Have you also had to constantly use painkillers due to joint pain, that is, arthritis? When taking such painkillers, some people experience problems like stomach inflammation and gastritis. Today we are talking about a special medicine that doctors often recommend to such people. The name of this is the combination of Diclofenac and Misoprostol (Diclofenac; Misoprostol).
What really happens with this medicine?
Simply put, this is a combination of two types of medicine.
1. Diclofenac: This is a painkiller that you may have heard of. It belongs to a class of drugs called NSAID (Non-Steroidal Anti-Inflammatory Drug). It works by reducing pain and swelling in your joints.
2. Misoprostol: This is the specialty of this medicine. It is added to prevent the damage that painkillers like diclofenac can cause to the stomach. This does two main things. One is to reduce the amount of acid produced in the stomach. The other is to protect the lining of the stomach (gastric wall).
This means that this pill does two things at once. While reducing pain, it also prevents the potential damage to the stomach caused by the painkiller.
Things you need to tell your doctor before starting this medication
This medicine is not suitable for everyone. Therefore, before prescribing this medicine, your doctor should clearly inform you about any other medical conditions you have. If you have any of the conditions below, be sure to tell them about it.
| Situation you need to report | Simply put... |
|---|---|
| If you are pregnant or trying to get pregnant | (Very important) This medicine can cause serious harm to the baby. |
| If you are breastfeeding | The medicine can pass to the baby through breast milk. |
| Heart disease, heart attacks, high blood pressure | This medicine can increase the risk of heart attack and stroke. |
| If you have recently had bypass surgery (CABG) | This medicine is not suitable if taken within 2 weeks. |
| Ulcers/bleeding in the stomach or intestines | This medicine may cause bleeding again. |
| Kidney or liver disease | The medicine can affect these organs. |
| Asthma or respiratory disease | Some people may experience increased asthma. |
| If you are taking medication that prevents blood clotting | For example: Warfarin. The risk of bleeding increases. |
| Frequent drinking or smoking | The risk of stomach ulcers increases further. |
| Allergies to other medicines, foods or substances | Tell us if you are allergic to medications like aspirin and ibuprofen. |
How should I use the medicine?
- Take this pill with a glass of water.
- Try to take it at the same time every day , as prescribed by your doctor.
- Very important: Do not break, crush, or chew this tablet. Swallow the tablet whole. Otherwise, the stomach-protecting part will not work properly.
- You can take it before or after meals. However, if you have an upset stomach, it is best to take it with food.
- Continue using it until your doctor tells you to stop.
If you suspect you have overdosed: If you think you have overdosed, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital .
This medicine is for you only. Do not give it to anyone else who has the same symptoms as you.
Things to be careful about when taking medicine
When using this medicine, you need to be a little more careful about some things.
Stomach ulcers and bleeding
The main risk of this medicine is the possibility of stomach ulcers and bleeding. This can sometimes happen without warning. If you have severe stomach pain, vomit blood, vomit something that looks like coffee grounds, or pass black, tarry stools or blood, see a doctor immediately. Smoking and drinking alcohol increase this risk.
Risk of heart attack and stroke
This medicine may slightly increase your risk of heart attack or stroke when used long-term, especially if you already have heart disease. This is not a medicine that will prevent a heart attack or stroke.
Severe skin reactions
Rarely, some people may develop a severe skin reaction a few weeks after using this medicine. If you experience symptoms such as fever, body aches, red, itchy skin, blistering, peeling skin, swelling of the face, lips, or a rash on the neck or armpits , seek medical advice immediately.
Pregnancy and childbirth
This is very important: Do not use this medicine for any reason if you are trying to get pregnant, are pregnant, or suspect you may be pregnant. The ingredient in this medicine, misoprostol, can cause serious birth defects in the baby. It may also temporarily affect fertility in some women.
Other points
This medicine may make you feel dizzy or drowsy . Therefore , avoid driving or operating dangerous machinery until you know how it affects you. Also, be careful when brushing and flossing your teeth, as there is a slight increase in bleeding while taking this medicine.
What are the possible side effects?
Like any medicine, this one can have side effects. Some are serious, some are common.
| Classification of side effects | |
|---|---|
| Serious side effects that require immediate medical attention | |
| Allergic Reactions | Skin rashes, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Bleeding symptoms | Bloody or tarry stools, vomiting blood, vomiting coffee grounds, dark red/brown urine, red/purple spots on the skin. |
| Symptoms of a heart attack | Chest pain or tightness, pain spreading to the shoulders, arms, jaw area, nausea, shortness of breath. |
| Symptoms of a Stroke | Sudden numbness/weakness on one side of the face, arm, or leg, difficulty speaking, difficulty walking, severe headache. |
| Kidney or liver damage | Decreased urine output, swelling of the ankles, hands, and feet, yellowing of the eyes or skin, dark urine, and pain in the upper right side of the abdomen. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Stomach ache | Bloating, stomach ache, nausea. |
| Diarrhea | This is a common side effect. |
| Headache | A slight headache may occur. |
Take-Home Message
- This is a combination of two medications that reduce pain (Diclofenac) and protect the stomach (Misoprostol).
- If you are pregnant, or trying to get pregnant, taking this medicine is strictly prohibited.
- Tell your doctor about all the medications you take and any medical conditions you have (especially heart, kidney, or liver disease).
- Be aware of signs of stomach bleeding, heart attack, stroke, or severe skin allergies. If in doubt, see a doctor immediately.
- Do not break, crush, or chew the tablet. Swallow it whole.
- Never start or stop taking this medication without consulting a doctor.
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