Arthrotec

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What is Arthrotec?

A combination of Diclofenac and Misoprostol. Diclofenac reduces the joint pain, stiffness, inflammation, or swelling caused by rheumatoid arthritis or osteoarthritis. Misoprostol is a synthetic prostaglandin shown to protect the stomach lining from irritating effects of NSAIDs.

FDA approved:

December 1997

Brand Names and International Availability:

Arthrotec (US)

How does it work?

As with most other nonsteroidal anti-inflammatory agents, its mode of action is not known. However, the ability to inhibit prostaglandin production is probably involved in the anti-inflammatory effect.
Misoprostol can increase bicarbonate and mucus production thus protecting the stomach to some degree.

Dosage:

Arthrotec 50 contains mg diclofenac sodium/200 mcg misoprostol.
Arthrotec 75 contains 75 mg diclofenac sodium/200 mcg misoprostol.

The usual dose of for osteoarthritis is Arthrotec 50 three times a day. Rheumatoid arthritis is Arthrotec 50 three or four times a day. 

How should I take it?

Arthrotec should be taken with food.

Contraindications:

Those who have had a prior allergic reaction to other NSAIDs should not take Athrotec.

Athrotec should be avoided in those with a history of peptic ulcer or GI bleeding. 

Athrotec should be used with caution in those with a history kidney disease.

Athrotec should NOT be taken by pregnant women or women who could potentially become pregnant.

Athrotec should not be used by nursing mothers.

Should be used with caution in patients with preexisting asthma.

Drug Interactions:

Athrotec can increase the effect of anti-coagulants and digoxin.

Athrotec can inhibit the activity of antihypertensives,

Athrotec should not be taken with any other NSAIDs.

Magnesium containing antacids may increase the risk of diarrhea side effect.

Athrotec may affect renal function and increase the toxicity of certain drugs such as methotrexate. 

Because of the potent nature of this medicine, be sure to tell your doctor about any other medicines you are taking, including nonprescription medicines and vitamins.

Possible side effects:

These side effects are not considered serious but are certainly annoying for those experiencing them. The most frequently reported side effects include diarrhea, dizziness, gas or heartburn, headache, menstrual irregularity or cramps, nausea, stomach pain or cramps, postmenopausal vaginal bleeding and dry mouth.

More serious side effects that you should report right away include black, tarry stools, blurred vision, chest pain, dark yellow or brown urine, decrease in the amount of urine passed, difficulty breathing, ringing in the ears, swelling of eyelids, throat, lips or feet, unusual bleeding or bruising, red spots on the skin, vomiting, weight change, yellowing of eyes or skin, vomit that looks like coffee grounds and any other unusual gastrointestinal symptoms.

Signs of a possible allergic reaction are rash, swelling and difficulty breathing. These symptoms should be reported immediately. 

Precautions & Special Notes:

Diarrhea and abdominal pain noted in the first couple days of therapy may resolve on it's own after 2-7 days.

You will be required to have frequent blood work while on this medication. It is very important that you keep all lab and doctor's appointments.

If you get black, tarry stools or vomit up what looks like coffee grounds, call your doctor at once. You may have a bleeding ulcer.

For more information:

RxList Arthrotec
MedicineNet Arthrotec

References:
Mosby's GenRx®, 10th ed. Copyright © 2000 Mosby, Inc.
RxList.com