Indications 

Arthrotec is a prescription medicine used to manage the signs and symptoms of osteoarthritis or rheumatoid arthritis in high-risk patients for nonsteroidal anti-inflammatory drug (NSAID)-induced gastric and duodenal ulcers, and associated complications. 

Arthortec contains two active ingredients: diclofenac and misoprostol. Diclofenac, an NSAID, halts the body’s production of a substance that causes pain and inflammation. While misoprostol, a prostaglandin, is responsible for preventing diclofenac-induced ulcers by safeguarding the stomach lining and decreasing stomach acid production. 

Uses and Dosage 

Before taking Arthrotec and with each prescription refill, carefully read its medication guide and patient information leaflet. For questions or concerns, do not hesitate to seek guidance from your doctor or pharmacist. 

Arthotec dosage is determined based on the patient’s medical condition, response to the treatment, and concomitant medications. It is usually taken at the lowest effective dose for the shortest possible duration. 

Typically, Arthrotec is taken 3-4 times daily with food as directed by the physician. Tablets must be swallowed whole with a full glass of water and should not be cut, crushed, or chewed. 

For optimal results, take Arthrotec regularly, around the same time daily, exactly as instructed by your doctor. Do not take less or more of it or take it longer or more frequently than prescribed. 

Side Effects 

Listed below are the side effects associated with the use of Arthrotec. If any of them persist or worsen, tell your doctor right away. 

Common Side Effects 

• Abnormal vaginal bleeding 
• Heartburn 
• Indigestion 
• Stomach pain 
• Gas 
• Nausea 
• Vomiting 
• Diarrhea 
• Constipation 
• Dizziness 

Serious Side Effects 

• First sign of skin rash, regardless of the severity 
• Shortness of breath, even with mild exertion 
• Swelling or rapid weight gain 
• Signs of stomach bleeding: 
  • Bloody or tarry stools 
  • Coughing up blood 
  • Vomiting that looks like coffee grounds 
• Signs of liver problems: 
  • Loss of appetite 
  • Upper right stomach pain 
  • Tiredness 
  • Itching 
  • Dark urine 
  • Clay-colored stools 
  • Yellowing of skin/eyes 
• Signs of kidney problems: 
  • Little or no urination 
  • Swelling in feet or ankles 
  • Fatigue 
  • Shortness of breath 
• Signs of low red blood cells (anemia): 
  • Pale skin 
  • Unusual tiredness 
  • Lightheadedness 
  • Cold hands/feet 
• Signs of a severe drug reaction that can impact several parts of your body: 
  • Skin rash 
  • Fever 
  • Swollen glands 
  • Muscle aches 
  • Extreme weakness 
  • Unusual bruising 
  • Yellowing of the skin or eyes 
• Signs of a heart attack or stroke: 
  • Chest pain that radiates to the jaw or shoulder 
  • Sudden numbness or weakness on one side of the body 
  • Slurred speech 
  • Shortness of breath 

Stop taking Arthrotec and call your doctor immediately for medical assistance if you experience any of the serious symptoms listed above. 

Allergic Reactions 

Seek emergency medical attention if you experience signs of an allergic reaction to Arthrotec, such as: 

• Sneezing 
• Runny or congested nose 
• Hives 
• Wheezing 
• Breathing difficulties 
• Face or throat swelling 

Seek emergency medical help if you experience severe skin reactions such as: 

• Fever 
• Sore throat 
• Burning eyes 
• Skin pain 
• Red or purple rash with blistering and peeling 

This list does not contain all the potential side effects of Arthrotec. If you experience other effects not listed above, inform your doctor promptly.  

Cautions 

Before starting treatment with Arthrotec, inform your doctor and pharmacist if you have any known allergies, especially to: 

• Diclofenac 
• Misoprostol 
• Aspirin 
• Other NSAIDs such as celecoxib, ibuprofen, or naproxen 
• Other medicines 
• Any ingredients present in Arthrotec tablets 

To ensure Arthrotec is safe for you, disclose to your physician your medical background, specifically regarding any history of: 

• Liver disease 
• Stomach, intestinal, or esophagus problems such as ulcers, bleeding, or heartburn 
• Heart disease such as previous heart attack 
• Hypertension (high blood pressure) 
• Stroke 
• Swelling (edema, fluid retention) 
• Blood disorders such as anemia 
• Bleeding/clotting problems 
• Aspirin-sensitive asthma (past occurrences of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDs) 
• Growths in the nose (nasal polyps) 

Arthrotec may interact with other medications, potentially affecting its efficacy or increasing the likelihood of severe side effects. To avoid such drug interactions, disclose to your physician and pharmacist all your current medications, including prescriptions, over-the-counter drugs, dietary supplements, and herbal products.  

Some products that may interact with Arthrotec include: 

• Aliskiren 
• ACE inhibitors (e.g., captopril, lisinopril) 
• Angiotensin II receptor blockers (e.g., valsartan, losartan) 
• Cidofovir 
• Corticosteroids (e.g., dexamethasone, prednisone) 
• Lithium 
• Methotrexate 
• Diuretics (e.g., furosemide) 

Arthrotec may elevate the risk of bleeding when combined with other medications that can also cause bleeding, including anti-platelet drugs like clopidogrel, blood thinners like dabigatran/enoxaparin/warfarin, and others. 

Check all your medication labels carefully as they may contain pain relievers/fever reducers (e.g. aspirin, celecoxib, ibuprofen, ketorolac) similar to diclofenac, which can increase the risk of side effects if taken together. However, continue taking low-dose aspirin (81-162mg/day) as directed by your doctor for heart attack/stroke prevention unless advised otherwise.  

Do not take magnesium-containing antacids during your treatment with Arthrotec as they may exacerbate diarrhea. Consult your doctor or pharmacist to find a suitable antacid if necessary. 

Diclofenac raises the risk of deadly heart attack or stroke. Avoid taking Arthrotec before or after heart bypass surgery (coronary artery bypass graft or CABG).  

Arthrotec use, particularly in elderly patients, can lead to life-threatening stomach or intestinal bleeding caused by diclofenac. Such conditions may happen without any warning signs. 

Arthrotec use elevates sun sensitivity. Minimize sun exposure, avoid tanning booths/sunlamps, and wear protective clothing and sunscreen when outdoors. Inform your doctor immediately if you encounter sunburn, skin blisters, or redness. 

Arthrotec should not be taken during pregnancy due to the risk of birth defects, miscarriage, premature labor, or uterine rupture from misoprostol. A negative pregnancy test within 2 weeks before starting treatment is necessary. Begin taking this medication on the 2nd or 3rd day of your menstrual cycle and use effective contraception while using Arthrotec. 

No lactation studies exist for Arthrotec, but diclofenac and the active metabolite of misoprostol are found in breast milk as per limited literature. Nursing mothers should consult their doctor before using this medication.