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This medication is a combination of diclofenac and misoprostol, and it requires careful consideration due to potential risks and specific precautions. Below are important safety and warning details to keep in mind:

• Pregnancy Risks: Do not take this medication if you are pregnant, planning to become pregnant, or think you might be pregnant. Misoprostol can lead to miscarriage, premature birth, or birth defects. Serious complications like uterine rupture have occurred, particularly if the pregnancy is advanced or there is a history of uterine surgery or multiple pregnancies. Women of childbearing potential should use effective contraception and meet specific criteria before starting this medication, including a negative pregnancy test and beginning the medication on the second or third day of their menstrual cycle. Contact your healthcare provider immediately if pregnancy occurs during treatment.

• Heart Risks: Diclofenac may increase the risk of heart attack or stroke, especially with long-term use or in individuals with existing heart disease or risk factors like smoking or high blood pressure. Avoid using this medication around the time of coronary artery bypass graft (CABG) surgery.

• Stomach and Intestinal Bleeding: The risk of serious and possibly fatal bleeding from the stomach or intestines is increased, particularly in older adults or those with a history of ulcers or bleeding disorders. Seek immediate medical attention if you experience persistent stomach pain, black/tarry stools, or vomit resembling coffee grounds.

• High Blood Pressure and Heart Failure: Diclofenac can lead to fluid retention, increasing blood pressure and the risk of heart failure. Inform your doctor of any heart conditions or blood pressure medications before starting treatment. Watch for symptoms like unexplained fainting or irregular heartbeat.

• Kidney Damage: Long-term use may harm the kidneys, especially in older adults or those with pre-existing kidney issues or taking diuretics. Report symptoms like changes in urination frequency, fatigue, dry skin, or muscle cramps to your healthcare provider.

• Liver Problems: Monitor for signs of liver damage, such as abdominal swelling, jaundice, dark urine, or changes in stool color. These symptoms require immediate medical attention.

• Severe Allergic Reactions: Diclofenac may cause serious allergic reactions, including anaphylaxis. Those with aspirin or NSAID allergies should be cautious. Seek emergency help for symptoms like hives, swelling of the lips or tongue, or breathing difficulties.

• Increased Bleeding Risk: The medication can heighten bleeding risks, especially when used with blood thinners or SSRIs/SNRIs. Notify a healthcare professional if you notice unusual bleeding or bruising.

Contraindications: Do not use this medication if you have a history of asthma, hives, or other allergic reactions to aspirin or NSAIDs, are pregnant, have active stomach bleeding, or are undergoing CABG surgery.

Always consult with your healthcare provider to fully understand the risks and benefits of this medication, and report any concerning symptoms immediately.

When using this medication, some individuals may experience common side effects such as stomach pain, diarrhea, upset stomach or indigestion, nausea, and gas. These effects are generally mild, but if they persist or worsen, it is advisable to consult your healthcare provider. Other possible side effects include vomiting, constipation, dry mouth, headache, dizziness, fatigue, vaginal bleeding, and menstrual cramps. These symptoms, while less common, should be addressed with your healthcare provider if they occur.

There are also rare but serious side effects associated with this medication that require immediate medical attention. These include signs of a heart attack such as dizziness, tiredness, cold sweat, trouble breathing, and chest pain; symptoms of a stroke like lightheadedness, blurred vision, and difficulty speaking or walking; and indications of stomach bleeding, including blood in vomit or black, coffee-ground-like stool. Heart failure symptoms such as trouble breathing, tiredness, and swelling in the body, as well as liver damage signs like fever, chills, yellowing of the skin or eyes, and dark urine, also warrant urgent care.

Kidney damage and high potassium levels may present as nausea, muscle weakness, and changes in urination, while a severe asthma attack could cause chest pain, cough, and difficulty breathing. Additionally, serious allergic reactions might manifest as fever, rash, swelling of the face, and painful blisters. If you encounter any of these severe symptoms, seek medical help immediately. Always communicate with your healthcare provider regarding any side effects you experience.

When taking Arthrotec (Diclofenac/Misoprostol), be aware that it can interact with various medications. It's crucial to inform your healthcare provider about all the medications and supplements you are currently using, whether prescribed, over-the-counter, or herbal, to prevent possible interactions.

Significant interactions include:

1. Bleeding Risk: This medication can increase bleeding risk, especially when taken with anti-platelet drugs like Clopidogrel or blood thinners such as Warfarin, Enoxaparin, or Dabigatran.

2. Similar Drugs: Avoid combining Arthrotec with other NSAIDs like Ibuprofen, Ketorolac, or Aspirin, unless directed by your healthcare provider, as these may heighten the likelihood of side effects. If you're on low-dose aspirin (81-162 mg daily) for heart protection, continue unless advised otherwise by your doctor.

3. Blood Pressure and Heart Medications: Medications such as ACE inhibitors (e.g., Lisinopril, Captopril) and angiotensin II receptor blockers (e.g., Losartan, Valsartan) may require dose adjustments if used with Arthrotec to manage potential side effects.

4. Diuretics and Lithium: Using diuretics like Furosemide or lithium concurrently with Arthrotec may necessitate careful monitoring and dosage changes to mitigate interaction risks.

Always consult your doctor or pharmacist for more detailed guidance tailored to your specific medications and health profile.