DICLOFENAC AND MISOPROSTOL

(dye KLOE fen ak and mye so PROST ole) Brand: Arthrotec

What is the most significant information I must know about diclofenac and misoprostol?

• You must not use this medicine if you have a history of allergic reaction to aspirin or another NSAID (non-steroidal anti-inflammatory drug).

• Do not use diclofenac and misoprostol if you are pregnant. This medicine can reason birth defects, miscarriage, premature labor, or rupture of the uterus. Use effective birth control to prevent pregnancy while you are using this medication. Speak your doctor right away if you become pregnant.

• Diclofenac may magnify your risk of heart onslaught or stroke, especially if you use it long term or have heart malady. Do not use this medication just till or after heart bypass surgery (coronary artery bypass graft, or CABG).

• Diclofenac may also reason stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking this medicine.

What is diclofenac and misoprostol?

• Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that reason inflammation and pain in the body.

• Misoprostol reduces stomach acid and replaces protective substances in the stomach that are reduced by NSAIDs.

• Diclofenac and misoprostol is a combination medication used to treat osteoarthritis and rheumatoid arthritis in people at tall risk for developing stomach or intestinal ulcers.

• Diclofenac and misoprostol may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking diclofenac and misoprostol?

• You must not use this medicine if you are allergic to diclofenac (Cataflam) or misoprostol (Cytotec), or if you have a history of allergic reaction to aspirin or another NSAIDs.

• Diclofenac may magnify your risk of heart onslaught or stroke, especially if you use it long term or have heart malady. Do not use this medication just till or after heart bypass surgery (coronary artery bypass graft, or CABG).

• Diclofenac may also reason stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking this medicine.

• To create certain diclofenac and misoprostol is safety for you, speak your doctor if you have:

· heart malady, tall blood pressure, or history of heart onslaught, stroke, or blood clot;

· a history of stomach ulcers or bleeding;

· liver or kidney disease;

· asthma;

· polyps in your nose;

· porphyria;

· a bleeding or blood clotting disorder;

· if you smoke; or

· drink more than three alcoholic beverages a day.

• FDA pregnancy category X. Do not use this medication if you are pregnant. Diclofenac and misoprostol can reason birth defects, miscarriage, premature labor, or rupture of the uterus. Use an effective form of birth control to prevent pregnancy while you are using this medication. Speak your doctor right away if you become pregnant during treatment.

• You will need to have a pregnancy test within 2 weeks till you start taking diclofenac and misoprostol.

• Diclofenac and misoprostol can pass into breast milk and may harm a nursing child. You must not breast-feed while you are using this medication.

How must I take diclofenac and misoprostol?

• Follow all directions on your prescription label. Do not take this medication in larger or less amounts or for longer than recommended.

• Take diclofenac and misoprostol with food or milk to lessen stomach upset.

• Swallow the tablet intact. Do not crush, interrupt, or chew the pill.

• Do not share this medicine with anyone else, even if they have the same symptoms you have.

• If you use this medicine long-term, you may need frequent medical trials at your doctor's office.

• Store at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

What must I avoid while taking diclofenac and misoprostol?

• Avoid using antacids without your doctor's advice. Use only the type of antacid your doctor recommends. Some antacids can create it harder for your body to absorb diclofenac and misoprostol.

• Ask a doctor or pharmacist till using any cool, allergy, or pain medicine. Much medicines accessible over the counter contain aspirin or another medicines similar to diclofenac. Taking determined commodity together can reason you to get too many of this type of medicine. Check the label to see if a medication contains aspirin, ibuprofen, ketoprofen, or naproxen.

• Avoid drinking alcohol. It may magnify your risk of stomach bleeding caused by diclofenac.

• Avoid exposure to sunlight or tanning beds. Diclofenac and misoprostol can create you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

What are the possible side effects of diclofenac and misoprostol?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your person, lips, tongue, or throat.

• Stop using this medication and call your doctor at once if you have:

· sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;

· chest pain, sudden cough, wheezing, shortness of breath;

· bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

· few or no urinating;

· swelling, rapid weight gain;

· nausea, upper stomach pain, itching, diarrhea, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

· bruising, severe tingling, numbness, pain, muscle weakness;

· pale skin, feeling light-headed or short of breath, rapid heart course, trouble concentrating;

· fever, neck stiffness, heighten sensitivity to easy, purple spots on the skin, and/or seizure (convulsions); or

· severe skin reaction -- fever, sore throat, swelling in your person or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the person or upper body) and causes blistering and peeling.

• General side effects may include:

· upset stomach, mild heartburn or stomach pain, bloating, gas;

· mild diarrhea, constipation;

· dizziness, mild headache;

· unusual vaginal bleeding;

· mild skin rash; or

· ringing in your ears.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect diclofenac and misoprostol?

• Ask your doctor till using diclofenac if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may reason you to bruise or bleed easily.

• Speak your doctor about all medicines you use, and those you start or stop using during your treatment with diclofenac and misoprostol, especially:

· cyclosporine;

· digoxin;

· lithium;

· methotrexate;

· rifampin;

· antifungal medication--fluconazole, voriconazole;

· a blood thinner (warfarin, Coumadin);

· a diuretic or "water pill";

· heart or blood pressure medication--amiodarone, benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril;

· insulin or oral diabetes medicine; or

· another NSAIDs--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

• This list is not complete. Another drugs may interact with diclofenac, including prescription and over-the-counter medicines, vitamins, and herbal commodity. Not all possible interactions are listed in this medicine manual.

Where can I get more information?

• Your pharmacist can provide more information about diclofenac and misoprostol.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information 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 must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. 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.