DICLOFENAC SODIUM AND MISOPROSTOL- diclofenac sodium and misoprostol tablet, film coated 
Greenstone LLC


Medication Guide for
(diclofenac sodium and misoprostol delayed-release tablets)
for oral use

What is the most important information I should know about diclofenac sodium/misoprostol?

Diclofenac sodium/misoprostol contains diclofenac (a nonsteroidal anti-inflammatory drug (NSAID)) and misoprostol, and can cause uterus to tear (uterine rupture), abortion, premature birth, or birth defects. The risk of uterine rupture increases as your pregnancy advances, if you have given birth to 5 or more children, and if you have had surgery on the uterus, such as a cesarean delivery.

Do not take diclofenac sodium/misoprostol if you are pregnant.

Tell your healthcare provider if you become pregnant or think you may be pregnant during treatment with diclofenac sodium/misoprostol. If you are able to become pregnant, your healthcare provider should do a pregnancy test before you start treatment with diclofenac sodium/misoprostol. Females who are able to become pregnant should use an effective form of birth control (contraception) during treatment with diclofenac sodium/misoprostol.

What is the most important information I should know about medicines containing Nonsteroidal Anti-inflammatory Drugs (NSAIDs)?

NSAIDs can cause serious side effects, including:

Increased risk of a heart attack or stroke that can lead to death. This risk may happen early in treatment and may increase:
with increasing doses of NSAIDs
with longer use of NSAIDs

Do not take NSAID containing medicines right before or after a heart surgery called a "coronary artery bypass graft (CABG)."

Avoid taking NSAID containing medicines after a recent heart attack, unless your healthcare provider tells you to. You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack.

Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines:
anytime during use
without warning symptoms
that may cause death

The risk of getting an ulcer or bleeding increases with:

past history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs
taking medicines called "corticosteroids", "antiplatelet drugs", "anticoagulants", "SSRIs", or "SNRIs"
increasing doses of NSAIDs
longer use of NSAIDs
drinking alcohol
older age
poor health
advanced liver disease
bleeding problems

NSAID containing medicines should only be used:

exactly as prescribed
at the lowest dose possible for your treatment
for the shortest time needed

What is diclofenac sodium/misoprostol?
Diclofenac sodium/misoprostol contains 2 medicines:

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). See "Error! Hyperlink reference not valid.
Misoprostol is a medicine used to protect the lining of the esophagus, stomach and intestines while taking diclofenac.

Diclofenac sodium/misoprostol is a prescription medicine used to treat:

symptoms of osteoarthritis or rheumatoid arthritis in adults at high risk of developing stomach (gastric) and intestinal (duodenal) ulcers while taking NSAIDs.
It is not known if diclofenac sodium/misoprostol is safe and effective for use in children.

What are NSAIDs?
NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as different types of arthritis.


Who should not take diclofenac sodium/misoprostol?
Do not take diclofenac sodium/misoprostol:

if you are pregnant.
right before or after heart bypass surgery.
if you currently have bleeding in your stomach (gastrointestinal bleeding).
if you have had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAIDs.
if you are allergic to diclofenac sodium and misoprostol, other prostaglandins or any other ingredients in diclofenac sodium/misoprostol. See the end of this Medication Guide for a list of ingredients in diclofenac sodium/misoprostol.

Before taking diclofenac sodium/misoprostol, tell your healthcare provider about all of your medical conditions, including if you:

have liver or kidney problems.
have high blood pressure.
have heart problems, including a history of heart failure or heart attack.
have asthma.
are pregnant or plan to become pregnant. See "Error! Hyperlink reference not valid."
are breastfeeding or plan to breast feed.

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. NSAIDs and some other medicines can interact with each other and cause serious side effects. Do not start taking any new medicine without talking to your healthcare provider first.

What are the possible side effects of NSAIDs?

NSAIDs can cause serious side effects, including:

See "Error! Hyperlink reference not valid.

new or worse high blood pressure
heart failure
liver problems including liver failure
kidney problems including kidney failure
low red blood cells (anemia)
life-threatening skin reactions
life-threatening allergic reactions
asthma attacks in people who have asthma
Other side effects of NSAIDs include: stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness

Get emergency help right away if you get any of the following symptoms:

shortness of breath or trouble breathing
chest pain
weakness in one part or side of your body
slurred speech
swelling of the face or throat

Stop taking your NSAID and call your healthcare provider right away if you get any of the following symptoms:

more tired or weaker than usual
your skin or eyes look yellow
indigestion or stomach pain
flu-like symptoms
vomit blood
there is blood in your bowel movement or it is black and sticky like tar
unusual weight gain
skin rash or blisters with fever
swelling of the arms, legs, hands and feet

If you take too much of your NSAID, call your healthcare provider or get medical help right away.

These are not all the possible side effects of NSAIDs. For more information, ask your healthcare provider or pharmacist about NSAIDs.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other information about NSAIDs

Aspirin is an NSAID but it does not increase the chance of a heart attack. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.
Some NSAIDs are sold in lower doses without a prescription (over-the-counter). Talk to your healthcare provider before using over-the-counter NSAIDs for more than 10 days.

General information about the safe and effective use of NSAIDs

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use NSAIDs for a condition for which it was not prescribed. Do not give NSAIDs to other people, even if they have the same symptoms that you have. It may harm them.

If you would like more information about NSAIDs, talk with your healthcare provider. You can ask your pharmacist or healthcare provider for information about NSAIDs that is written for health professionals.

Active ingredients: diclofenac sodium, misoprostol.
Inactive ingredients: colloidal silicon dioxide, crospovidone, hydrogenated castor oil, hypromellose, lactose, magnesium stearate, methacrylic acid copolymer, microcrystalline cellulose, povidone (polyvidone) K-30, sodium hydroxide, starch (corn), talc, triethyl citrate.

For more information, go to www.greenstonellc.com or call 1-800-438-1985



This Medication Guide has been approved by the U.S. Food and Drug Administration.

Revised: August 2022  

Revised: 8/2023
Greenstone LLC