Arthrotec (Diclofenac and Misoprostol) Side Effects

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Arthrotec is a combination of diclofenac and misoprostol. The combination of these two medications helps make Arthrotec a good option for many people who have arthritis.

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Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain, swelling, and stiffness in the joints. Misoprostol is added to help protect the stomach from the potentially damaging effects caused by taking an NSAID such as diclofenac. This combination is a good option for those who have a history of stomach ulcers or gastrointestinal bleeding and need help controlling the discomfort arthritis creates. 

Currently, Arthrotec is only available in tablet form. For this medication to be most effective, it is essential to take the tablet whole. Do not take a tablet that is cut, crushed, or broken in any way.

Common Side Effects

When you start this medication, you may experience some side effects that are unpleasant but not life-threatening. In many cases, these side effects will disappear after one week.

  • Gas
  • Acne
  • Change in taste
  • Decreased appetite
  • Upset stomach
  • Nausea
  • Bloating
  • Diarrhea
  • Constipation
  • Dizziness
  • Drowsiness
  • Headache
  • Blurred vision
  • Ringing sensation in ears
  • Unusual vaginal bleeding

If you are experiencing bothersome symptoms or side effects after taking Arthrotec, take time to discuss them with your pharmacist or the healthcare provider who wrote your prescription. 

Serious Side Effects

It’s important to talk to the prescribing healthcare provider or a pharmacist about any side-effect symptoms you are experiencing. However, if you are experiencing life-threatening symptoms, call 911 immediately.

  • Difficulty swallowing
  • Swollen hands or feet
  • Sudden weight change
  • Sudden vision change
  • Rapid or irregular heartbeat
  • Severe, persistent headache
  • Fainting
  • Easily bruising or bleeding
  • Increased or worsening blood pressure
  • Heart failure
  • Rash
  • Itching

If you are experiencing any of the following symptoms, get emergency medical attention immediately:

  • Difficulty breathing
  • Chest pain
  • Weakness in one part or one side of your body
  • Slurring your words
  • Swelling of the face, throat, or eyes


Black Box Warning

All NSAIDs increase the risk of a severe cardiac event, which includes heart attack and stroke. NSAID medications also increase the risk for serious gastrointestinal complications, both of which can be fatal. Because of this, and the increased risk to an unborn child during pregnancy, the Food and Drug Administration (FDA) requires Arthrotec to provide a black box warning to inform both patients and prescribers of the increased risk. The black box warning is considered the highest warning level for prescription medications. 


Make sure your healthcare provider is aware of any vitamin, supplement, over-the-counter, or prescription medication you take. Any of these can increase the risk of a serious side effect or interaction. NSAIDs are known to interact with other medications and supplements.


Alcohol alone is known to be tough on the digestive system. However, while taking an NSAID, such as diclofenac, alcohol consumption significantly increases the risk of ulcers or gastrointestinal bleeding. It is crucial to avoid alcohol while taking Arthrotec.


Let your healthcare provider or pharmacist know if you need to take antacids while on Arthrotec. Some antacids can cause a dangerous interaction while taking Arthrotec.


Let your healthcare provider know if you have ever experienced an asthma attack or had your asthma exacerbated after taking another NSAID or aspirin. Since diclofenac is part of the NSAID family, you may experience a similar reaction with Arthrotec.


In general, NSAIDs have been known to affect fertility negatively. However, this negative effect is reversible. If you are trying to get pregnant, it may be best to discuss alternative medications.


Do not take Arthrotec if you are pregnant or planning to become pregnant. Taking Arthrotec while pregnant may cause a miscarriage, premature birth, or cause a congenital disability.

History of Cardiac Problems

NSAIDs, such as diclofenac, have been known to increase the risk of heart attack and stroke. Both of which can result in death. 

Gastrointestinal Bleeding or Ulcers

While having misoprostol in Arthrotec helps reduce the risk of ulcers and gastrointestinal (GI) bleeding, it does not entirely remove the threat. If you’ve had a history of ulcers or GI bleeding, your healthcare provider must know. This way, they can look at the severity of your case, along with the benefits of taking the medication to make the best recommendation.

A Word From Verywell

Talk to your healthcare provider about any side effects you may be experiencing. If these side effects are bothersome, you may be able to try another medication less likely to cause these problems. Call your pharmacist or healthcare provider if you notice any unusual problems while taking Arthrotec.

At Verywell, our goal is to provide you with accurate and relevant information. However, not all side effects or interactions could be listed. Always take time to speak with your healthcare provider about possible interactions or concerns you may have about taking any medication.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Durg Administration. Arthrotec.

  2. MedlinePlus. Diclofenac and misoprostol.

  3. Food and Drug Administration. Highlights of prescribing information for Arthrotec.

  4. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugsJ Clin Pharm Ther. 2002;27(6):391-401. doi:10.1046/j.1365-2710.2002.00444.x

  5. Sostres C, Gargallo CJ, Lanas A. Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damageArthritis Res Ther. 2013;15(Suppl 3):S3. doi:10.1186/ar4175