Diclofenac/Misoprostol (By Mouth)

Diclofenac (di-KLO-fen-ack), Misoprostol (mye-soe-PROST-ole)

Treats the symptoms of arthritis. This medicine is a combination of a nonsteroidal anti-inflammatory drug (NSAID) and a prostaglandin (to protect against ulcers of the stomach and intestines).

Brand Name(s):

Arthrotec
There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to any of the following medicines: diclofenac, misoprostol, other pain or arthritis medicine (such as aspirin, Aleve®, Feldene®, Motrin®, Indocin®, Orudis®, Relafen®, Voltaren®), or other prostaglandins such as dinoprostone (Cerividil®), epoprostenol (Flolan®), alprostadil (Caverject®, Muse®), or carboprost (Hemabate®). Do not use this medicine if you are pregnant.

How to Use This Medicine:

Tablet, Coated Tablet

• Your doctor will tell you how much of this medicine to take and how often. Do not take more medicine or take it more often than your doctor tells you to.
• It is best to take this medicine with meals to avoid stomach upset. You may have stomach pain, nausea, or diarrhea, especially when you first start taking the medicine. If these symptoms continue for more than one week, call your doctor.
• Swallow the tablet whole. Do not crush, break, or chew it.

If a dose is missed:

• If you miss a dose or forget to take your medicine, take it as soon as you can. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using aspirin, a blood thinner (Coumadin®), digoxin (Lanoxin®), methotrexate (Rheumatrex®), blood pressure medicine (such as Accupril®, Altace®, Lotensin®, Lotrel®, Monopril®, Prinivil®, Vasotec®, Zestril®), diabetes medicine (insulin or oral medicine such as Amaryl®, Glipizide®, Glucotrol®, Glucophage®, Glyburide®), diuretics (water pills, such as furosemide, hydrochlorothiazide (HCTZ), triamterene, Hyzaar®, Lotrel®, Norvasc®, Zestoretic®), a steroid taken by mouth (such as cortisone, prednisone).
• Do not take antacids such as Maalox® or Mylanta® while you are using this medicine.

Warnings While Using This Medicine:

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Make sure your doctor knows if you are breastfeeding, or if you have asthma, kidney disease, lupus, high blood pressure, heart problems, porphyria, or a stomach ulcer. Tell your doctor if you smoke, or if you have ever had bleeding in your stomach or intestines.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in face or hands, swelling or tingling in the mouth or throat, tightness in chest, trouble breathing
• Blood in urine or stools, dark colored urine
• Confusion, extreme weakness
• Fast or pounding heartbeat
• Flu-like symptoms
• Severe nausea, diarrhea, stomach pain or cramps
• Swelling in your hands, ankles, or feet
• Unusual bleeding or bruising
• Unusual vaginal bleeding or discharge
• Vomiting or coughing up blood or material that looks like coffee grounds
• Yellow eyes or skin

If you notice these less serious side effects, talk with your doctor:

• Increase or decrease in how much or how often you urinate
• Joint or muscle pain

If you notice other side effects that you think are caused by this medicine, tell your doctor.