MedlinePlus Drug Information: Diclofenac and Misoprostol

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Other drug names:	A-Am An-Az B C-Ch Ci-Cz D-Dh Di-Dz E F G H I-J K-L M-Mh Mi-Mz N-Nh Ni-Nz O P-Pl Pm-Pz Q-R S-Sn So-Sz T-To Tp-Tz U-V W-Z 0-9

Diclofenac and Misoprostol

(dye kloe' fen ak) and (mye soe prost' ole)

Brand name(s): Arthrotec

Contents of this page:
Why is this medication prescribed? How should this medicine be used? What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose?	What side effects can this medication cause? What storage conditions are needed for this medicine? In case of emergency/overdose What other information should I know?

IMPORTANT WARNING:

IMPORTANT WARNING: Do not take diclofenac and misoprostol if you are pregnant, plan to become pregnant, or are breast-feeding. This medicine causes miscarriages and serious bleeding if taken during pregnancy. Use a reliable method of birth control while taking diclofenac and misoprostol. If you become pregnant while taking this medicine, stop taking it and call your doctor immediately. If you are a woman of childbearing age you should not take this medication unless you need nonsteroidal anti-inflammatory (NSAID) therapy and you are at high risk for stomach ulcers. If you and your doctor decide you need this medication, you must: have a negative serum pregnancy test within 2 weeks prior to taking diclofenac and misoprostol;use a reliable method of birth control;receive both oral and written warning of the dangers of diclofenac and misoprostol, the risk of possible birth control failure, and the danger to other women of childbearing age if they take the medicine by mistake; begin the medication only on the second or third day of the next normal menstrual period.Only take this medication by mouth.Do not give this medication to anyone else, especially a woman who may be or could become pregnant.

Why is this medication prescribed?

The combination of diclofenac and misoprostol is used to treat symptoms of osteoarthritis or rheumatoid arthritis in patients who have a high risk of developing stomach ulcers. Diclofenac belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) and is used to relieve the pain, tenderness, inflammation (swelling), and stiffness caused by arthritis. Misoprostol belongs to a class of drugs called prostaglandins. Misoprostol is used to prevent ulcers caused by diclofenac and other NSAIDs. It protects the stomach lining and decreases stomach acid secretion.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

The combination of diclofenac and misoprostol comes as a tablet to take by mouth. It is usually taken two to four times daily. Take diclofenac and misoprostol with food to decrease the chance of diarrhea. Swallow this medication whole. Do not chew, crush, divide, or dissolve the tablets. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take diclofenac and misoprostol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

The combination of diclofenac and misoprostol is used to treat the symptoms of osteoarthritis and rheumatoid arthritis but it does not cure them. Continue to take diclofenac and misoprostol even if you feel well. Do not stop taking diclofenac and misoprostol without talking with your doctor.

What special precautions should I follow?

Before taking diclofenac and misoprostol,

tell your doctor and pharmacist if you are allergic to diclofenac, misoprostol, aspirin, NSAIDs such as ibuprofen (Advil) and naproxen (Aleve), other medications for pain or arthritis, or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antacids; anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; atenolol (Tenormin); cyclosporine (Neoral, Sandimmune); digoxin (Lanoxin); diuretics ('water pills'); lithium (Eskalith, Lithobid); medications for arthritis, diabetes, or high blood pressure; methotrexate (Rheumatrex); phenobarbital (Donnatal, others); prednisolone; and vitamins or herbal products.
do not take this medication with antacids containing magnesium (Mylanta, Maalox, others).
tell your doctor if you smoke, drink alcohol, or have or have ever had any of following: heart, liver, or kidney disease; anemia; asthma; bleeding problems; diabetes; gastritis; high blood pressure; inflammatory bowel disease; intestinal problems such as bleeding from the stomach or rectum; ulcers or other gastrointestinal disease; gynecologic (female) problems; porphyria; SLE (systemic lupus erythematosus); or other water retention problems.
do not take this medication if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking diclofenac and misoprostol, stop taking the medication and call your doctor immediately. This medication can cause miscarriages or rupture the uterus, which may result in severe bleeding, hospitalization, surgery, infertility, or death. Wait at least 1 month or through one menstrual cycle after you stop taking diclofenac and misoprostol before you try to become pregnant.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking diclofenac and misoprostol.
you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
remember that alcohol can add to the drowsiness caused by this drug. Do not drink alcohol while taking this medication.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Although side effects from diclofenac and misoprostol are not common, they can occur. Most will go away in about 7 days after taking it regularly. Tell your doctor if any of these symptoms are severe or do not go away:

diarrhea
upset stomach
indigestion
stomach pain or cramps
gas

If you experience any of the following symptoms, call your doctor immediately:

skin rash
itching
hives
difficulty breathing or swallowing
swelling of the face, throat, hands, feet, ankles, or lower legs
weight gain or swelling
bloody diarrhea or black, tarry stools
blood in urine
postmenopausal vaginal bleeding
ringing in the ears
fever
headache
stiff or painful neck
sensitivity to light
unusual bleeding or bruising, easy bruising
tiredness
pain in the right upper part of your stomach
yellowing of the skin or eyes
confusion
drowsiness
convulsions
irregular heartbeat
vomiting, especially if there is blood in it
flu-like symptoms

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to diclofenac and misoprostol.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Last Revised - 01/01/2003

American Society of Health-System Pharmacists, Inc. Disclaimer