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Arthrotec 50 Tablets/
Artrotec 50 Tablets
(diclofenac sodium and misoprostol)

Your medicine is known by either of the above names, but will be referred to
as Arthrotec throughout this:
Patient Information Leaflet
Read all of this leaflet carefully before you start taking this medicine
 Keep this leaflet. You may need to read it again.
 If you have any further questions, ask your doctor or pharmacist.
 This medicine has been prescribed for you. Do not pass it on to others.
It may harm them, even if their symptoms are the same as yours.
 If any of the side effects get serious, or if you notice any side effects not
listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
1) What Arthrotec is and what it is used for
2) Before you take Arthrotec
3) How to take Arthrotec
4) Possible side effects
5) How to store Arthrotec
6) Further information

1) What Arthrotec is and what it is used for
Arthrotec helps to relieve the pain and swelling of rheumatoid arthritis and
osteoarthritis, and may help to protect patients at risk of irritation or
ulceration of the stomach or intestines.
Arthrotec contains diclofenac and misoprostol. Diclofenac belongs to a group
of medicinal products called Non-Steroidal Anti-Inflammatory drugs (NSAIDs).
Although NSAIDs relieve the pain, they can reduce the amount of natural
protective substances called prostaglandins in the stomach lining.
This means that NSAIDs can lead to stomach upsets or stomach ulcers.
Arthrotec also contains misoprostol which is very similar to these
prostaglandins and may help protect your stomach.

2) Before you take Arthrotec
Do not take Arthrotec
If you:
 have had an allergic reaction such as a skin rash, swelling or
itchiness of the skin, severe nasal congestion, asthma or wheezing
after taking diclofenac or other NSAIDs such as aspirin (acetylsalicylic
acid), misoprostol or another prostaglandin medicine, or any of the
other ingredients in Arthrotec (see Further Information section 6)
 currently have an ulcer or perforation (hole) in your stomach or
 currently suffer from bleeding in your stomach, intestines or brain
 are undergoing or you have just had coronary artery bypass graft
(CABG) surgery
 have severe kidney or liver failure
 have severe heart failure
 are pregnant, or trying to become pregnant, because it may cause a
miscarriage. Women who have not reached the menopause should
use reliable contraception while they are taking Arthrotec.
Take special care with Arthrotec
Check with your doctor if any of the following applies to you:
If you:
 have any heart problems, previous stroke or think you might be at risk
of these conditions (for example if you have high blood pressure,
problems with your blood circulation, diabetes, high cholesterol or are
a smoker) you should discuss your treatment with your doctor or
 have other health problems such as a disease of the liver or kidneys.
Do not take Arthrotec if you have severe kidney or liver failure
previously had an ulcer or bleeding in your stomach or intestines. Do
not take Arthrotec if you currently have an ulcer or bleeding in you
stomach or intestines
 bleed or bruise easily
 have inflammation of the intestines (ulcerative colitis or Crohn’s
 have, or have ever had asthma or an allergic disease
 have an infection, as Arthrotec may mask a fever or other signs of
 are dehydrated
 are over the age of 65 as your doctor may want to keep a regular
check on you.
NSAID medicines such as Arthrotec can cause bleeding or ulceration. If this
occurs, treatment should be stopped.

Medicines such as Arthrotec may be associated with a small increased risk of
heart attack (myocardial infarction) or stroke. Any risk is more likely with high
doses and prolonged treatment. Do not exceed the recommended dose or
duration of treatment.
As with other NSAIDs (e.g. ibuprofen) Arthrotec may lead to an increase in
blood pressure, and so your doctor may ask to monitor your blood pressure
on a regular basis.
If you have heart, liver or kidney problems, your doctor will want to monitor
you regularly.
Taking other medicines
Some medicines can affect the way other medicines work.
Please tell your doctor or pharmacist if you are taking or have recently
taken any other medicines, including medicines obtained without a
 Aspirin (acetylsalicylic acid) or other NSAIDs (e.g. ibuprofen)
 Medicines used to treat osteoarthritis or rheumatoid arthritis known as
cyclo-oxygenase-2 (COX-2) inhibitors
 Diuretics (used to treat excess fluid in the body)
 Ciclosporin or tacrolimus (used for immune system suppression e.g.
after transplants)
 Lithium (used to treat some types of depression)
 Digoxin (a medicine for an irregular heart beat and/or heart failure)
 Warfarin or other oral anticoagulants (blood-thinning agents that reduce
blood clotting)
 Medicines used to treat anxiety and depression known as Serotonin
Selective Re-uptake Inhibitors (SSRIs)
 Medicines used to control your blood sugar (oral hypoglycaemics for
 Methotrexate (used to treat rheumatoid arthritis, psoriasis and
 Steroid medications (e.g. corticosteroids, which are often used as antiinflammatory medicines)
 Medicines for high blood pressure (anti-hypertensives)
 Magnesium containing antacids (used to treat heatburn, indigestion)
 Quinolone antibiotics (used to treat some infections)
 Ketoconazole (used to treat some fungal infections)
 If you have taken a medicine called mifepristone (used to terminate
pregnancy) within the last 12 days. Arthrotec 50 should not be taken
within 8-12 days of taking mifepristone.
Pregnancy and breastfeeding
Do not use Arthrotec if you are pregnant or trying to become pregnant.
Women who have not reached the menopause should use reliable
contraception while they are taking Arthrotec.
Do not use Arthrotec while you are breastfeeding.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
If you feel dizzy or drowsy after taking Arthrotec, do not drive and do not use
any tools or machines until these effects have worn off.
Important information about some ingredients of Arthrotec
Lactose or Sugar intolerance
Arthrotec contains lactose (a type of sugar). If you have been told by your
doctor that you have an intolerance to some sugars, contact your doctor
before taking Arthrotec.

3) How to take Arthrotec
Always take Arthrotec exactly as your doctor has told you. You should check
with your doctor or pharmacist if you are not sure.
Take one tablet two or three times a day, or as directed by your doctor.
Arthrotec should be swallowed whole with a drink of water (not chewed),
taken during or after mealtimes.
In the elderly and patients with liver or kidney disorders, your doctor may
want to monitor you more closely. No change in dose is needed.
Children: Arthrotec is for adults only, it is not for use in children (under 18

If you take more Arthrotec than you should
You should not take more tablets than your doctor tells you to. If you take too
many tablets contact your doctor, pharmacist or hospital as soon as possible,
and take your medicine with you.
If you forget to take Arthrotec
If you forget to take a tablet, take it as soon as you remember. Do not take a
double dose to make up for forgotten doses.
If you stop taking Arthrotec
Do not stop taking Arthrotec 50 unless your doctor tells you to. If you have
any questions on the use of this product ask your doctor or pharmacist.

4) Possible side effects
Like all medicines, Arthrotec can have side effects, although not everybody
gets them.
If you are worried about side effects, ask your doctor. It is important that you
know what can happen, so that you can take action if Arthrotec does have a
side effect. Arthrotec sometimes causes side effects but these usually go
away during treatment as your body gets used to the medicine.
If any of the following happen, stop taking Arthrotec and tell your doctor
If you have
 severe stomach pain or any sign of bleeding or rupture in the stomach or
intestines, such as passing black or bloodstained stools, or vomiting blood
– this occurs very rarely
 a serious skin reaction such as rash, blistering or peeling of the skin
(Stevens-Johnson syndrome, exfoliative dermatitis and toxic epidermal
necrolysis) – this occurs very rarely
 a serious allergic reaction such as skin rash, swelling of the face,
wheezing or difficulty breathing (anaphylactic shock) – this occurs rarely
 jaundice (your skin or the whites of your eyes look yellow) – this occurs
Additionally, if any of the following side effects gets serious, or if you
notice any side effects not listed in this leaflet, please tell your doctor or
 Very common side effects
(affecting more than 1 in every 10):
 Stomach ache, diarrhoea, nausea (feeling sick), indigestion
Diarrhoea is the most common problem and is occasionally severe. You have
less chance of getting diarrhoea if you take Arthrotec with food. If you use an
antacid (something to reduce acid in the stomach) you should avoid antacids
with magnesium in them as these may make diarrhoea worse. Your
pharmacist can help you choose a suitable antacid. If this diarrhoea continues
and is severe tell your doctor.
 Common side effects
(affecting less than 1 person in every 10, but more than 1 in every 100):
 Rash, itching
 Vomiting, wind, constipation, burping, gastritis (indigestion, stomach ache,
 Ulcers in the stomach or intestines
 Headache, dizziness
 Difficulty sleeping
 Changes in blood tests relating to the liver
 Uncommon side-effects
(affecting less than 1 person in every 100, but more than 1 in every 1000):
 Swelling of the mouth
 Abnormal or unexpected bleeding from the vagina, menstrual
 Reduction in the number of blood platelets (increased chance of bleeding
or bruising)
 Purpura (purple spots on the skin)
 Urticaria (raised itchy rash)
 Rare side-effects
(affecting less than 1 person in every 1,000, but more than 1 in every
 Inflammation of the liver (possible yellow discoloration of skin, headache,
fever, chills, general weakness)
 Very rare side effects
(affecting less than 1 person in every 10,000 patients):
 Severe liver disorders including liver failure

 Additional side effects experienced in actual use
(post-marketing experience, frequency unknown):
 Heart failure, chest pain, palpitations (awareness of your heartbeat)
 Damage to the gullet
 Worsening of ulcerative colitis or Crohn’s disease (inflammation of the
 Kidney or liver problems
 Shortness of breath
 Seizures
 Allergic reaction, (including asthma, breathing problems, itching, hair loss,
inflamed blood vessels (can cause fever, aches, purple blotches))
 Symptoms of meningitis (stiff neck, headache, nausea (feeling sick),
vomiting, fever or loss of consciousness)
 Fluid build-up in the body that can cause swollen ankles and legs
 Vomiting blood
 Psychotic reactions (mental disorder that features loss of contact with
 Swelling of the tongue, mouth ulcers, dry mouth
 Depression, feeling anxious, mood swings, irritability, memory problems,
feeling confused, feeling shaky, nightmares, drowsiness, tiredness
 Difficulty seeing, impaired or blurred vision, ringing in the ears, changes in
the way things taste
 Chills, fever, increased sensitivity to light, inflammation
 Loss of appetite
 Abnormal contractions of the womb, rupture in the womb, retained
placenta after giving birth, clotting in the amniotic fluid (fluid covering the
fetus), bleeding in the womb, miscarriage, death of the unborn baby, birth
defects, premature birth
 Low blood pressure, high blood pressure
 Reduction in the number of white blood cells (these help protect the body
from infection and disease)
 Anaemia (low number of red blood cells) which can lead to pale skin and
cause weakness or breathlessness.
Medicines such as Arthrotec may be associated with a small increased risk of
heart attack or stroke.
If any of the side effects gets serious, or if you notice any side effects
not listed in this leaflet, please tell your doctor or pharmacist.

5) How to store Arthrotec
 Do not use after the expiry date printed on the carton label or blister strip.
 Do not store your tablets above 25°C. Store in a dry place in the original
 Keep all medicines out of the sight and reach of children.
 If your doctor tells you to stop taking the tablets, please take them back to
the pharmacist for safe disposal. Only keep the tablets if your doctor tells
you to.
 If the tablets become discoloured or show signs of any deterioration, you
should seek the advice of your pharmacist.
 Medicines should not be disposed of via wastewater or household waste.
Ask your pharmacist how to dispose of medicines no longer required. These
measures will help to protect the environment.

6) Further information
What Arthrotec contains:
Each tablet contains 50 milligrams of diclofenac sodium in a gastro-resistant
formulation and 200 micrograms of misoprostol, as active ingredients.
Arthrotec Tablets also contain the following inactive ingredients: lactose,
microcrystalline cellulose, maize starch, povidone K-30, cellulose acetate
phthalate, diethyl phthalate, hypromellose, crospovidone, magnesium
stearate, hydrogenated castor oil, colloidal anhydrous silica.
What Arthrotec looks like and contents of the pack
The tablets are white, round, biconvex tablets marked ‘A A A A’ in a circular
pattern on one side and ‘Searle 1411’ on the reverse.
Arthrotec 50 Tablets are available in blister packs in boxes of 40 tablets.
PL 10383/1508

Arthrotec 50 Tablets/Artrotec 50 Tablets


Who makes and repackages your medicine?
Your medicine is manufactured by Pharmacia Limited, Davy Avenue, Milton
Keynes MK5 8PH United Kingdom. Procured from within the EU and
repackaged by Product Licence Holder: Primecrown Ltd., 4/5 Northolt Trading
Estate, Belvue Road, Northolt, Middlesex, UB5 5QS.
Leaflet date: 07.04.2013

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.