Arthrotec (diclofenac / misoprostol) is a combination medication used to treat osteoarthritis (OA) and rheumatoid arthritis (RA) in non-pregnant adults. The diclofenac in Arthrotec is a non-steroidal anti-inflammatory drug (NSAID) that helps with pain and swelling, while the misoprostol is a prostaglandin E1 analog that lowers the risk of stomach and intestinal ulcers from diclofenac. Arthrotec (diclofenac / misoprostol) is taken by mouth, typically two to four times per day. Common side effects of this medication include stomach cramps (pain) and diarrhea. Avoid drinking alcohol with Arthrotec (diclofenac / misoprostol) because doing so can raise the risk of stomach bleeding.
Arthrotec (diclofenac / misoprostol) is a combination of two medications:
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Contact your healthcare provider immediately if you experience any of the following.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Stomach pain
Less common
Black, tarry stools
bladder pain
bloody or cloudy urine
burning feeling in the chest or stomach
burning while urinating
chest pain, discomfort, or tightness
chills
deep or fast breathing with dizziness
difficult, burning, or painful urination
difficulty swallowing
dizziness
double vision
feeling of constant movement of self or surroundings
frequent urge to urinate
increased sensitivity of the skin to sunlight
increased volume of pale, dilute urine
indigestion
itching, skin rash
lightheadedness
longer or heavier menstrual periods
lower back or side pain
nosebleed
numbness of the feet, hands, and around the mouth
pain or burning in the throat
pain with swallowing
redness or other discoloration of the skin
seeing double
sensation of spinning
severe sunburn
sores, ulcers, or white spots on the lips or in the mouth
stomach upset or tenderness
swollen glands
unusual bleeding or bruising
unusual tiredness or weakness
vaginal bleeding
vomiting with or without blood
Incidence not known
Ankle, knee, or great toe joint pain
black, tarry stools
bleeding gums
blindness
blistering, peeling, or loosening of the skin
bloating or swelling of the face, arms, hands, lower legs, or feet
bluish color of the skin
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
burning, dry, or itching eyes
cloudy or dark urine
decreased frequency or amount of urine
decreased vision
difficulty in speaking
dilated neck veins
discharge, excessive tearing
dizziness, fainting, or lightheadedness when getting up suddenly from a lying or sitting position
drowsiness
excessive muscle tone
extreme tiredness or weakness
fainting
fast, irregular, pounding, or racing heartbeat or pulse
general feeling of illness
headache, severe and throbbing
hoarseness
inability to move the arms, legs, or facial muscles
inability to speak
increased sensitivity to pain or touch
increased thirst
irregular, fast or slow, or shallow breathing
joint pain, stiffness, or swelling
large, hive-like swelling on the pain, face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
light-colored stools
lightheadedness
loss of appetite
loss of consciousness
muscle stiffness, tension, or tightness
nervousness
night blindness
pain or discomfort in the arms, jaw, back, or neck
pains in the stomach, side, or abdomen, possibly radiating to the back
pain, warmth, or burning in the fingers, toes, and legs
pale or blue lips, fingernails, or skin pale skin
pinpoint red spots on the skin
pounding in the ears
problems with vision or hearing
rapid weight gain
red skin lesions, often with a purple center
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
redness or soreness of the skin
seizures
severe stomach cramping
slow heartbeat
slow speech
sores, welts, or blisters
stiff neck or back
trouble breathing
unusual bleeding or bruising
unusual weight gain or loss
upper right stomach pain
uterine cramping and bleeding
vomiting of material that looks like coffee grounds, severe and continuing
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Breast pain
change in or loss of taste
confusion about identity, place, and time
continuing ringing or buzzing or other unexplained noise in the ears
decreased concentration
difficulty in moving
frequent urge to defecate
increased clear or white vaginal discharge
irritability
itching of the vagina or genital area
lack or loss of strength
loss or thinning of hair
pain during sexual intercourse
seeing, hearing, or feeling things that are not there
straining while passing stool
thick, white vaginal discharge with no odor or with a mild odor
trouble sleeping
Incidence not known
Blemishes on the skin
decreased interest in sexual intercourse
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance
sleepiness or unusual drowsiness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Arthrotec (diclofenac / misoprostol) isn't considered a blood thinner. But diclofenac in Arthrotec is an NSAID, and NSAIDS can raise the risk of bleeding. Bleeding longer than normal and bruising can happen when taking Arthrotec (diclofenac / misoprostol). If you feel lightheaded, dizzy, or have excess bleeding that's difficult to stop, seek medical help right away, especially if you're taking other blood thinners.
It's recommended to avoid drinking alcohol while you're taking Arthrotec (diclofenac / misoprostol) because doing so can raise your risk for stomach bleeds and ulcers as well as upset stomach. Talk with your healthcare team if you regularly drink alcohol and it's difficult for you to stop. They can recommend resources to help you stop drinking or discuss other treatment options to help with your condition.
You can take acetaminophen (Tylenol) with Arthrotec (diclofenac / misoprostol) if your prescriber says it's safe to do so. These two medications work differently to treat pain and inflammation, and don't directly interact with each other. But acetaminophen (Tylenol) isn't recommended for people with certain conditions, like liver problems. Speak with your primary care provider to make sure it's safe for you to take acetaminophen (Tylenol).
No, don't take ibuprofen (Advil) or other NSAIDs, including over-the-counter (OTC) NSAIDs, with Arthrotec (diclofenac / misoprostol). Taking more than one NSAID can raise your risk for severe side effects, such as heart problems, kidney problems, or bleeding. If you need additional pain relief while taking Arthrotec (diclofenac / misoprostol), talk with your primary care provider.
People who took Arthrotec (diclofenac / misoprostol) didn't report weight gain as a side effect. However, NSAIDS like diclofenac can cause swelling in your arms and legs because it makes your body hold onto more fluid. This can make you feel like you've gained weight. People with heart failure are at higher risk. Let your prescriber know if you notice swelling in your arms or legs after starting Arthrotec (diclofenac / misoprostol).
People with active stomach ulcers that are bleeding must avoid taking Arthrotec (diclofenac / misoprostol). Even though the medication contains misoprostol to help protect the stomach, it's not a guarantee that it'll completely protect the stomach from diclofenac; there's still a risk of stomach bleeding with Arthrotec (diclofenac / misoprostol). Make sure to tell your prescriber if you have a history of stomach ulcers before starting Arthrotec (diclofenac / misoprostol).
No, Arthrotec (diclofenac / misoprostol) is only available by a prescription from a healthcare professional.
Arthrotec (diclofenac / misoprostol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Arthrotec (diclofenac / misoprostol) can cause life-threatening problems for both the mother and the unborn baby, including spontaneous abortion, premature birth, and birth defects. Don't take Arthrotec (diclofenac / misoprostol) at any stage of pregnancy, or if you're planning on getting pregnant. Females who are able to get pregnant and prescribed Arthrotec (diclofenac / misoprostol) must use a reliable and effective form of birth control. You'll also need to have a negative pregnancy test within 2 weeks of starting this medication. If you get pregnant while taking this medication, let your prescriber know right away. You'll need to immediately stop taking it.
Even though Arthrotec contains misoprostol to help protect your stomach lining, taking this medication can still raise your risk for stomach ulcers (sores) and bleeds because of diclofenac. These stomach injuries can happen at any time while you're taking Arthrotec (diclofenac / misoprostol); it's a dangerous side effect that requires treatment right away. Tell your prescriber or pharmacist about all of your medical conditions and medications before you start Arthrotec (diclofenac / misoprostol) so they can talk with you about your risk for stomach bleeding.
Oftentimes, people who have stomach bleeds don't have noticeable symptoms, especially if the bleeding is slow and happens over a long period of time. Stomach ulcers can feel like a gnawing pain in the stomach area. Seek medical attention right away if you're feeling faint, vomiting blood, have bloody or dark stools, or have severe stomach pain or discomfort that doesn't go away while you're taking Arthrotec (diclofenac / misoprostol).
Diclofenac in Arthrotec might raise your risk of having blood clots, which can sometimes lead to a heart attack or stroke. Talk to your prescriber before you start taking Arthrotec (diclofenac / misoprostol) if you have heart problems. Don't take this medication if you had, or will have, heart surgery.
To lower your risk of blood clots, heart attack, and stroke, your prescriber will recommend that you take Arthrotec (diclofenac / misoprostol) for the shortest time needed to treat your condition. Call 911 or get immediate help if you experience chest pain, shortness of breath, weakness on one side of your body, or trouble speaking or walking. These can be signs of a serious blood clot.
Diclofenac in Arthrotec can cause your body to hold onto extra fluid. This can raise your blood pressure or put you at risk for heart failure. Tell your prescriber if you have a history of a heart condition or if you're taking blood pressure medications before you start Arthrotec (diclofenac / misoprostol). Your prescriber will also check for heart problems before your treatment with Arthrotec (diclofenac / misoprostol) starts. Contact your healthcare team if you have unexplained fainting, chest pain with physical activity, or irregular heartbeat while you're taking Arthrotec (diclofenac / misoprostol). These can be signs of heart problems from fluid build-up.
Long-term use of NSAIDs, like diclofenac, in Arthrotec can cause injury to the kidneys. Your risk is higher if you're of older age, if you have certain medical problems like kidney problems, or if you take medications that can cause kidney damage such as diuretics (water pills). Contact your care team if you develop any signs or symptoms of kidney problems, including changes in your need to urinate, tiredness, dry and itchy skin, low appetite, and muscle cramps.
Some people who took Arthrotec (diclofenac / misoprostol) had higher liver enzyme levels in their blood, which can mean harm to your liver. Although rare, there have been reports of serious liver problems that can lead to liver failure. Get medical attention right away if you notice swelling of your stomach; stomach pain; yellowing of your skin or the whites of your eyes; stool changes (black, tarry, or bloody stools); nausea; or dark or brown urine. These can be signs of liver damage, and you might need to stop taking Arthrotec (diclofenac / misoprostol) to prevent further harm.
Severe allergic reactions to diclofenac in Arthrotec are possible, including life-threatening reactions like facial swelling and anaphylaxis. Tell your prescriber if you have an allergy to aspirin or other NSAIDs; you might be at risk for an allergic reaction to Arthrotec (diclofenac / misoprostol). Get medical help right away if you notice hives, swelling of the lips or tongue, or difficulty breathing after you take Arthrotec (diclofenac / misoprostol).
Although rare, diclofenac in Arthrotec can also cause serious skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Stop taking Arthrotec (diclofenac / misoprostol) and get medical attention right away if you notice changes in your skin, such as rash, blisters, skin reddening, or skin peeling.
NSAIDs like diclofenac in Arthrotec can raise your risk for bleeding. Let a healthcare professional know if you bleed more easily, if bleeding takes longer to stop, or if bleeding doesn't stop while you're taking this medication.
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg/200mcg | 60 tablets | $48.16 | $0.80 |
| 75mg/200mcg | 60 tablets | $54.72 | $0.91 |
Arthrotec and its generics come in 2 different strengths:
Osteoarthritis
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Arthrotec (diclofenac / misoprostol) will not be safe for you to take.