Prostaglandin Analog to Prevent NSAID-Induced Peptic Ulcer

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Prostaglandin Analog to Prevent NSAID-Induced Peptic Ulcer


Generic NameBrand Name
misoprostol and diclofenacArthrotec

Arthrotec is a medicine that contains both an NSAID (diclofenac) and misoprostol.

How It Works

Misoprostol reduces the amount of acid produced by the stomach and enhances protection of the lining of the stomach and the upper small intestine (duodenum).

Why It Is Used

Misoprostol is sometimes used to reduce the risk of peptic ulcer disease in people who must use large doses of NSAIDs to treat arthritis or other painful, long-term (chronic) diseases.

How Well It Works

Misoprostol works to prevent ulcers and problems caused by ulcers (such as bleeding) in people who use NSAIDs long-term.1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if:

  • You have hives.
  • You are a woman and find out you are pregnant while taking this medicine. Misoprostol can cause uterine contraction and miscarriage in pregnant women.

Common side effects of this medicine include:

  • Diarrhea.
  • Nausea.
  • Stomach cramps.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

The side effects of misoprostol are common and unpleasant. Because of this, using misoprostol is not always a good choice. Using an acid reducer (such as a proton pump inhibitor) along with NSAIDs to prevent peptic ulcers works just as well without the unpleasant side effects. Taking a lower dose of misoprostol may also help prevent ulcers but with fewer side effects.2

Taking misoprostol with food or milk can help prevent side effects such as diarrhea and stomach cramps.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.



  1. Rostom A, et al. (2002). Prevention of NSAID-induced gastroduodenal ulcers. Cochrane Database of Systematic Reviews (4).
  2. Lanza FL, et al. (2009). Guidelines for prevention of NSAID-related ulcer complications. American Journal of Gastroenterology, 104(3): 728–738.


ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerJerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Last RevisedMay 14, 2012

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