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Arthrotec
Diclofenac and Misoprostol
$162.00
200mcg/75mg · 3 × 60 tablets · 3 months supply
BrandBranded medicine
$54.00 per month
Strength
How long a supply?
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Annual cost
$648a year at this pack size
Prescription required
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200mcg/50mg
200mcg/75mg
FDA boxed warningRisk of uterine rupture, abortion, premature birth, birth defects; serious cardiovascular events; and serious gastrointestinal events
Administration of misoprostol, a component of ARTHROTEC, to pregnant women can cause uterine rupture, abortion, premature birth, or birth defects. Uterine rupture has occurred when misoprostol was administered in pregnant women to induce labor or an abortion.
ARTHROTEC is contraindicated in pregnancy and is not recommended in women of childbearing potential. Patients must be advised of the abortifacient property and warned not to give the drug to others.
Increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.
ARTHROTEC is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.
Increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal and can occur at any time and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk.
About Arthrotec
Overview
Arthrotec is a tablet containing diclofenac sodium and misoprostol. It treats the signs and symptoms of osteoarthritis or rheumatoid arthritis in adults at high risk of stomach and duodenal ulcers and their complications caused by non-steroidal anti-inflammatory drugs (NSAIDs). Diclofenac reduces pain and inflammation, while misoprostol helps protect the lining of the digestive tract.
What it treats
Osteoarthritis or rheumatoid arthritis symptoms in adults at high risk of stomach and duodenal ulcers and their complications caused by nonsteroidal anti-inflammatory drugs (NSAIDs).
Safety information
Side effects
Common side effects include stomach pain, diarrhea, indigestion, nausea, gas, stomach inflammation, vomiting, constipation, headache and dizziness. Blood tests may show increased liver enzymes or a decrease in the proportion of red blood cells. Serious side effects include blood clots affecting the heart or circulation; stomach or intestinal bleeding, ulcers or perforation; liver injury; high blood pressure; heart failure and fluid retention; kidney damage; high potassium levels; and anemia. Contact a doctor promptly if you suspect a serious side effect. Stop taking Arthrotec and seek medical advice at the first sign of a skin rash or other allergic symptoms. Serious skin reactions and DRESS, a severe drug reaction that can affect multiple organs, can occur. Seek emergency help for a severe allergic reaction (anaphylaxis). Arthrotec can also worsen asthma in people sensitive to aspirin. Diclofenac use from about 20 weeks of pregnancy onward can harm the unborn baby’s kidneys, reduce the fluid surrounding the baby and prematurely close an important blood vessel in the baby’s heart.
FDA boxed warning
Risk of uterine rupture, abortion, premature birth, birth defects; serious cardiovascular events; and serious gastrointestinal events
Administration of misoprostol, a component of ARTHROTEC, to pregnant women can cause uterine rupture, abortion, premature birth, or birth defects. Uterine rupture has occurred when misoprostol was administered in pregnant women to induce labor or an abortion.
ARTHROTEC is contraindicated in pregnancy and is not recommended in women of childbearing potential. Patients must be advised of the abortifacient property and warned not to give the drug to others.
Increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.
ARTHROTEC is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.
Increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal and can occur at any time and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk.
A boxed warning is the strongest warning the US Food and Drug Administration requires on a medicine label. Text is taken from the official label, with internal section references removed.
When to call your doctor
If symptoms are severe or getting worse quickly, seek emergency care rather than waiting.
Before taking this medicine
Do not take Arthrotec if you: • Are pregnant. It can cause miscarriage, premature birth, birth defects or rupture of the uterus, harming both mother and baby. • Are undergoing coronary artery bypass graft (CABG) surgery. • Have active bleeding in the stomach or intestines. • Have had asthma, hives or another allergic reaction after taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). • Are allergic to diclofenac, misoprostol, other prostaglandins or any ingredient in Arthrotec. Arthrotec should generally be avoided in people with severe heart failure or advanced kidney disease. Older adults with heart, blood vessel or kidney risk factors should also avoid it. Tell your prescriber if you have high blood pressure, heart failure, kidney or liver problems, dehydration, low blood volume, asthma or signs of anemia. Blood pressure, kidney function, liver tests or blood counts may need monitoring. Some blood pressure medicines may work less well while taking Arthrotec. If you are having difficulty conceiving, your prescriber may consider stopping treatment because it can cause reversible infertility. Stop taking Arthrotec and seek medical advice at the first sign of a rash or other allergic symptoms. Seek emergency help for a severe allergic reaction. Serious skin reactions and DRESS, a reaction that can affect several organs, require stopping treatment and medical assessment. Persistent or worsening abnormal liver tests, or signs of liver disease, also require stopping treatment.
Interactions
Arthrotec can interact with the following medicines: Blood thinners such as warfarin, antiplatelet medicines such as aspirin, and SSRI or SNRI antidepressants can increase bleeding risk. Corticosteroids can increase the risk of stomach or intestinal ulcers and bleeding. Your doctor may monitor you for signs of bleeding. Other NSAIDs and salicylates, including diflunisal and salsalate, are not recommended with Arthrotec because they increase stomach and intestinal risks with little or no additional benefit. Aspirin used for pain relief is also generally not recommended alongside Arthrotec. Arthrotec does not replace aspirin prescribed for cardiovascular protection. Blood pressure medicines, including ACE inhibitors, angiotensin receptor blockers (ARBs) and beta-blockers, may work less effectively. Diuretics such as furosemide and thiazides may also become less effective. Kidney problems can occur, particularly with ACE inhibitors or ARBs in older people, people who are dehydrated or those with existing kidney problems. Blood pressure and kidney function may need monitoring. Digoxin and lithium levels can rise with Arthrotec. Your doctor may check digoxin levels and monitor for lithium toxicity. Methotrexate toxicity may increase, including effects on blood cells and kidneys. Cyclosporine may increase the risk of kidney damage. Pemetrexed can have increased harmful effects on blood cell production, the kidneys and the digestive tract. The label advises avoiding Arthrotec around pemetrexed treatment; discuss this with your doctor. People with reduced kidney function may need additional monitoring. Antacids can reduce absorption of the misoprostol component and delay absorption of diclofenac. Magnesium-containing antacids can worsen diarrhoea and are not recommended with Arthrotec. Medicines that affect the liver enzyme CYP2C9 can change how diclofenac is processed. Inhibitors such as voriconazole can increase diclofenac exposure and toxicity, while inducers such as rifampin can reduce its effectiveness. Your prescriber may need to adjust treatment.
Using Arthrotec
Dosing
Dosing is set by your prescriber. Each health care professional may prescribe medication differently according to a patient's medical history and condition, so follow the directions on your prescription label and speak to your doctor or pharmacist before changing anything.
Storage
Store below 25°C in a dry place, in the original pack, away from direct light and moisture. Do not keep it in a bathroom. Keep all medicines out of the sight and reach of children.
Clinical information on this page is summarised from the US FDA label ARTHROTEC (DICLOFENAC SODIUM AND MISOPROSTOL) TABLET, FILM COATED [PFIZER LABORATORIES DIV PFIZER INC] (DailyMed, retrieved 19 September 2026).
Patient information and references
Official and supporting information to read alongside advice from your prescriber or pharmacist.
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