Nalfon is a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat mild to moderate pain, osteoarthritis, or rheumatoid arthritis.

Nalfon may also be used for purposes not listed in this medication guide.

Nalfon can increase your risk of fatal heart attack or stroke. Do not use Nalfon just before or after heart bypass surgery (coronary artery bypass graft, or CABG). This medicine may also cause stomach or intestinal bleeding, which can be fatal.

Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.

You may take Nalfon with food or milk.

If you use this medicine long-term, you may need frequent medical tests.

It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Nalfon.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Nalfon can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Nalfon may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults.

You should not use Nalfon if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Tell your doctor if you have ever had:

• heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;

• a heart attack, stroke, or blood clot;

• stomach ulcers or bleeding;

• asthma;

• fluid retention;

• liver or kidney disease; or

• if you take aspirin to prevent heart attack or stroke.

If you are pregnant, you should not take Nalfon unless your doctor tells you to. Taking an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.

You should not breastfeed while using Nalfon.

Nalfon is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include drowsiness, vomiting, stomach pain, or stomach bleeding.

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to Nalfon (such as ibuprofen, ketoprofen, or naproxen).

Avoid taking aspirin unless your doctor tells you to.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Ask your doctor before using an antacid, and use only the type your doctor recommends. Some antacids can make it harder for your body to absorb Nalfon.

Get emergency medical help if you have signs of an allergic reaction (hives, runny or stuffy nose, wheezing, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, swelling in your legs, feeling short of breath.

Nalfon may cause serious side effects. Stop using Nalfon and call your doctor at once if you have:

• changes in your vision;

• any skin rash, no matter how mild;

• shortness of breath (even with mild exertion);

• swelling or rapid weight gain;

• signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

• liver problems--nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• kidney problems--little or no urination, swelling in your feet or ankles, feeling tired; or

• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed, cold hands and feet.

Common side effects of Nalfon may include:

• nausea, vomiting, stomach pain, indigestion;

• diarrhea, constipation;

• headache, dizziness, drowsiness, tiredness;

• feeling nervous;

• itching, sweating; or

• ringing in your ears.

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 FDA at 1-800-FDA-1088.

Ask your doctor before using Nalfon if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your other medicines, especially:

• cyclosporine;

• lithium;

• methotrexate;

• a blood thinner (warfarin, Coumadin, Jantoven);

• heart or blood pressure medication, including a diuretic or "water pill";

• oral diabetes medicine;

• seizure medicine (especially phenobarbital or phenytoin);

• steroid medicine (such as prednisone); or

• a sulfa drug.

This list is not complete. Other drugs may affect Nalfon, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.