Adult Dose
Osteoarthritis
50 mg/200 mcg, 75mg/200mcg: 1 tab PO three times daily; not to exceed 200 mcg misoprostol/dose or 800 mcg/day
Rheumatoid Arthritis
50 mg/200 mcg, 75mg/200mcg: 1 tab PO three or four times daily; not to exceed 200 mcg misoprostol/dose or 800 mcg/day
If not tolerated may reduce frequency to twice daily
Three times daily dose of misoprostol is more protective than when given twice daily
Mode of Action
Diclofenac: Inhibits cyclooxygenase-1 (COX-1) & -2 (COX-2), thereby inhibiting prostaglandin synthesis; has anti-inflammatory, antipyresis, and analgesic properties.
Misoprostol: Replaces protective prostaglandins consumed by prostaglandin-inhibiting therapies (NSAID-induced ulcers).
Side Effect
>10%
Rash including erythematous, rash macular and maculo-papular (18%),Pyrexia (15%),Urticaria (13%),Flushing (13%)
1-10%
Hypertension (10%),Hyperhydrosis (8%),Decreased oxygen saturation (8%),Cough (8%),Tachypnea (8%),Tachycardia (8%),Urticaria (8%),Anaphylaxis (7%),Chest discomfort (7%),Muscle twitching (7%),Erythema (5%),Vomiting (5%),Rigors (5%),Pallor (5%),Cyanosis (5%),Agitation (5%),Tremor (5%),Myalgia (5%),Flushing (5%),Peripheral edema (3%),Pruritus (3%),Rash, papular (3%),Throat tightness (3%)
<1%
Fatigue,Malaise,Chills,Edema,Atrial fibrillation,Congestive heart failure,Myocardial infarction,Phlebitis,Vasculitis,Syncope,Dysphagia,Enteritis,Peptic ulcer,Vaginitis,Breast pain,Dysmenorrhea,Uterine cramping,Ulcerative stomatitis,Impotence,Perineal pain,Glycosuria,Alopecia