The Prokarin gel must be refrigerated at all times. When traveling, carry Prokarin in an insulated carrier with ice packs. Do not freeze the Prokarin gel and do not allow the Prokarin tubes to come in direct contact with ice or ice pack.

1.     Make sure the skin is clean and dry

2.     Inspect the skin for any open areas or sores. Do not apply the patch to any areas that have a sore, crack in the skin, or open areas.

3.     Peel back the white paper backing on the adhesive patch until ¾ of the sticky adhesive side is exposed.

4.     Apply 0.2ml of the medication in the syringe to the middle portion of the exposed sticky side of the adhesive patch.

5.     Completely remove the adhesive patch from the white paper backing and apply the patch to the skin that has been prepared with the hydrocortisone cream. Make sure there are no wrinkles in the patch and that all edges are well sealed to the skin.

6.     Apply the patch as prepared above in the AM. This patch may be left in place until bedtime – or removed when a new patch is applied (if this is unclear please ask your pharmacist). When removing a patch gently rub any remaining medication.

7.     Follow steps 1 through 6 to prepare a new patch to be applied in the afternoon (8 hours after the first patch). Be sure to rotate the sites where the patch is applied. Do not apply the patch to the same site twice in 24 hours.

8.     Remove the afternoon patch at bedtime. Gently rub any medication remaining on the skin or patch into the skin. If there is no skin irritation, the second patch of the day may be worn all night and removed the next morning. It is important that the patches be worn for 2 consecutive 8-hour intervals during the waking hours.

9.     Repeat steps 1 through 8 every day.

Note: Do not get the patch wet. If the patch gets wet, remove the patch immediately, gently pat the area dry and apply a new patch at a different site following the above steps. Do not apply a heating pad over the patch site.

Precautions:  If any sores develop on your skin or you experience any nausea, diarrhea, stomach pains, difficulty breathing, frequent headaches or a headache that does not resolve with acetaminophen, rapid pulse, or chest pain, remove the immediately and call your doctor.

Side Effects: Possible side effects of Prokarin use include: pain, tenderness, bruising, swelling, inflammation, or rash at the patch site, flushing, dizziness, headache, fainting, cyanosis (bluish coloring) of the face, hypotension, hypertension, pulse irregularities, rapid pulse, chest pain, dyspnea (difficult or painful breathing), abdominal discomfort, nausea, vomiting, diarrhea, increased urination, increase in symptoms of bursitis and tendonitis, burning or itching skin, nervousness, metallic taste, blurred vision, blood clots in arms or legs, may decrease blood sugars in diabetics, (use caution in patients with hypoglycemia), and severe allergic reaction that could result in shock, convulsions, and death.

Contraindications: Contraindicated in respiratory disorders (asthma, chronic bronchitis, emphysema, etc.), gastrointestinal ulceration, or concurrent use with some medications used to treat stomach or esophageal disorders (e.g. Zantac , Tagamet, Pepcid, Axid , ranitidine, cimetidine). Baclofen (lioresal) and Zanaflex  may decrease the effectiveness of Prokarin.