Arthritis Today

Diclofenac sodium with misoprostol


Drug Class:

NSAIDs (Traditional NSAID)

Brand Names




For OA: 100 to 150 mg diclofenac and 400 to 600 mcg misoprostol daily in two or three doses.

For RA: 100 to 200 mg diclofenac and 400 to 800 mcg misoprostol in two to four doses.

Potential Side Effects


Abdominal cramps, pain or discomfort; diarrhea; dizziness; drowsiness; gastrointestinal bleeding; headache; heartburn; high blood pressure; nausea or vomiting; peptic ulcer; swelling of feet; rash; ringing in the ears.

Be Aware

  • Misoprostol can cause miscarriage and birth defects. Do not take if you are pregnant. Liver enzymes should be checked within 4 to 8 weeks of starting any type of diclofenac. Compared to other NSAIDs, this drug has a lower risk of gastric ulcers but an increased risk of abdominal pain and diarrhea.
  • Before taking any type of NSAID, tell your doctor if you drink alcohol or take blood thinners (including warfarin), ACE inhibitors, lithium or furosemide. Also report any sensitivity or allergy to aspirin or similar drugs. All non-aspirin NSAIDs may cause an increased risk of serious blood clots, heart attack and stroke, which can be fatal. This risk can occur as early as the first weeks using an NSAID and increases with dose and duration of use. Patients who have or who are at risk for cardiovascular disease are at greater risk for these complications than someone without cardiovascular disease or its risk factors. Treatment with NSAIDs following a first heart attack increases the risk of death in the first year after the heart attack (compared to not using NSAIDs after a first heart attack). NSAID use increases the risk of heart failure. NSAIDs should not be used for pain if you have had (or are about to have) coronary bypass surgery. Do not take NSAIDs late in pregnancy.

The Arthritis Today Drug Guide is meant for education – not self-medicating. Arthritis Today, the Arthritis Foundation and the Drug Guide Medical Review Panel do not endorse any products mentioned in this guide. While we endeavor to keep the information up to date, we make no representations or warranties about the completeness of the information provided.

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