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ARTROTEC 75 MODIFIED-RELEASE TABLETS

Active substance(s): DICLOFENAC SODIUM / MISOPROSTOL

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Arthrotec® 75 modified-release Tablets/
Artrotec® 75 modified-release 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
because it contains important information for you.
• 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 only. Do not pass it on to
others.
It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This
includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1) What Arthrotec is and what it is used for
2) What you need to know before you take Arthrotec
3) How to take Arthrotec
4) Possible side effects
5) How to store Arthrotec
6) Contents of the pack and other 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) What you need to know 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 section 6)
• currently have an ulcer or perforation (hole) in your stomach or
intestines
• 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 established heart disease and/or cerebrovascular disease e.g. if
you have had a heart attack, stroke, mini-stroke (TIA) or blockages to
blood vessels to the heart or brain or an operation to clear or bypass
blockages
• have or have had problems with your blood circulation (peripheral
arterial disease)
• 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
Warnings and precautions
Talk to your doctor before taking Arthrotec
If you:
• 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 your
stomach or intestines
• bleed or bruise easily
• have inflammation of the intestines (ulcerative colitis or Crohn’s
disease)
• have, or have ever had asthma or an allergic disease
• have an infection, as Arthrotec may mask a fever or other signs of
infection
• are dehydrated
• are over the age of 65 as your doctor will want to monitor you
regularly
NSAID medicines such as Arthrotec can cause bleeding or ulceration. If this
occurs, treatment should be stopped.
Use of Arthrotec with another NSAID other than aspirin (e.g. ibuprofen) may
also increase frequency of ulcers or bleeding in your stomach or intestines.
Arthrotec may cause serious side effects, especially stomach and intestinal
complications, if you are using a corticosteroid (e.g. prednisone), an oral
anticoagulant, or a Selective Serotonin Re‑uptake Inhibitor (e.g. sertaline) or
if you drink alcohol.
Make sure your doctor knows, before you are given Arthrotec
If you:
• smoke
• have diabetes
• have angina, blood clots, high blood pressure, raised cholesterol or
raised triglycerides

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.
Side effects may be minimised by using the lowest effective dose for the
shortest duration necessary.
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.
Other medicines and Arthrotec
Some medicines can affect the way other medicines work.
Tell your doctor or pharmacist if you are taking, have recently taken or
might take any other medicines,
including:
• 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, e.g. aspirin)
• Medicines used to treat anxiety and depression known as Selective
Serotonin Re-uptake Inhibitors (SSRIs)
• Medicines used to control your blood sugar (oral hypoglycaemics for
diabetes)
• Methotrexate (used to treat rheumatoid arthritis, psoriasis and
leukaemia)
• 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 heartburn, indigestion)
• Quinolone antibiotics (used to treat some infections)
• Ketoconazole, fluconazole, miconazole and voriconazole (used to treat
some fungal infections)
• Amiodarone (used to treat an abnormal heart beat)
• Sulfinpyrazole (used to treat gout)
• If you have taken a medicine called mifepristone (used to terminate
pregnancy) within the last 12 days. Arthrotec should not be taken within
8-12 days of taking mifepristone
Pregnancy, breast-feeding and fertility
Do not use if you are pregnant, think you may be pregnant or trying to
become pregnant. You should tell your doctor if you are planning to become
pregnant. Ask your doctor or pharmacist for advice before taking this
medicine if you are breast-feeding. Women who have not reached
menopause should use reliable contraception while they are taking Arthrotec.
Do not use Arthrotec while you are breast-feeding.
Ask your doctor or pharmacist for advice before taking this 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.
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 this medicine exactly as your doctor or pharmacist has told you.
Check with your doctor or pharmacist if you are not sure.
The recommended dose is one tablet twice a day.
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.
Use in children: Arthrotec is for adults only, it is not for use in children (under
18 years).
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 a forgotten dose.
If you stop taking Arthrotec
Do not stop taking Arthrotec unless your doctor tells you to. If you have any
further questions on the use of this medicine, ask your doctor or pharmacist.

• 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
reality)
• Swelling of the tongue, mouth ulcers, dry mouth
• Depression, feeling anxious, mood swings, irritability, memory problems,
feeling confused, feeling shaky, drowsiness, tiredness
• Difficulty seeing, ringing in the ears, changes in the way things taste
• Increased sensitivity to light
• Inflammation
• Loss of appetite
• Abnormal contractions of the womb, rupture in the womb, retained
placenta after giving birth, a life-threatening reaction in the mother due to
the passage of amniotic fluid (fluid covering the fetus) or other fetal
material into the maternal blood stream, bleeding in the womb,
miscarriage, death of the unborn baby, premature birth
• Low blood pressure
• Anaemia (low number of red blood cells) which can lead to pale skin and
cause weakness or breathlessness
• Painful menstrual/period cramps
• Decreased fertility in females

4) Possible side effects
Like all medicines, this medicine can cause 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 immediately:
If you have
• Weakness of or inability to move one side of body, slurred speech
(stroke) or chest pain (heart attack) – the occurrence is uncommon
• Shortness of breath – the occurrence is uncommon
• 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
• Heart failure, chest pain, palpitations (awareness of your heartbeat) – 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
rarely
• Arthrotec can cause a decrease in a type of white blood cell (these help
protect the body from infection and disease) and lead to infections with
symptoms like chills, sudden fever, sore throat, or flu-like symptoms.
Immediately contact your doctor if any of these symptoms develop – it is
not known how often this occurs
• Reduction in the number of blood platelets (increased chance of bleeding
or bruising) – it is not known how often this occurs

If you get any side effects, talk to your doctor or pharmacist. This
includes any possible side effects not listed in this leaflet.
• Very common: may affect more than 1 in 10 people
• 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: may affect up to 1 in 10 people
• Rash, itching
• Vomiting, wind, constipation, burping, gastritis (indigestion, stomach
ache, vomiting)
• Ulcers in the stomach or intestines
• Headache, dizziness
• Difficulty sleeping
• Changes in blood tests relating to the liver
• Inflammation of the digestive tract, including the intestines, such as
nausea, diarrhoea, abdominal pain
• Uncommon: may affect up to 1 in 100 people
• Swelling of the mouth
• Abnormal or unexpected bleeding from the vagina, menstrual
disturbances
• Reduction in the number of blood platelets (increased chance of
bleeding or bruising)
• Purpura (purple spots on the skin)
• Urticaria (raised itchy rash)
• Infection of the vagina (itching, burning, soreness, pain especially
during intercourse and/or urination)
• Blurred vision
• High blood pressure
• Menstrual disorders such as usually heavy or light bleeding, or delayed
periods
• Chills or fever
• Rare: may affect up to 1 in 1,000 people
• Inflammation of the liver (possible yellow discoloration of skin,
headache, fever, chills, general weakness)
• Inflammation of the pancreas, which causes severe pain in the
abdomen and back
• Inflammation of the lung such as coughing, increased sputum
• Breast pain
• Birth defects
• Very rare: may affect up to 1 in 10,000 people
• Severe liver disorders including liver failure
• Nightmares
• Not known: frequency cannot be estimated from the available data
• Damage to the gullet
• Worsening of ulcerative colitis or Crohn’s disease (inflammation of the
intestines)
• Kidney or liver problems
• Seizures
• Allergic reaction, including asthma, breathing problems, itching, hair loss,
inflamed blood vessels (can cause fever, aches, purple blotches)

Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any
possible side effects not listed in this leaflet. You can also report side effects
directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or
search for MHRA Yellow Card in the Google Play or Apple App Store. By
reporting side effects you can help provide more information on the safety of
this medicine.

5) How to store Arthrotec





Do not use after the expiry date printed on the carton label or blister strip.
Do not store above 25°C. Store in the original package.
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) Contents of the pack and other information
What Arthrotec contains:
Each modified-release tablet contains diclofenac sodium 75mg and
misoprostol 0.2mg.
Arthrotec also contain the following inactive ingredients: lactose,
microcrystalline cellulose, maize starch, povidone K-30, magnesium stearate,
methylacrylic acid copolymer type C, sodium hydroxide, triethyl citrate,
hydroxypropylmethylcellulose, crospovidone, colloidal anhydrous silica,
hydrogenated castor oil, and talc.
What Arthrotec looks like and contents of the pack
The tablets are white, round and marked 'SEARLE 1421' on one side and '75'
within a circle of 4 A’s on the reverse.
Arthrotec Tablets are available as blister packs of 30 tablets.
PL 10383/0757
Arthrotec
modified-release Tablets

75

modified-release
POM

Tablets/Artrotec

75

Who makes and repackages your medicine?
Your medicine is manufactured by Pharmacia Ltd, Whalton Road, Morpeth,
Northumberland UK. 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: 09.10.2017
Arthrotec and Artrotec are registered trademarks of G. D. Searle LLC, United
States of America.

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