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ZIPSOR is a prescription treatment for mild-to-moderate acute pain in adults 18 years of age or older.

The most common side effects of ZIPSOR include abdominal pain, constipation, diarrhea, dyspepsia, nausea, and vomiting; also reported were dizziness, headache, somnolence, pruritus, and increased sweating.

Why is ZIPSOR prescribed?

ZIPSOR is prescribed for different types of pain, including after surgery or for an injury such as a sprain or strain.

How do I know if ZIPSOR is right for me?

  • Your pain is acute—most acute pain lasts less than 6 months and goes away when the underlying problem has healed
  • You prefer not to take an opioid
  • Your pain is mild to moderate—which means that you would probably rate it no higher than a 7 on a scale of 0 to 1

Nonnarcotic analgesics:

Indications for ZIPSOR:

Mild-to-moderate acute pain.


≥18yrs: Use lowest effective dose for the shortest duration. 25mg 4 times daily. Hepatic impairment: may require reduced doses.


<18yrs: not established.


Aspirin allergy. Coronary artery bypass graft surgery. Bovine protein sensitivity.

Boxed Warning:

Risk of serious cardiovascular and gastrointestinal events.


Not interchangeable with other forms of diclofenac. Increased risk of serious cardiovascular events (including MI, stroke). Avoid in recent MI, severe heart failure; if necessary, monitor. Increased risk of serious GI adverse events (including inflammation, bleeding, ulceration, perforation). History of ulcer disease and/or GI bleeding. Hypertension; monitor BP closely. Hepatic or renal impairment. Discontinue if signs/symptoms of liver disease develop, or if abnormal LFTs persist or worsen. Dehydration. Hypovolemia. Advanced renal disease: not recommended. Hyperkalemia. Coagulation disorders. Monitor CBCs, blood chemistry, hepatic, and renal function in long-term therapy. Pre-existing asthma. May mask signs of infection or fever. Discontinue at 1st sign of a rash or any other hypersensitivity. Elderly. Debilitated. Labor & delivery. Pregnancy (Cat.C: <30 weeks gestation; Cat.D: ≥30 weeks gestation; avoid). Nursing mothers: not recommended.

Pharmacologic Class:

NSAID (benzeneacetic acid deriv.).


Avoid concomitant aspirin, salicylates (eg, diflunisal, salsalate) or other NSAIDs. Increased risk of GI bleeds with anticoagulants, antiplatelets, oral corticosteroids, SSRIs, SNRIs, smoking, alcohol, or prolonged NSAID therapy; monitor. May antagonize, or increase risk of renal failure with diuretics (eg, loop or thiazides), ACE inhibitors, ARBs, or β-blockers; monitor closely. Potentiates digoxin; monitor levels. May potentiate lithium, methotrexate, cyclosporine; monitor for toxicity. Concomitant with pemetrexed may increase risk of pemetrexed-associated myelosuppression, renal, and GI toxicity. Potentiated by CYP2C9 inhibitors (eg, voriconazole) and antagonized by CYP2C9 inducers (eg, rifampin); may need dose adjustments. Caution with other hepatotoxic drugs (eg, acetaminophen, certain antibiotics, antiepileptics).

Adverse Reactions:

GI upset, abdominal pain, constipation, dyspepsia, dizziness, headache, somnolence, pruritus, increased sweating; cardiovascular thrombotic events, GI ulcer/bleed, hepatotoxicity, renal toxicity, hypertension, hypersensitivity reactions, anemia.

How Supplied:



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