Relafen Precautions and Warnings (Cont.)

• There are certain other medications that Relafen can interact with (see Relafen Drug Interactions).
   
• All NSAIDs, including Relafen, have been reported to cause cardiovascular events such as a heart attack or stroke, both of which can result in loss of life. People with cardiovascular disease or who have risk factors for cardiovascular disease appear to be at greater risk.

To reduce the risk of experiencing these problems, you are recommended to take the smallest effective dose for the shortest period of time. Also, call 911 or an ambulance if you notice things such as chest pain, shortness of breath, weakness, and slurring of speech.

• All NSAIDs, including Relafen, may worsen high blood pressure or cause high blood pressure. Relafen should be used with caution in people with known high blood pressure.
   
• All NSAIDs, including Relafen, may cause congestive heart failure or swelling. Make sure to contact your healthcare provider if you notice unexplained weight gain or swelling. Also, Relafen should be used with caution in people with heart failure.
   
• All NSAIDs, including Relafen, have been reported to cause problems in the stomach and intestines, including bleeding (known as gastrointestinal bleeding), stomach ulcers, or holes in the stomach or intestines. These problems can lead to serious complications or even loss of life. Extreme caution should be used if Relafen is prescribed to people with a history of ulcers or gastrointestinal bleeding.

To reduce the risk of experiencing these problems, you are recommended to take the smallest effective dose for the shortest period of time. Make sure to contact your healthcare provider immediately if you experience any signs or symptoms of stomach ulcers or bleeding, including:

o Stomach pain

o Indigestion

o Black, tarry stools

o Vomiting blood.

• People taking NSAIDs, including Relafen, can experience kidney damage. It is more common in the elderly and people with kidney disease, heart failure, or liver problems. It is also more common in those taking diuretics or ACE inhibitors.

   
• People taking Relafen can experience liver damage. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain, or flu-like symptoms.
   
• NSAIDs, including Relafen, have been reported to cause allergic reactions. Seek emergency medical attention immediately if you notice things such as difficulty breathing or swelling of the face and throat.
   
• In rare cases, people taking Relafen can develop a very serious rash. If you notice an unexplained rash or blisters, fever, or itchy skin, stop taking the Relafen and call your healthcare provider.
   
• If you are an alcoholic or drink alcohol frequently, discuss this with your healthcare provider prior to starting Relafen. Alcohol can affect the way the liver works, indirectly affecting the Relafen.
   
• NSAIDS have been known to cause an increase in liver enzymes. Therefore, it is recommended that you have a blood test that looks at your liver function before starting Relafen and 12 weeks after treatment has started.
   
• Relafen has been known to cause anemia. If you are taking Relafen for an extended amount of time and show signs of anemia, talk with your healthcare provider.
   
• Relafen may increase your sensitivity to the sun. Therefore, when going outside try wearing long sleeves, pants, and a hat. Any exposed skin should be covered with sunscreen that is at least SPF 15.
   
• You should not take Relafen with any other NSAID, as this may increase your risk of any of the problems discussed above. There are many NSAIDs available with or without a prescription; make sure to read labels carefully. Some examples of NSAIDs are ibuprofen (Motrin^®, Advil^®), naproxen (Aleve^®, Anaprox^®, Naprosyn^®, and Naprelan^®), celecoxib (Celebrex^®), ketoprofen (Orudis^®, Oruvail^®), etodolac (Lodine^®, Lodine XL), diclofenac (Cataflam^®, Voltaren^®), meloxicam (Mobic^®), and others. You can ask your doctor or pharmacist for a complete list of these medications.
   
• Relafen is a pregnancy Category C medicine, meaning that Relafen could potentially cause harm to your unborn child. If you are pregnant, you should take Relafen only if the benefits outweigh the possible risks to your unborn child. Relafen is not recommended for women in the third trimester of pregnancy because it can cause injury (and even death) to the developing fetus. If you become pregnant while taking Relafen, contact your healthcare provider immediately (see Relafen and Pregnancy for more information).
   
• If you are nursing, you are recommended not to take Relafen. Therefore, if you are taking Relafen, talk with your healthcare provider about whether to stop nursing or stop taking Relafen.