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Generic name: diclofenac and misoprostol [dye-KLOE-fen-ak-and-mye-so-PROST-ole]
Class of drug: nonsteroidal anti-inflammatory drugs

What is Arthrotec?

Arthrotec includes a mix comprising diclofenac and misoprostol. Diclofenac is an anti-inflammatory medication that is nonsteroidal (NSAID). It reduces the number of substances within the body that trigger inflammation and pain.Misoprostol lowers stomach acid and substitutes for the protective substances of the stomach, which are diminished through non-steroidal antidepressants. Misoprostol helps protect the tissues of the oesophagus and stomach, as well as the intestines, when taking diclofenac.Arthrotec is a prescription medication that is prescribed to treat osteoarthritis and rheumatoid arthritis in those who are at high risk of developing ulcers in the stomach or intestines.Arthrotec is available as tablets with delayed release that contain 50 mg diclofenac salt and misoprostol, 200 mcg or 75 mg diclofenac sodium, and 200 mg misoprostol.


Don't use Arthrotec when there is a possibility of pregnancy. Misoprostol could result in birth defects, miscarriage, early labour, and rupture of the uterus. It is necessary to have the pregnancy test negative within two weeks prior to when you begin taking Arthrotec. You might need to begin taking this medicine on either the second or third day of your normal menstrual cycle. Make sure you are using effective birth control when you're taking Arthrotec.Arthrotec is not a good choice for you in the event of active bleeding in the stomach or intestines.Diclofenac increases the chance of suffering death from coronary heart attacks and strokes. Avoid using Arthrotec prior to or following the procedure to bypass your heart (coronary bypass grafts for artery bypass, also known as CABG). Diclofenac can also trigger diarrhoea or stomach bleeding, which could be fatal.

Before you take this drug

Diclofenac may increase the chance of having a fatal heart attack or stroke, even if you do not suffer from any of the risk factors. Avoid using Arthrotec prior to or following the procedure for heart bypass (coronary bypass grafts (CABG)).Diclofenac can cause diarrhoea or stomach bleeding, which could be fatal. These issues can happen at any time while taking Arthrotec, particularly among older adults.It is not recommended to use this medication if you have an allergy to diclofenac, misoprostol, or diclofenac.

  • If you're experiencing bleeding within your stomach or intestines,
  • If you are pregnant;
  • If you've had a previous asthma attack or a severe allergic reaction following the use of aspirin or an NSAID,

To ensure that Arthrotec is appropriate for you, ask your doctor if you've had any of the following:

  • Cardiovascular disease, hypertension, high cholesterol, or diabetes; smoking cigarettes;
  • A stroke, heart attack, or blood clot
  • Stomach ulcers, bleeding, or ulcers in the stomach;
  • Asthma;
  • Porphyria (a genetic disorder of enzymes that results in symptoms affecting the skin or the nervous system);
  • Kidney or liver disease;
  • Fluid retention.

Avoid using Arthrotec when you are expecting. Diclofenac and misoprostol may cause birth defects, miscarriage, early labour, and ruptures of the uterus. Utilise a safe method for birth control in order to avoid pregnancy while taking Arthrotec. Inform your doctor immediately when you begin to become pregnant while receiving treatment.It is recommended to take an ultrasound of your pregnancy within two weeks before starting Arthrotec. It is possible that you will need to begin taking the medicine on either the second or third day of your normal menstrual cycle.It is not recommended to breastfeed when using Arthrotec. Talk to your doctor regarding any risks.

Similar/related drugs

Simponi, aspirin, prednisone, ibuprofen, meloxicam, naproxen, and Cymbalta

How to take Arthrotec?

Use Arthrotec according to the prescription given by your physician. Follow the instructions on the prescription label and all drug instructions. Choose the dosage that works for your condition.Take Arthrotec along with food to ease the stomach upset.

Suck the tablet completely, and don't crush, chew, or break it.Do not share this medication with anyone other than yourself, even if they share the same symptoms as you do.If you take Arthrotec long-term, you could require frequent medical examinations in the office of your doctor.Keep it at room temperature, far from heat and moisture.

Details on dosage

Usual Adult Dose of Arthrotec for Osteoarthritis:

A tablet (diclofenac 50 mg, misoprostol 200 mg) orally three times a day
Maximum doses are: diclofenac, 150 mg/day; misoprostol, 200 mg/dose; and 800 mg/day.
Monitor the response to the first therapy and adjust the dosage and frequency according to your individual needs. Consider the possibility of titration for individual components, as needed.
If you have a patient who has intolerance, diclofenac 25 mg-misoprostol 200 mg or diclofenac 50 mg-misoprostol 200 mg daily, taken orally, may be administered; however, these regimens are not as efficient in stopping ulcers.
To prevent gastric ulcers Misoprostol 200 mg three times per day is equivalent to 200 mg four times a day. Both are more effective than 200 mg twice daily.
For the purpose of duodenal ulcer prevention, Misoprostol 200 mg 4 times per day is more effective than 200 mg 2 or 3 times per day; however, it is not always easily tolerated.
Use: To treat symptoms and signs of osteoarthritis in people with a high likelihood of developing nonsteroidal antiinflammatory drugs (NSAIDs) inducing duodenal and gastric ulcers and their complications.

Usual Adult Dose of Arthrotec for Rheumatoid Arthritis:

1 tablet (diclofenac 50 mg, misoprostol 200 mg) orally, 3 to 4 times daily.
Maximum doses: diclofenac, 225 mg/day; misoprostol, 200 mg/dose; and 800 mg/day.
If you have a patient who has intolerance, diclofenac 75 mg, misoprostol 200 mg, or diclofenac 50 mg, misoprostol 200 mg daily, taken orally, may be taken, but these regimens aren't as efficient in the prevention of ulcers.
Monitor response to the first therapy and adjust dosage and frequency according to personal needs. You may also consider the titration of specific components when appropriate.
For the prevention of gastric ulcers, Misoprostol 200 mg three times a day is equivalent to 200 mg four times a day. Both are more effective than 200 mg twice every day.
To prevent duodenal ulcers Misoprostol 200 mg taken 4 times per day is more effective than 200 mg taken 2 or 3 times daily; however, it is not easily tolerated.
Use: To treat symptoms and signs of rheumatoid arthritis in patients who are at risk of developing NSAID duodenal and gastric ulcers and their complications.

What happens if I miss the dose?

You should take the medication as quickly as you can. However, avoid your missed dosage if it's close to the time of the next dose. Do not take two doses at the same time.

What happens if I overdose?

For medical emergencies, seek emergency medical attention or contact the Poison Help Line toll-free at 1-800-222-1222.

What should be avoided?

Avoid exposure to the sun as well as tanning beds. Arthrotec may cause sunburn more quickly. Be sure to wear protective attire and sunblock (SPF 30 or greater) while you're outdoors.Do not use anti-inflammatory medications without consulting your physician. Make sure you only use the kind of antacid recommended by your physician. Certain anti-inflammatory medications may make it difficult for your body to absorb diclofenac or misoprostol.Beware of drinking alcohol. It could increase the chance of bleeding in your stomach due to diclofenac.Talk to your doctor or pharmacist prior to using any other medicines to treat swelling, pain, fever, or symptoms of the cold or flu. They may contain ingredients that are similar to diclofenac (such as aspirin, ibuprofen, ketoprofen, and naproxen).

Side effects of Arthrotec

Take immediate medical attention. If you notice symptoms that you are experiencing an allergic reaction with Arthrotec (sneezing or running nose, wheezing, hives, difficulty breathing, swelling of your throat or face) or a severe reaction to your skin (fever, sore throat, eye burning, irritation, the skin is red or purple with peeling and blisters),Stop taking Arthrotec and seek medical assistance when you experience a serious drug reaction that could affect the body in a variety of ways. Symptoms may include the appearance of a skin rash or fever, swelling of the glands, muscle pains, excessive weakness, unusual swelling, or discoloration of your eyes or skin.Take immediate medical care. If you're experiencing symptoms of an attack on your heart or stroke: chest pain spreading into your shoulder or jaw A sudden feeling of weakness or numbness in one part of your body; speech slurred; feeling breathless

Stop taking Arthrotec and consult your physician immediately if you suffer from:

  • The initial sign of a skin rash, regardless of how minor;
  • Breathlessness (even when exerting only a little);
  • Weight gain or swelling that is rapid
  • Indications that stomach blood is bleeding, bloody or tarry stool, coughing blood, or vomiting that appears like coffee grounds
  • Liver issues loss of appetite and abdominal pain (upper right side) itching, fatigue, and the dark colour of urine; the stools are made of clay; jaundice (yellowing of the eyes or skin);
  • Kidney issues there is no or little urinary tract swelling on your ankles or feet, and you feel tired, sluggish,
  • The red blood cell count is low (anemia);  pale skin; unusual tiredness; feeling lightheaded or short of breath; cold feet and hands.

Common Arthrotec adverse effects can include:

  • Abnormal vaginal bleeding
  • Heartburn, indigestion, stomach pain, gas;
  • Nausea, vomiting;
  • Diarrhoea, constipation,
  • Dizziness.

This isn't a complete list of possible side effects, and others could happen. Contact your doctor for advice regarding medical adverse effects. Report any side effects directly to the FDA at 1-800-FDA-1088.

Interaction with other drug

Talk to your doctor prior to taking this medication if you are taking any antidepressants. Taking certain antidepressants together with an NSAID can cause bleeding or bruises easily.

Inform your physician of any medications taken outside of their prescribed range, particularly:

  • Cyclosporine;
  • Lithium;
  • Methotrexate;
  • Blood pressure or heart medication such as diuretics or "water pills";
  • Oral diabetes medicine;
  • Is a blood thinner; warfarin (coumadin, jantoven);
  • Other forms of diclofenac include cambia, cataflam, flector, voltaren, zipsor, and zorvolex.
  • Other nsaids other nsaids include aspirin, ibuprofen (advil, motrin), naproxen (aleve), celecoxib (celebrex), indomethacin, meloxicam, and many others.
  • Steroid medication medicine contains prednisone, dexamethasone, and many more.

This list is not comprehensive. Other medications can be incompatible when used in conjunction with diclofenac and misoprostol. These include medications that are prescribed and available over the counter, vitamins, and herbal products. Some interactions with drugs may not be listed here. are included here.




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