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What should I discuss with my healthcare provider before taking diclofenac and misoprostol (Arthrotec)?

Do not use diclofenac and misoprostol just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

This medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.

This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking diclofenac and misoprostol, especially in older adults.

Do not use this medication if you are allergic to diclofenac (Cataflam) or misoprostol (Cytotec), or if you have a history of allergic reaction to aspirin or other NSAIDs.

To make sure you can safely take diclofenac and misoprostol, tell your doctor if you have any of these other conditions:

• a history of heart attack, stroke, or blood clot;
• heart disease, congestive heart failure, high blood pressure;
• a history of stomach ulcers or bleeding;
• liver or kidney disease,
• asthma;
• polyps in your nose;
• porphyria;
• a bleeding or blood clotting disorder;
• if you smoke; or
• drink more than three alcoholic beverages a day.

Diclofenac and misoprostol can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using diclofenac and misoprostol.

FDA pregnancy category X. Misoprostol can cause birth defects, miscarriage, premature labor, or rupture of the uterus if the medication is taken during pregnancy. Diclofenac can cause birth defects if it is taken during the last 3 months of pregnancy.

You will need to have a pregnancy test within 2 weeks before you start taking diclofenac and misoprostol.

How should I take diclofenac and misoprostol (Arthrotec)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

Swallow the diclofenac and misoprostol tablet whole. Do not crush, break, or chew the pill.

Take diclofenac and misoprostol with food or milk to lessen stomach upset.

Do not share this medication with anyone else, even if they have the same symptoms you have.

If you use this medication long-term, your liver function may need to be checked with frequent blood tests. Visit your doctor regularly.

Store at room temperature away from moisture and heat.

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