WARNING

Taking Arthrotec (a combination of diclofenac and misoprostol) comes with several risks and potential side effects. Here’s a detailed overview of the risks associated with this medication:

• Ulcers and Bleeding: Diclofenac, an NSAID, can increase the risk of developing stomach ulcers, bleeding, and perforation of the gastrointestinal tract. This risk is particularly high if used for long periods or in higher doses.
• Symptoms: Watch for symptoms such as severe stomach pain, black or bloody stools, or vomit that looks like coffee grounds. These symptoms indicate serious gastrointestinal problems that require immediate medical attention.
• Heart Attack and Stroke: NSAIDs, including diclofenac, can increase the risk of heart attack and stroke, particularly with long-term use or in individuals with preexisting heart conditions.
• High Blood Pressure: Diclofenac can contribute to elevated blood pressure or worsen existing hypertension.
• Kidney Damage: NSAIDs can impair kidney function, potentially leading to kidney damage or failure, especially in those with existing kidney issues or with prolonged use.
• Symptoms: Monitor for symptoms such as swelling in the legs or feet, reduced urine output, or significant changes in urine color.
• Liver Damage: Both diclofenac and misoprostol can affect liver function. Diclofenac, in particular, can cause liver enzyme elevations, which might lead to liver damage.
• Symptoms: Report symptoms such as jaundice (yellowing of the skin or eyes), dark urine, or persistent fatigue to your healthcare provider.
• Pregnancy Risks: Misoprostol can induce miscarriage and should not be used during pregnancy, especially in the third trimester, due to the risk of preterm labor and other complications.
• Cramping and Bleeding: Misoprostol can cause abdominal cramping and bleeding, particularly in women of childbearing age.
• Severe Reactions: Some people may experience severe allergic reactions to diclofenac or misoprostol, including rash, itching, swelling, and difficulty breathing.
• Signs: Seek emergency medical care if you experience signs of a severe allergic reaction.
• Drug Interactions: Diclofenac can interact with other medications, such as blood thinners, other NSAIDs, certain antidepressants, and medications affecting kidney function. This can increase the risk of bleeding, kidney problems, or other adverse effects.
• Monitoring: Always inform your healthcare provider about all the medications and supplements you are taking.
• Preexisting Conditions: Use Arthrotec with caution if you have a history of gastrointestinal problems, cardiovascular issues, kidney disease, or liver disease.
• Long-Term Use: Long-term use of NSAIDs should be monitored closely by a healthcare provider to mitigate risks and adjust treatment as needed.

By being aware of these risks and working closely with your healthcare provider, you can better manage your treatment and minimize potential complications associated with Arthrotec.

Why is this medication prescribed?

Arthrotec, which combines diclofenac and misoprostol, is prescribed for managing symptoms of osteoarthritis or rheumatoid arthritis, such as pain, inflammation, and stiffness. The misoprostol component helps to reduce the risk of stomach ulcers that can be caused by diclofenac, a nonsteroidal anti-inflammatory drug (NSAID).

How should this medicine be used?

Here’s how Arthrotec should be used:

• Dosage: Follow your doctor’s prescribed dosage. Typically, the medication is taken orally, with or without food. The usual starting dose is 1 tablet 2 to 3 times daily, but this can vary based on your specific condition and response to the medication.
• Administration: Swallow the tablets whole with a full glass of water. Do not crush or chew the tablets as this can affect how the medication works.
• Consistency: Take the medication at the same times each day to help remember to take it consistently.
• Monitoring: Your doctor may monitor you for side effects, especially gastrointestinal issues or changes in kidney function, since NSAIDs can have effects on these areas.
• Avoidance: If you experience severe stomach pain, black or bloody stools, or vomit that looks like coffee grounds, contact your doctor immediately, as these could be signs of serious gastrointestinal problems.

Always follow your healthcare provider’s instructions and consult them if you have any questions or experience side effects.

Other uses for this medicine

While Arthrotec is primarily prescribed for arthritis-related pain and inflammation, it may also be used off-label for other conditions involving pain and inflammation, such as:

• Chronic Back Pain: For long-term pain management in certain cases.
• Menstrual Pain: To relieve severe menstrual cramps.
• Gout: In some cases, it may be used to manage acute gout attacks.

What special precautions should I follow?

When using Arthrotec, consider the following precautions:

• Gastrointestinal Risks: Because Arthrotec contains diclofenac, it can increase the risk of gastrointestinal problems such as ulcers, bleeding, and perforation. Take it with food or milk to help minimize stomach upset.
• Kidney and Liver Function: Monitor for changes in kidney and liver function, especially if you have preexisting conditions affecting these organs. Regular check-ups with your healthcare provider may be necessary.
• Cardiovascular Risks: NSAIDs can increase the risk of heart attack or stroke. Use Arthrotec with caution if you have a history of cardiovascular issues.
• Pregnancy: Misoprostol can cause miscarriage and should be avoided during pregnancy. If you are pregnant or planning to become pregnant, discuss alternative treatments with your healthcare provider.
• Allergies: Inform your doctor if you have any known allergies to NSAIDs or misoprostol.
• Interactions: Be aware of potential drug interactions, especially with other medications that affect blood clotting, blood pressure, or kidney function.
• Dosage and Duration: Use the medication for the shortest duration necessary to control symptoms and at the lowest effective dose to reduce the risk of side effects.

Always consult with your healthcare provider to ensure that Arthrotec is appropriate for your specific condition and to address any concerns about potential risks.

What special dietary instructions should I follow?

• Food Intake: Take Arthrotec with food or milk to reduce the risk of stomach irritation and gastrointestinal upset.
• Avoid Alcohol: Limit alcohol consumption, as it can increase the risk of gastrointestinal bleeding when combined with NSAIDs.

What should I do if I forget a dose?

• Timing: If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose. Do not double up to make up for a missed dose.
• Routine: Try to take your medication at the same times each day to establish a routine and reduce the chance of forgetting doses.

What side effects can this medication cause?

Arthrotec can cause a range of side effects, some of which may require medical attention. Here are common and serious side effects to be aware of:

Common Side Effects:

• Gastrointestinal Issues: Nausea, vomiting, diarrhea, constipation, stomach pain, or indigestion.
• Headache: Mild to moderate headaches may occur.
• Dizziness: Some people may experience dizziness or lightheadedness.
• Rash: Skin rash or itching may develop.

Serious Side Effects:

• Gastrointestinal Problems: Severe stomach pain, black or bloody stools, or vomit that looks like coffee grounds, which could indicate gastrointestinal bleeding or ulcers.
• Kidney Issues: Symptoms such as swelling in your legs or feet, or changes in urine output.
• Liver Problems: Jaundice (yellowing of the skin or eyes), dark urine, or severe fatigue.
• Cardiovascular Issues: Chest pain, shortness of breath, or symptoms of heart attack or stroke.
• Severe Allergic Reactions: Rash, itching, swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing.
• Misoprostol Effects: Misoprostol can cause cramping or bleeding, particularly in pregnant women, and should not be used during pregnancy.

If you experience any of these serious side effects, seek medical attention immediately. For less severe side effects, consult your healthcare provider to determine whether they are manageable or if an adjustment to your treatment is needed.

What should I know about storage and disposal of this medication?

Storage of Arthrotec:

• Store Arthrotec at room temperature, away from heat and moisture. The typical range is 68°F to 77°F (20°C to 25°C).
• Keep the medication in its original container, tightly closed, to protect it from light and moisture.
• Keep out of reach of children and pets to prevent accidental ingestion.

Disposal of Arthrotec:

• Do not flush medications down the toilet or pour them into a drain unless specifically instructed. This can harm the environment.
• Use a drug take-back program or contact your local pharmacy or waste disposal authority for safe disposal options. Many communities have drug take-back programs or special disposal kiosks.

In case of emergency/overdose

• Symptoms of Overdose: Symptoms may include severe stomach pain, nausea, vomiting, dizziness, and in severe cases, kidney problems or liver damage.
• Immediate Action: If you suspect an overdose, seek emergency medical attention immediately. Contact your local poison control center or go to the nearest emergency room.
• Information: Be prepared to provide information about the medication taken, the amount, and the time of ingestion.

What other information should I know?

• Medication Review: Regularly review your medications with your healthcare provider to ensure they are still appropriate for your condition and to adjust dosages if necessary.
• Side Effects: Monitor for side effects and report any unusual or severe symptoms to your healthcare provider.
• Medical History: Keep your healthcare provider informed about any changes in your medical history, including new diagnoses or changes in existing conditions.

Always follow your healthcare provider’s instructions regarding the use of Arthrotec and consult them if you have any questions or concerns about the medication.