Select a medication above to begin.
Arthrotec
diclofenac/ misoprostol
Black Box Warnings .
Pregnancy
contraindicated in pregnancy; use in pregnant women can cause birth defects, abortion, premature birth, or uterine rupture; uterine rupture reported w/ use to induce labor or abortion; risk of uterine rupture incr. w/ advancing gestational age and prior uterine surgery, incl. cesarean delivery; advise pts of abortifacient property and warn not to give to others
Women of Child-Bearing Potential
do not use to decr. risk of NSAID-induced ulcers in women of child-bearing potential unless high risk of gastric ulcer; in such pts only use if 1) negative serum pregnancy test <2wk prior to start tx, 2) pt capable of complying w/ effective contraception, 3) pt given oral and written warnings of hazards, risk of contraception failure, and danger if taken by other women of child-bearing potential, 4) start med on 2nd or 3rd day of next normal menstrual period
Cardiovascular Risk
NSAIDs incr. risk of serious and potentially fatal cardiovascular thrombotic events, incl. MI and stroke; risk may occur early in tx and may incr. w/ duration of use; contraindicated in CABG periop setting
GI Risk
NSAIDs incr. risk of serious and potentially fatal GI adverse events incl. bleeding, ulcer, and stomach or intestine perforation; GI events may occur at any time during use and w/o warning sx; elderly pts and pts w/ hx of PUD or GI bleeding at greater risk for serious GI events
Adult Dosing .
Dosage forms: DR TAB: 50 mg/0.2 mg, 75 mg/0.2 mg
rheumatoid arthritis
- [1 tab PO bid-qid]
- Max: 200 mg/day diclofenac; Info: for prior hx or high risk of PUD; use lowest effective dose, shortest effective tx duration; give w/ food if GI adverse effects occur; do not cut/crush/chew/dissolve tab
osteoarthritis
- [1 tab PO bid-tid]
- Max: 150 mg/day diclofenac; Info: for prior hx or high risk of PUD; use lowest effective dose, shortest effective tx duration; give w/ food if GI adverse effects occur; do not cut/crush/chew/dissolve tab
renal dosing
- [see below]
- CrCl <30: avoid use; advanced renal dz: avoid use
- HD/PD: avoid use
hepatic dosing
- [adjust dose amount]
- hepatic impairment: decr. usual dose, amount not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.