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Drug info>Arthrotec

ARTHROTEC

Generic Name: diclofenac and misoprostol
Brand Names: Arthrotec

What is the most important information I should know about diclofenac and misoprostol?

 

Do not take misoprostol if you are pregnant or if you are planning a pregnancy. Misoprostol can induce a miscarriage or an abortion. Your doctor will ask you to have a pregnancy test before you start treatment with misoprostol, and therapy will begin only after your next regular menstrual cycle begins. Also, you will need to use appropriate contraception to prevent pregnancy during therapy.
Do not share this medication with anyone else.
Take diclofenac and misoprostol with food, milk, or an antacid to lessen stomach upset.
Do not crush, chew, or break diclofenac and misoprostol tablets. Swallow them whole.
Watch for bloody, black, or tarry stools or blood in your vomit. These symptoms could indicate damage to your stomach.
If you drink more than three alcoholic beverages a day, diclofenac and misoprostol may increase the risk of stomach bleeding.

What is diclofenac and misoprostol?

Diclofenac is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Diclofenac works by reducing substances that cause inflammation and pain in the body.
Misoprostol replaces protective substances in your stomach that are inhibited by nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin.
The combination, diclofenac and misoprostol, is used to treat osteoarthritis and rheumatoid arthritis in people at high risk for developing stomach or intestinal ulcers.
Diclofenac and misoprostol may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking diclofenac and misoprostol?

Before taking this medication, tell your doctor if you
        have an allergy to any other NSAID or to aspirin,
        have an ulcer or bleeding in your stomach,
        drink more than three alcoholic beverages a day,
        have liver or kidney disease,
        have a coagulation (bleeding) disorder,
        have congestive heart failure,
        have fluid retention,
        have heart disease, or
        have high blood pressure.
You may not be able to take diclofenac and misoprostol, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.
Diclofenac and misoprostol is in the FDA pregnancy category X. This means that it is known to harm an unborn baby. Misoprostol can induce a miscarriage or a spontaneous abortion.Do not take diclofenac and misoprostol if you are pregnant or if you are planning a pregnancy. Do not share this medication with any one else. Your doctor will ask you to have a pregnancy test before you start treatment with diclofenac and misoprostol, and therapy will begin only after your next regular menstrual cycle begins. Also, you will need to use appropriate contraception to prevent pregnancy during your therapy.
Diclofenac passes into breast milk and may affect a nursing baby. It is not known whether misoprostol passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take diclofenac and misoprostol?

Take diclofenac and misoprostol exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Take each dose with a full glass of water.
To lessen stomach upset and/ or diarrhea, take diclofenac and misoprostol with food, milk, or an aluminum or calcium antacid.
Do not crush, break, or chew diclofenac and misoprostol tablets. Swallow them whole.
Store diclofenac and misoprostol at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.
Symptoms of a diclofenac and misoprostol overdose are not known but might include nausea, vomiting, stomach pain, diarrhea, dizziness, drowsiness, tremor, headache, ringing in the ears, blurred vision, seizures, sweating, numbness or tingling, little or no urine production, irregular heartbeats, and slow breathing.

What should I avoid while taking diclofenac and misoprostol?

Avoid prolonged exposure to sunlight. Diclofenac and misoprostol may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.
If you drink more than three alcoholic beverages a day, diclofenac and misoprostol may increase the risk of stomach bleeding.

What are the possible side effects of diclofenac and misoprostol?

If you experience any of the following serious side effects, stop taking diclofenac and misoprostol and seek medical treatment or call your doctor immediately:
        an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
        severe diarrhea, abdominal cramping, indigestion, or heartburn;
        jaundice (yellowing of the skin and eyes), nausea and upper abdominal tenderness, a flulike feeling, unusual fatigue, and itching;
        ulcers (open sores) in the mouth;
        rapid weight gain (fluid retention);
        seizures;
        black, bloody, or tarry stools;
        blood in your urine or vomit; or
        decreased hearing or ringing in the ears.
Other, less serious side effects may be more likely to occur. Continue to take diclofenac and misoprostol and talk to your doctor if you experience
        nausea, gaseousness, or abdominal pain;
        diarrhea;
        dizziness or headache;
        fatigue or weakness;
        dry mouth; or
        irregular menstrual periods.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect diclofenac and misoprostol?

To reduce the incidence of diarrhea, do not take antacids that contain magnesium while you are taking diclofenac and misoprostol. If you need an antacid, take one with aluminum or calcium instead of magnesium.
Before taking diclofenac and misoprostol, tell your doctor if you are taking any of the following medicines:
        another nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Aleve, Anaprox), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), or tolmetin (Tolectin);
        aspirin or another salicylate (form of aspirin) such as salsalate (Disalcid), bismuth subsalicylate (Pepto-Bismol), choline salicylate, or magnesium salicylate (watch the aspirin content of other over-the-counter products such as cough, cold, and allergy medicines);
        a diuretic (water pill) such as hydrochlorothiazide (Hydrodiuril, others), chlorothiazide (Diuril, others), chlorthalidone (Hygroton, Thalitone), bumetanide (Bumex), ethacrynic acid (Edecrin), furosemide (Lasix), spironolactone (Aldactone), triamterene (Dyrenium, Dyazide, Maxzide), or amiloride (Midamor);
        an angiotensin-converting-enzyme (ACE) inhibitor such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), or ramipril (Altace);
        a beta-blocker such as acebutolol (Sectral), metoprolol (Lopressor), propranolol (Inderal), atenolol (Tenormin), or carteolol (Cartrol);
        an anticoagulant such as warfarin (Coumadin);
        insulin or an oral diabetes drug such as glipizide (Glucotrol) or glyburide (Micronase, Diabeta);
        a steroid such as prednisone (Orasone, Deltasone, others), methylprednisolone (Medrol), dexamethasone (Decadron), prednisolone (Prelone, others), and others;
        digoxin (Lanoxin);
        phenobarbital (Luminal, Solfoton);
        lithium (Eskalith, Lithobid, others);
        cyclosporine (Sandimmune, Neoral);
        tacrolimus (Prograf);
        methotrexate (Rheumatrex); or
        alcohol.
You may not be able to take diclofenac and misoprostol, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with diclofenac and misoprostol. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

Your pharmacist has additional information about diclofenac and misoprostol written for health professionals that you may read.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided  is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. The information has been compiled for use by healthcare practitioners and consumers in the United States and U.K, unless specifically indicated otherwise. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/ or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. We do not assume any responsibility for any aspect of healthcare administered with the aid of information we provide. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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