation at the application site, skin peeling (desquamation),
• elevated liver enzyme levels (seen on blood tests),
• discolouration of skin.

If you notice any side effects not mentioned in this leaflet, please inform your doctor or pharmacist.

Store all medicines out of reach of children. Store at or below 25 ºC, in a dry place. Do not store in a bathroom. Do not use after the expiry date stated on the label. Return all unused medicine to your pharmacist.

Do not dispose of unused medicine in drains or sewerage systems (e.g. toilets).