ST. LOUIS–(BUSINESS WIRE)–The American College of Rheumatology (ACR) Subcommittee on Osteoarthritis Guidelines has approved and issued several updates to clinical practice guidelines for the treatment of osteoarthritis (OA).

“We support the ACR treatment guidelines and believe topical NSAIDs, like PENNSAID, provide an effective option for reducing knee OA pain.”

the new guidelines, published in the April issue of Arthritis Care & Research, conditionally recommend that healthcare providers consider topical nonsteroidal anti-inflammatory drugs (NSAIDs) as one option for the initial management of knee OA, along with other treatments including acetaminophen, oral NSAIDs, tramadol and intraarticular corticosteroid injections. In addition, the guidelines strongly recommend the use of oral or topical NSAIDs or intraarticular corticosteroid injections in patients with an unsatisfactory clinical response to full-dose acetaminophen, and furthermore strongly recommend topical over oral NSAIDs in those patients aged 75 years or older initiating NSAID therapy.1

Commenting on the new guidelines, Marc C. Hochberg, MD, MPH, said, “Osteoarthritis is the most common form of arthritis affecting adults in the United States and is the principal cause of musculoskeletal pain, limitation in physical activity and reduction in health-related quality of life. it is important for all primary care providers and specialists taking care of patients with osteoarthritis to recognize that there is a lot that can be offered to the patient to reduce their pain and improve their function.” Dr. Hochberg is professor of medicine and epidemiology and public health, University of Maryland School of Medicine, Baltimore, and chair of the Task Force that developed the new ACR recommendations.

Knee OA is a chronic condition in which joint cartilage–the smooth tissue that cushions the bone and allows easy joint movement–breaks down, leading to pain and loss of physical function.2 Mallinckrodt LLC, a Covidien company, markets PENNSAID® (diclofenac sodium topical solution) 1.5% w/w, a topical NSAID. PENNSAID is the only U.S. Food and Drug Administration (FDA)-approved topical NSAID for the treatment of the signs and symptoms of knee OA, which demonstrated statistically significant differences in pain and physical function compared to placebo.

“Knee OA pain is one of the top five causes of disability in American adults,” said Alfredo Bozzini, Interim Chief Medical Officer, Pharmaceuticals, Covidien. “We support the ACR treatment guidelines and believe topical NSAIDs, like PENNSAID, provide an effective option for reducing knee OA pain.”

“The American College of Rheumatology osteoarthritis treatment guidelines propose to advance the use of topical NSAIDs beyond what the American Geriatric Society and American Academy of Orthopedic Surgeons recommend,” said Dr. Joseph Markenson, attending physician at the Hospital for Special Surgery and professor of clinical medicine at Weill Cornell Medical College. “The updated guidelines are helpful to physicians in their clinical practice, especially when seeing patients over 75 years of age.”

For Important Risk Information on PENNSAID, including boxed warning, see below.

About Osteoarthritis

OA is a chronic condition characterized by the breakdown of cartilage in the joint. Cartilage cushions the ends of the bones in joints – such as knees, hands, elbows, wrists, ankles and feet – which allows for easy movement. When this cartilage erodes, bones can rub together, resulting in pain and loss of free movement in the joint. Today, an estimated 27 million Americans live with OA.2

the most common symptoms include pain, joint soreness, stiffness and deterioration of overall coordination, posture and walking. Despite the high prevalence of OA, there is no cure for this disease, which tends to progressively reduce mobility and the overall health state in affected patients.

About PENNSAID®

PENNSAID is the only FDA-approved topical NSAID for the treatment of knee OA which demonstrated statistically significant differences in all three primary efficacy endpoints: pain and physical function (WOMAC®), patient overall health assessment (POHA) and patient global assessment of knee OA.

INDICATION

PENNSAID is a nonsteroidal anti-inflammatory drug (NSAID) indicated for the treatment of signs and symptoms of osteoarthritis of the knee(s).

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WARNING: CARDIOVASCULAR AND GASTROINTESTINAL RISK

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Cardiovascular Risk

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• Non-steroidal anti-inflammatory drugs (NSAIDs) may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. this risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.

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• PENNSAID is contraindicated in the perioperative setting of coronary artery bypass graft (CABG) surgery.

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Gastrointestinal Risk

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• NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events.

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IMPORTANT RISK INFORMATION

PENNSAID is also contraindicated in patients:

• with a known hypersensitivity to diclofenac sodium or any other component of PENNSAID
• who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal anaphylactic-like reactions to NSAIDs have been reported in such patients.

Elevation of one or more liver tests may occur during therapy with NSAIDs. PENNSAID should be discontinued immediately if abnormal liver tests persist or worsen.

use with caution in patients with fluid retention or heart failure. Hypertension can occur with NSAID treatment. Monitor blood pressure closely with PENNSAID treatment.

Long-term administration of NSAIDs can result in renal papillary necrosis and other renal injury.

use PENNSAID with caution in patients at greatest risk of this reaction, including the elderly, those with impaired renal function, heart failure, liver dysfunction, and those taking diuretics and ACE-inhibitors.

should not be used in pregnant or lactating women and is not approved for use in pediatric patients.

Anaphylactoid reactions may occur in patients without prior exposure to PENNSAID. NSAIDs can cause serious skin adverse events such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal.

the most common treatment-related adverse events in patients receiving PENNSAID were application site skin reactions including dry skin (32%), contact dermatitis characterized by skin erythema and induration (9%), contact dermatitis with vesicles (2%) and pruritus (4%). In a long term safety study, contact dermatitis occurred in 13% and contact dermatitis with vesicles in 10% of patients, generally within the first 6 months of exposure, leading to a withdrawal rate for an application site event of 14%. Other common adverse events greater than placebo include: dyspepsia (9%), abdominal pain (6%), flatulence (4%), diarrhea (4%) and nausea (4%).

do not apply to open wounds. Protect treated knee(s) from natural or artificial sunlight. Topicals such as sunscreen and bug repellant may be applied after PENNSAID treated knee(s) are completely dry. Avoid contact of PENNSAID with eyes and mucous membranes. Wash and dry hands after use. Concurrent use with oral NSAIDs should be avoided unless benefit outweighs risk and periodic laboratory evaluations are conducted.

you are encouraged to report negative side effects of prescription drugs to the FDA. Visit fda.gov/medwatch or call 1-800-FDA-1088.

PENNSAID is a registered trademark of Nuvo Research inc.

WOMAC is a registered trademark of Nicholas Bellamy.

ABOUT COVIDIEN

Covidien is a leading global healthcare products company that creates innovative medical solutions for better patient outcomes and delivers value through clinical leadership and excellence. Covidien manufactures, distributes and services a diverse range of industry-leading product lines in three segments: Medical Devices, Pharmaceuticals and Medical Supplies. With 2011 revenue of $11.6 billion, Covidien has 41,000 employees worldwide in more than 65 countries, and its products are sold in over 140 countries. please visit covidien.com to learn more about our business.

1 Hochberg M, Altman R, et al. American College of Rheumatology 2012 Recommendations for the use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research. 2012;64:465-474.

2 Arthritis Foundation. Osteoarthritis Fact Sheet. arthritis.org/media/newsroom/media-kits/Osteoarthritis_fact_sheet.pdf [Last Accessed January 10, 2012]

The Swiss  Pharmacy has announced  a  15% discount offer on Generic Voltaren Tablets . The  50 mg tablets    are now available for only US $ 0.22   a pill  when you order  360 tablets,  whereas 100mg tablets of Generic Voltaren (Voveran tablets) are now available at       0.34 US $ a pill.  you can place an order Online for a minimum of 30 tablets.   this offer is valid only till 31st may 2011.  Generic Voltaren Tablets  (Voveran tablets) are used for the  treatment of  musculoskeletal complaints, especially arthritis, for relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis,  polymyositis, dermatomyositis,osteoarthritis, dental pain, TMJ, spondylarthritis, for acute or long-term use in the relief of signs and symptoms of ankylosing spondylitis, gout attacks, and pain management in cases of kidney stones and gallstones.  Voltaren  (diclofenac sodium enteric-coated tablets) is a benzene-acetic acid derivative. Generic Voltaren  is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic, and antipyretic activities.Generic Voltaren   is contraindicated in patients with known hypersensitivity to diclofenac. Voltaren should not be given to patients who have experienced asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs.  Voltaren is also contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery. In patients taking  Generic Voltaren  (diclofenac sodium enteric-coated tablets),   the most frequently reported adverse experiences occurring in approximately 1%-10% of patients are:Gastrointestinal experiences including: abdominal pain, constipation, diarrhea, dyspepsia, flatulence, gross bleeding/perforation, heartburn, nausea, GI ulcers (gastric/duodenal) and vomiting.Abnormal renal function, anemia, dizziness, edema, elevated liver enzymes, headaches, increased bleeding time, pruritus, rashes and tinnitus.  In case of  an  acute   overdose of Generic Voltaren symptoms   that occur   are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can also occur.The dose and frequency should be adjusted to suit an individual patient’s needs after observing the initial reaction to Generic Voltaren. The lowest effective dose forthe shortest duration consistent with individual patient treatment goals  should be used.  For the relief of osteoarthritis as well  as rheumatoid arthritis,  the recommended dosage is 100-150 mg/day in divided doses.  The Generic Voltaren  tablets supplied by the Swiss Pharmacy are   Voveran manufactured by Novartis, the holder of the original patent.  For more information please refer to theswisspharmacy.com/product_info.php?info=p9624_Voltaren-XR-100-Pills.html you can purchase Generic Voltaren Tablets  from The Swiss Pharmacy

Do you frequently suffer from stomach upsets? is your stomach always causing you trouble. if yes, then you could be suffering from gastritis. Find out what are the causes and symptoms of Gastritis by reading further.

Gastritis is the inflammation of mucosal layer lining the stomach. It is usually caused due faulty eating habits. Eating unhygienic stale food, very spicy, oily or fatty food can cause gastritis.

Other common causes of gastritis are excessive alcohol consumption, excessive tobacco intake in any form. even drinking excessive tea and coffee can cause gastritis. Infection by H pylori bacteria is also stated as a cause of Gastritis.

People who are anxious, get easily stressed are prone to recurrent gastritis. Whenever they undergo emotional stress, they usually land up into gastritis. also long term intake of NSAIDs is responsible for destruction of the mucosal lining and may cause gastritis. Broad spectrum antibiotics in high dosage cause gastritis in some persons. Genetic predisposition is seen in some persons.

Symptoms of gastritis are nausea, heartburn, vomiting, and pain. Gastritis can be acute or chronic. Acute gastritis is usually severe in intensity and lasts for a shorter duration. Chronic gastritis may be mild or severe but there are recurrences. Ulcers form in chronic gastritis along the lining of the stomach. These ulcers are responsible for recurrences as the ulcer does not heal completely after an attack.

Nausea is always present. Vomiting is frequent in acute gastritis. It may or may not be present in chronic gastritis. if present, it may be mixed with blood. There is uneasy sensation just behind the breast bone or behind the ribs of left side. Heat sensation is marked. It is also called heartburn. Pain is boring, pricking, or spasmodic in nature.

Depending on the type of ulcer present, the symptoms vary in nature. Peptic or duodenal ulcers are two types of ulcer that can be present in stomach in chronic gastritis. If peptic ulcers are present, then pain occurs immediately or up to one hour of food intake and is not present at night. if its duodenal ulcer, it occurs 3 hours after food intake and it is characteristically present at midnight.

Mild to moderate acute gastritis can be treated with home remedies but chronic gastritis needs to be investigated for presence of ulcer.