Camphor is a mild pain reliever.

Lidocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

Methyl salicylate is a nonsteroidal anti-inflammatory drug (NSAID) in a group of drugs called salicylates (sa-LIS-il-ates). Viva works by reducing substances in the body that cause pain and inflammation.

Viva (for the skin) is a combination medicine used to provide temporary relief of mild to moderate aches and pains of the muscles and joints. This medicine may be used for pain caused by muscle stiffness or bruising, arthritis, sprains or strains, backaches, and sore or bruised muscles.

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

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Use exactly as directed on the label, or as prescribed by your doctor.

This medicine comes in a patch that you apply to your skin.

Keep the patch away from your mouth, nose, and eyes.

Wash your hands before applying a skin patch, and after removing it.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Do not apply the patch over open wounds or sunburned, windburned, damaged, or irritated skin. Do not apply the skin patch to your face or your genitals.

Do not wear more than one skin patch at a time. Using extra skin patches will not make the medicine more effective, and could increase your risk of heart attack or stroke.

It may take up to several hours before you notice pain relief while wearing the skin patch.

Remove the skin patch after 8 to 12 hours and replace it with a new one if needed.

Call your doctor if your symptoms do not improve, or if they get worse while using this medicine.

After removing a skin patch: fold it in half firmly with the sticky side in, and throw it away in a place where children and pets cannot get to it.

Store unused skin patches at room temperature away from moisture, heat, and sunlight. Keep each patch in the foil pouch until ready to use. After opening a pouch, you must use the skin patches within 7 days.

Viva contains methyl salicylate, which is an NSAID. An NSAID can increase your risk of fatal heart attack or stroke, especially if you use it long term, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while using an NSAID.

Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

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

You should not use this medicine if you are allergic to camphor, lidocaine, or methyl salicylate.

Ask a doctor or pharmacist if this medicine is safe to use if you have ever had:

• high blood pressure or heart disease;

• a stomach ulcer or bleeding problems;

• a habit of drinking 3 or more alcoholic drinks per day;

• kidney disease;

• an allergy to any skin products; or

• an allergy to any NSAID (aspirin, ibuprofen, celecoxib, diclofenac, indomethacin, meloxicam, naproxen, Advil, Motrin, Aleve, and others).

Ask a doctor before using this medicine if you are pregnant or breast-feeding.

Using methyl salicylate during the last 3 months of pregnancy may harm the unborn baby, or cause bleeding in the mother or the baby during delivery.

This medicine is not approved for use by anyone younger than 12 years old.

Since Viva is used when needed, you may not be on a dosing schedule. Skip any missed dose if it's almost time for your next dose. Do not use more than 2 skin patches in a 24-hour period.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if a child has placed a skin patch into his or her mouth.

Do not expose treated skin to heat from a hot tub, heating pad, or sauna. Heat can increase the amount of drug absorbed through your skin and may cause harmful effects.

Rinse with water if the medicine gets in your eyes.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Remove the skin patch and 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, feeling short of breath.

Serious side effects are unlikely when Viva is applied to the skin, but can occur if the medicine is absorbed into your bloodstream.

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

• worsening of your muscle pain;

• skin rash, itching, or irritation;

• a light-headed feeling, like you might pass out;

• new or worsening stomach pain; or

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

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 a doctor or pharmacist before using any other medications, especially:

• a diuretic or "water pill";

• a blood thinner--warfarin, Coumadin, Jantoven; or

• an NSAID--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

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