Arthrotec

Arthrotec Medication Information:

Arthrotec medication comes in several different strengths; click on the strength you need to view prices from pharmacies competing to earn your business.

Arthrotec 50mg/200mcg
Arthrotec 75mg/200mcg

About Arthrotec

What Arthrotec is used for

Your health care provider has prescribed Arthrotec for one or more of the following medical conditions:

  • short-term and long-term use in the relief of the signs and symptoms of rheumatoid arthritis;

  • short-term and long-term use in the relief of the signs and symptoms of osteoarthritis

What Arthrotec does

Arthrotec contains two different medicines, a nonsteroidal anti-inflammatory drug (NSAID) called diclofenac and a drug that helps to protect the lining of your stomach called misoprostol (because NSAIDs can cause damage to your stomach).

Arthrotec (diclofenac plus misoprostol), as a nonsteroidal anti-inflammatory drug (NSAID), can reduce the chemicals produced by your body which cause pain and swelling. It helps to relieve joint pain, swelling, and stiffness by reducing the production of certain substances (prostaglandins) and by helping to control inflammation. Arthrotec, as a non-steroidal anti-inflammatory drug (NSAID) does NOT cure your illness or prevent it form getting worse but it promotes suppression of the inflammation and the tissue damaging effects resulting from this inflammation. Arthrotec can only relieve pain and reduce swelling as long as you continue to take it.

How do NSAIDs cause stomach damage?

Natural prostaglandins play an important role in protecting the stomach by working to keep a thick mucus layer on the inside surface of the stomach. If the lining of the stomach is not protected by a thick layer of mucus, it may be burned by natural stomach acids. NSAIDs lower natural prostaglandins both in the joints and in the stomach. This is good for the joints because it controls pain, swelling and stiffness. Unfortunately, lowering prostaglandins in the stomach can lead to burning stomach pain and the development of tiny holes in the lining of your stomach called “ulcers”.

Oddly enough, some NSAID patients who do develop ulcers never feel any stomach pain. On the other hand, some patients who do feel stomach pain have nothing wrong with them. For this reason people must be very careful when taking NSAIDs.

How does misoprostol protect the stomach?

Misoprostol is a synthetic form of a special kind of prostaglandin that is found in the stomach. Misoprostol replaces the prostaglandins that are lost when taking the NSAID medicine. It protects the thick mucus layer and reduces the acid in your stomach. This can help to protect your stomach from the NSAID.

When Arthrotec should not be used

Special Note for Women of Childbearing Age

Do not take Arthrotec if you are pregnant or think you are pregnant. Do not start Arthrotec until you have been tested to confirm that you are not pregnant. You should avoid becoming pregnant while you are taking Arthrotec and for at least one month (or through one menstrual cycle) after you stop taking it. This means using an effective form of birth control which you should discuss with your doctor. Stop taking Arthrotec, and contact your doctor immediately if you do become pregnant during Arthrotec therapy.

Misoprostol may cause uterine contractions (contractions of the uterus), premature birth, birth defects and abortion or may otherwise harm the unborn developing baby. Misoprostol has been reported to cause the uterus to tear when given after the eighth week of pregnancy. Tearing of the uterus can result in severe bleeding, hysterectomy, and/or maternal or fetal death. Therefore, if you are pregnant, you must not take this drug.

Abortions caused by misoprostol are likely to be incomplete. An incomplete abortion may result in very serious medical complications, resulting in hospitalization, surgery and possibly infertility, and may result in maternal death.

You should not take Arthrotec if you are nursing. The body changes misoprostol to the active form of the drug, misoprostol acid, which could get into the breast milk and cause significant diarrhea in the infant.

DO NOT TAKE Arthrotec if you have any of the following medical conditions:

  • Heart bypass surgery (planning to have or recently had)

  • Severe, uncontrolled heart failure

  • Bleeding in the brain or other bleeding disorders

  • Current pregnancy or pregnancy cannot be excluded

  • Currently breastfeeding (or planning to breastfeed)

  • Allergy to ASA (Acetylsalicylic Acid) or other NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

  • Ulcer (active)

  • Bleeding from the stomach or gut (active)

  • Inflammatory bowel disease (Crohn’s Disease or Ulcerative Colitis)

  • Liver disease (active or severe)

  • Kidney disease (severe or worsening)

  • High potassium in the blood

Patients who took a drug in the same class as Arthrotec after a type of heart surgery [coronary artery bypass grafting (CABG)] were more likely to have heart attacks, strokes, blood clots in the leg(s) or lung(s), and infections or other complications than those who did NOT take that drug. Arthrotec should NOT be used in patients under 18 years of age since safety and effectiveness have NOT been established.

What the medicinal ingredients for Arthrotec are

Diclofenac sodium and misoprostol.

What the important nonmedicinal ingredients for Arthrotec are

Lactose, Hydrogenated Castor Oil, Microcrystalline Cellulose, Colloidal Silicon Dioxide, Corn Starch, Crospovidone, Hypromellose, Magnesium Stearate, Methacrylic Acid Copolymer, Povidone K-30, Sodium Hydroxide, Talc, Triethyl Citrate.

What dosage forms Arthrotec comes in

Enteric coated Tablets:

Arthrotec 50: 50 mg diclofenac sodium/200 µg misoprostol.

Arthrotec 75: 75 mg diclofenac sodium/200 µg misoprostol.


Warnings and Precautions

Serious Warnings and Precautions

If you have, or previously had, any of the following medical conditions, see your healthcare provider to discuss treatment options other than Arthrotec:

  • Heart Attack or Angina

  • Stroke or Mini-stroke

  • Loss of Vision

  • Congestive Heart Failure

BEFORE you use Arthrotec talk to your doctor or pharmacist if you have any of the following

  • High blood pressure

  • High cholesterol

  • Diabetes mellitus or on a low sugar diet

  • Atherosclerosis

  • Poor circulation to your extremities

  • Smoker or ex-smoker

  • Kidney disease or urine problems

  • Previous ulcer or bleeding from the stomach or gut

  • Previous bleeding in the brain

  • Bleeding problems

  • Family history of allergy to NSAIDs, such as acetylsalicylic acid (ASA), celecoxib, diclofenac, diflunisal, etodolac, fenoprofen, fluribiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam, rofecoxib, sulindac, tenoxicam, tiaprofenic acid, tolmetin, or valdecoxib (NOT a complete list)

  • Family history of asthma, nasal polyps, long-term swelling of the sinus (chronic sinusitis) or hives.

  • you are on any special diet, such as a low sodium.

  • you drink alcohol;

Fertility may be decreased. The use of Arthrotec is not recommended in women who have difficulty conceiving.

WHILE taking Arthrotec

  • tell any other doctor, dentist, pharmacist or other health care professional that you consult or see, that you are taking this medication, especially if you are planning to have heart surgery;

  • do NOT drink alcoholic beverages while taking this medication because you would be more likely to develop stomach problems;

  • some NSAIDs may cause drowsiness or fatigue in some people taking them; be cautious about driving or participating in activities that require alertness if you are drowsy, dizzy or lightheaded after taking this medication;

  • your regular medical checkups are essential.

  • Do not give Arthrotec to anyone else. It has been prescribed for your specific condition. Arthrotec may not be the correct treatment for another person, and would be dangerous if the other person were pregnant.


Interactions with Arthrotec

Talk to your healthcare provider and pharmacist if you are taking any other medication (prescription or non-prescription) such as any of the following (NOT a complete list):

  • Acetylsalicylic Acid (ASA) or other NSAIDs (e.g. ASA, celecoxib, diclofenac, ibuprofen, indomethacin, ketorolac, meloxicam, naproxen)

  • Antacids

  • Antidepressants

    • Selective Serotonin Reuptake Inhibitors (SSRIs) (e.g. citalopram, fluoxetine, paroxetine, sertraline)

  • Blood pressure medications

    • ACE (Angiotensin converting enzyme) inhibitors (e.g. enalapril, lisinopril, perindopril, ramipril)

    • ARBs (angiotensin II receptor blockers) (e.g. candesartan, irbesartan, losartan, valsartan)

  • Blood thinners (e.g. warfarin, ASA, clopidogrel)

  • Corticosteroids (including glucocorticoids) (e.g. prednisone)

  • Cyclosporin

  • Digoxin

  • Diuretics (e.g. furosemide, hydrochlorothiazide)

  • Lithium

  • Methotrexate

  • Oral contraceptives

  • Oral hypoglycemics (diabetes medications)

  • Tacrolimus

Do not take ASA (acetylsalicylic acid), ASA-containing compounds, ibuprofen or other drugs used to relieve symptoms of arthritis while taking Arthrotec unless directed to do so by your physician.

Your healthcare provider may prescribe low dose ASA (acetylsalicylic acid) as a blood thinner to reduce your risk of having a heart attack or stroke while you are taking Arthrotec. Take only the amount of ASA prescribed by your healthcare provider. You are more likely to upset or damage your stomach if you take both Arthrotec and ASA than if you took Arthrotec alone.

Do not take antacids that contain magnesium (because they can cause diarrhea) while you are taking Arthrotec. Ask your pharmacist to help you select a suitable brand.

Stomach problems may be more likely to occur if you drink alcoholic beverages. Therefore, do not drink alcoholic beverages while taking this medication.

Some people may become more sensitive to sunlight than they are normally. Exposure to sunlight or sunlamps, even for brief periods of time, may cause sunburn, blisters on the skin, skin rash, redness, itching or discoloration, or vision changes. If you have a reaction from the sun, check with your doctor.


Proper Use of Arthrotec

Usual dose

Medical Condition Starting Dose Maximum Dose (per day)
Rheumatoid arthritis 100 mg/(50 mg twice a day) 150 mg/(50 mg three times a day or 75 mg twice a day)
Osteoarthritis 100 mg/(50 mg twice a day) 150 mg/(50 mg three times a day or 75 mg twice a day)

Arthrotec should be swallowed whole.

To lessen stomach upset, take Arthrotec immediately after a meal or with food or milk. Also, you should remain standing or sitting upright (i.e. do not lie down) for about 15-30 minutes after taking the medicine. This helps to prevent irritation that may lead to trouble swallowing.

Take Arthrotec only as directed by your healthcare provider. Do NOT take more of it, do NOT take it more often and do NOT take it for a longer period of time than your healthcare provider ordered. If possible, you should take the lowest dose of this medication for the shortest time period. Taking too much Arthrotec may increase the chance of unwanted and sometimes dangerous side effects, especially if you are an elderly patient, have other disease or take other medications.

If you will be using Arthrotec for more than 7 days, see your healthcare provider regularly to discuss whether this medicine is working for your and if it is causing you any unwanted effects. Be sure to take Arthrotec regularly as prescribed. In some types of arthritis, up to two weeks may pass before you feel the full effects of this medicine. During treatment, your doctor may decide to adjust the dosage according to your response to the medication.

This medication has been prescribed specifically for you. Do NOT give it to anyone else. It may harm them, even if their symptoms seem to be similar to yours.

Arthrotec is NOT recommended for use in patients under 18 years of age since safety and effectiveness have NOT been established.

Overdose

Symptoms of overdose may include stomach pain, confusion, drowsiness, low muscle tone, shaking hands that you cannot control, seizures, shortness of breath, diarrhea, fever, rapid or pounding heartbeat, slow heartbeat, dizziness or fainting

Seek immediate medical attention if you think that you or anyone else may have taken too much Arthrotec. Do this even if there are no signs of discomfort or poisoning.

Missed dose

If you miss a dose of Arthrotec, take the next dose at the regular time. It is important that Arthrotec be taken as prescribed. Try to remember to take Arthrotec at the appropriate time. Having a regular routine associated with taking your medicine will help.

Do not take a double dose.


Side Effects for Arthrotec and What to Do About Them

Along with its beneficial effects, Arthrotec like other NSAID drugs, may cause some undesirable reactions especially when used for a long time or in large doses. When these side effects occur, you may require medical attention. Report all symptoms or side effects to your healthcare provider.

Some NSAIDs such as Arthrotec may cause you to become drowsy or tired. Be careful about driving or participating in activities that require you to be alert. If you become drowsy, dizzy or light-headed after Arthrotec, do NOT drive or operate machinery.

Arthrotec may cause you to become more sensitive to sunlight. Any exposure to sunlight or sunlamps may cause sunburn, skin blisters, skin rash, redness, itching or discolouration, or vision changes. If you have reaction from the sun, check with your health care provider.

Check with your healthcare provider IMMEDIATELY if you develop chills, fever, muscle aches or pains, or other flu-like symptoms, especially if they occur before or together with a skin rash. These symptoms may be the first signs of a SERIOUS ALLERGIC REACTION to this medication.

If you are not getting any relief of your arthritis or if any problems develop, check with your doctor.

If you experience unexpected weakness while taking this medication, or if you vomit any blood or have dark or bloody stools, check with your doctor.

Elderly, frail, or debilitated patients often seem to experience more frequent or more severe side effects.

Stomach upset is one of the common problems with NSAIDs. If stomach upset (indigestion, nausea, vomiting, stomach pain or diarrhea) occurs and continues, contact your doctor.

Because misoprostol increases mucus production some patients experience diarrhea. Keep taking your Arthrotec. It is just a sign that the drug is working. Usually the diarrhea goes away in two to three days. If it is not gone after a week, check with your doctor.

While your body gets used to misoprostol you may feel a crampy pain in your stomach. Like the diarrhea it usually goes away in a few days. If it doesn't, check with your doctor.

Serious Side Effects, How Often They Happen and What to Do About Them
Symptom/Effect Stop taking Arthrotec and get emergency medical attention immediately Stop taking drug and call your doctor or pharmacist
Bloody or black tarry stools  
Shortness of breath, wheezing, any trouble in breathing or tightness in the chest  
Skin rash, hives or swelling, itching  
Blurred vision or any visual disturbance  
Any change in the amount or colour of your urine (red or brown)  
Any pain or difficulty experienced while urinating  
Swelling of the feet or lower legs; weight gain  
Vomiting or persistent indigestion, nausea, stomach pain or diarrhea  
Yellow discoloration of the skin or eyes, with or without itchy skin  
Malaise, fatigue, loss of appetite  
Headaches, stiff neck  
Mental confusion, depression  
Dizziness, light headedness  
Hearing problems  

This is not a complete list of side effects. For any unexpected effects while taking Arthrotec, contact your doctor or pharmacist.


 

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