A modified-release combination tablet containing diclofenac 75mg and misoprostol 200 micrograms, used for inflammatory joint conditions in patients at risk of NSAID-induced stomach ulcers.
Arthrotec 75 is prescribed at Courier Pharmacy after a careful online consultation reviewed by a UK clinician, then dispensed and delivered discreetly.
Arthrotec 75 tablets are a prescription combination medicine for adults who need NSAID treatment for chronic joint inflammation, but who also have a higher risk of stomach ulcers or GI bleeding. It combines an anti-inflammatory medicine with a stomach-protecting medicine in one tablet. So, it can be a practical option when standard NSAIDs cause problems.
Each tablet contains diclofenac sodium 75mg (for pain and inflammation) and misoprostol 200 micrograms (to help protect the stomach). Packs often contain 60 tablets, which usually covers one month at the standard twice-daily dose.
Arthrotec releases its two ingredients in different places. Diclofenac sits in a gastro-resistant core, which passes through the stomach and releases the medicine in the small intestine. Misoprostol sits in an outer layer and releases in the stomach. As a result, misoprostol can start protecting the stomach lining straight away.
Misoprostol helps by increasing mucus and bicarbonate production and supporting blood flow to the stomach lining. In other words, it helps reduce the ulcer risk that NSAIDs can cause in some people.
At Courier Pharmacy, a UK-registered prescriber reviews every Arthrotec prescription before we dispense it. We take extra care because Arthrotec has a strict pregnancy contraindication. For that reason, we will ask about contraception, pregnancy plans, and your wider stomach and cardiovascular history. The medicine can be very useful for the right patient. However, the “right patient” check really matters here.
Features and specifications
Active ingredients: Diclofenac sodium 75mg + Misoprostol 200 micrograms
Form: Modified-release tablet (gastro-resistant diclofenac core with misoprostol outer layer)
Pack size: 60 tablets (typical one-month supply at twice-daily dosing)
Class: NSAID combined with a prostaglandin E1 analogue
Prescription status: Prescription Only Medicine (POM)
Typical use: One tablet twice daily, with food
Storage: Store below 25°C in the original packaging; protect from moisture
Additional information
Quantity
1 x 60, 2 x 60
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Joint pain that’s worn you down, but every time you take an NSAID your stomach pays the price. It’s a familiar problem. Arthrotec is designed specifically for this trade-off: it pairs a proven anti-inflammatory with a built-in stomach-protecting ingredient. At Courier Pharmacy we want you to understand exactly what Arthrotec is, who it suits, the strict warnings around it (especially for anyone who could become pregnant), and why it remains a useful option when used properly.
Five key takeaways
Arthrotec 75 tablets combine diclofenac 75mg (a non-steroidal anti-inflammatory drug) with misoprostol 200 micrograms (a prostaglandin that protects the stomach lining).
They’re used to treat osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis in patients who need NSAID therapy but are at high risk of stomach ulcers or bleeding.
Arthrotec is strictly contraindicated in pregnancy. Misoprostol causes uterine contractions and serious harm to a developing pregnancy, so reliable contraception is essential while taking this medicine.
Like all NSAID-containing medicines, Arthrotec carries cardiovascular and kidney risks; the lowest effective dose for the shortest time is the rule.
It is a Prescription Only Medicine in the UK and needs careful clinical review before being dispensed.
Treatment dosage Arthrotec 75 tablets
The standard adult dose is one Arthrotec 75 tablet taken twice daily, with food. This delivers 150mg of diclofenac and 400 micrograms of misoprostol per day. The medicine should be taken with breakfast and the evening meal, swallowed whole with a glass of water.
For people who can’t tolerate twice-daily dosing because of misoprostol-related diarrhoea or abdominal cramps, the alternative is Arthrotec 50, which contains 50mg diclofenac plus 200 micrograms misoprostol and can be taken two or three times daily. Both strengths exist for the same reason: to match the diclofenac dose to symptoms while keeping the stomach-protective effect. Stepping down to Arthrotec 50 is often a sensible move if Arthrotec 75 causes GI side effects.
Don’t crush, split, or chew Arthrotec tablets. The two-layer design relies on intact tablets to release each ingredient at the right place. Doses should not be doubled if missed. If you remember within a few hours, take the missed dose with food; if it’s close to the next dose, skip it.
In older adults (over 65), severe liver impairment, or severe kidney impairment, dose adjustment or avoidance may be needed. Severe heart failure, active GI bleeding or ulceration, late pregnancy, and known hypersensitivity to either diclofenac or misoprostol are absolute contraindications.
Overview of Arthrotec 75 tablets
Five things worth knowing:
Arthrotec is one of the few NSAID products that builds stomach protection directly into the tablet rather than asking you to take a separate PPI.
It is strictly contraindicated in pregnancy. Misoprostol can cause miscarriage, premature birth, birth defects, and uterine rupture.
The misoprostol component commonly causes diarrhoea, abdominal cramps, and wind, especially in the first few weeks; these symptoms often settle but can be a reason to switch to Arthrotec 50.
Like all NSAIDs, the diclofenac component carries cardiovascular risk, particularly with longer-term use.
It’s most useful for patients who need ongoing NSAID therapy and have either had a stomach ulcer before or are at high risk of one (older age, history of GI bleeding, taking aspirin or steroids).
Arthrotec sits in an unusual space in the NSAID landscape. It isn’t trying to be the gentlest anti-inflammatory available (that title might go to celecoxib or low-dose meloxicam). Instead, it pairs a fully effective NSAID dose with built-in stomach protection. The medicine recognises a real clinical problem: many people need diclofenac (or another NSAID) for inflammatory conditions, and many of them get stomach ulcers as a result. Adding misoprostol directly to each tablet was designed to break that cycle.
For people living with chronic inflammatory pain alongside other complex conditions, fibromyalgia, autoimmune issues, MCAS, persistent musculoskeletal pain, finding a sustainable anti-inflammatory regimen can take years of trial and error. Arthrotec isn’t a first-choice medicine for most people. It’s a considered choice when previous NSAIDs have caused stomach problems, or where the risk of ulcer is high enough to warrant built-in protection from day one.
The pregnancy contraindication is non-negotiable. Misoprostol is a prostaglandin E1 analogue that causes the uterus to contract. It’s used legitimately in medical practice for inducing labour and managing miscarriage; in those settings, the effect is desired. In someone who is or might become pregnant while taking Arthrotec, that same effect causes profound harm. For anyone of childbearing potential, Arthrotec should only be considered alongside reliable contraception and with full understanding of the risks.
The diclofenac component carries the cardiovascular risk profile that comes with all NSAIDs, and the evidence on diclofenac specifically suggests it may carry slightly higher cardiovascular risk than some alternatives like naproxen. This doesn’t make Arthrotec a bad choice; it makes it a choice that should be deliberate rather than default.
For people who don’t have GI risk factors, simpler NSAID combinations (an NSAID plus a separate PPI) may be more appropriate. For people who do, Arthrotec offers the convenience and reliability of a combined formulation in one tablet.
Why choose Courier Pharmacy for Arthrotec 75 tablets
Arthrotec is one of the medicines where careful prescribing genuinely matters. The pregnancy contraindication, the GI risk-versus-benefit calculation, the cardiovascular considerations: none of this is paint-by-numbers. At Courier Pharmacy, every Arthrotec prescription is reviewed by a UK-registered prescriber who reads your answers properly, asks the questions that need asking, and explains the decision either way.
For anyone of childbearing potential, we’ll talk through contraception options and the strict requirements for safe use. We’ll also flag whether a different approach might suit you better, perhaps a separate NSAID-and-PPI combination, or a non-NSAID approach entirely. For older patients or those with cardiovascular risk, we’ll have an honest conversation about the trade-offs.
Our brand guide, Dr Ada Jex-Cori, sums it up: you’re not broken. The system that’s failed you might be. We want to do the part we can do, properly, and connect you with the rest. That includes our free fortnightly drop-in clinics and talks at Insomnia in Derby, where you can ask questions face-to-face without spending a penny.
Buy Arthrotec 75 tablets (Prescription Only) from Courier Pharmacy
Arthrotec 75 tablets are a Prescription Only Medicine (POM) in the UK, which means they cannot be sold over the counter. Buying through Courier Pharmacy is straightforward and built around your time, not ours.
Here’s how it works:
Complete a quick online consultation
A UK prescriber reviews your answers
If approved, a prescription is issued
We dispense and deliver discreetly to your door
If it isn’t suitable for you, we’ll explain why and suggest the next best option.
Active ingredients in Arthrotec 75 tablets
Arthrotec contains two active ingredients working together. The first is diclofenac sodium, a non-steroidal anti-inflammatory drug from the phenylacetic acid family. Diclofenac is one of the most widely used NSAIDs globally, valued for its strong anti-inflammatory and analgesic effects in arthritis and other inflammatory conditions. In Arthrotec, the diclofenac is enclosed in a gastro-resistant core that delays release until the medicine reaches the small intestine.
The second active ingredient is misoprostol, a synthetic prostaglandin E1 analogue. Prostaglandin E1 occurs naturally in the body and plays a role in protecting the stomach lining: it stimulates mucus and bicarbonate production, improves mucosal blood flow, and reduces acid secretion modestly. NSAIDs work in part by blocking prostaglandin production, which is also why they cause stomach ulcers. Adding misoprostol back replaces the protective prostaglandin that diclofenac would otherwise suppress.
Inactive ingredients vary by manufacturer but typically include lactose monohydrate, povidone, microcrystalline cellulose, sodium hydroxide, magnesium stearate, talc, hypromellose, and other coating polymers. The lactose content matters for some patients, and the formulation as a whole is complex enough that brand consistency may be helpful for people with multiple sensitivities.
What are Arthrotec 75 tablets used for?
Arthrotec 75 is licensed in the UK for the symptomatic treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis in patients who need NSAID therapy and who are at increased risk of developing NSAID-induced gastric or duodenal ulcers. It is not a first-line treatment for arthritis in general; it’s a considered choice when stomach protection is part of the equation from the outset.
Osteoarthritis is the wear-and-tear arthritis affecting joints over time, with knees, hips, hands, and spine most commonly involved. Rheumatoid arthritis is the autoimmune inflammatory condition that affects multiple joints and often other body systems. Ankylosing spondylitis is the inflammatory condition affecting the spine and sacroiliac joints. In all three, NSAIDs provide symptomatic relief; Arthrotec adds the built-in stomach-protective component for patients at higher GI risk.
The patient profile where Arthrotec earns its place includes: people over 65 needing NSAIDs, people with a history of peptic ulcer or GI bleeding, people who require concurrent low-dose aspirin (which adds GI risk to any NSAID), and people on corticosteroids or anticoagulants where GI bleeding risk is elevated. For these patients, Arthrotec can offer real benefit over an unprotected NSAID. For lower-risk patients, simpler approaches are often preferable.
How do Arthrotec 75 tablets work?
The diclofenac component works in the same way as other NSAIDs. Pain and inflammation involve a family of enzymes called cyclooxygenases (COX-1 and COX-2). These enzymes produce prostaglandins that drive pain, swelling, and fever (mostly via COX-2) as well as protect the stomach lining and support kidney function (mostly via COX-1). Diclofenac blocks both COX-1 and COX-2, reducing inflammation but also reducing the stomach’s natural protective prostaglandins, which is why NSAIDs cause ulcers.
The misoprostol component addresses this directly. As a synthetic prostaglandin E1 analogue, misoprostol replaces the protective prostaglandins that diclofenac suppresses. In the stomach, misoprostol stimulates mucus production, increases bicarbonate secretion, improves blood flow to the stomach lining, and modestly reduces acid secretion. Together, these effects significantly reduce the risk of NSAID-induced ulcers.
The two-layer tablet design is essential to this working properly. Misoprostol is in the outer mantle, where it’s released quickly in the stomach to provide protection at the same time diclofenac is starting to circulate. Diclofenac is in the gastro-resistant inner core, which protects it from stomach acid and ensures it’s released in the small intestine for systemic absorption. Crushing or splitting the tablet destroys this design and undermines both components.
Misoprostol also causes the uterus to contract by acting on uterine prostaglandin receptors. This is why it’s contraindicated in pregnancy. In a non-pregnant person, this effect can cause cramping and is not harmful. In a pregnant person, it causes uterine contractions that can lead to miscarriage, premature labour, or uterine rupture.
For pain and inflammation, you’ll usually notice some effect within a few hours of the first dose. Full anti-inflammatory effect builds over a few days of regular use. The stomach-protective effect of misoprostol is immediate from the first dose.
How to use Arthrotec 75 tablets
Take one Arthrotec 75 tablet twice daily, with food. Take one tablet with breakfast and one with your evening meal. Swallow each tablet whole with a glass of water. Don’t chew, crush, split, or dissolve the tablets, as this disrupts the two-layer release mechanism.
Taking the tablet with food does two things: it reduces stomach irritation and helps slow misoprostol absorption, which can ease the diarrhoea and cramping that some people experience. Antacids containing magnesium can worsen misoprostol-related diarrhoea, so if you need antacid relief, choose an aluminium-only or non-magnesium-containing product, or speak to your pharmacist.
If you miss a dose and remember within a few hours, take it with food. If your next dose is due soon, skip the missed one. Never double up. If side effects like persistent diarrhoea, severe cramping, or any signs of GI bleeding (vomiting blood, black tarry stools) develop, stop taking Arthrotec and contact your prescriber. For long-term users, regular review is essential to confirm continued need and check for cardiovascular, kidney, and GI issues.
Warnings and precautions for Arthrotec 75 tablets
Arthrotec is contraindicated in pregnancy. This is the most important warning attached to this medicine and applies absolutely. Misoprostol causes uterine contractions and can cause miscarriage, premature birth, birth defects, and uterine rupture. Anyone of childbearing potential who is prescribed Arthrotec must use reliable contraception throughout treatment and for at least one menstrual cycle after stopping. A negative pregnancy test before starting is recommended, and treatment should usually only begin on the second or third day of a normal menstrual period.
Other absolute contraindications include active peptic ulcer disease or GI bleeding, severe heart failure, severe liver impairment, severe kidney impairment, known hypersensitivity to diclofenac, misoprostol, other NSAIDs, or any excipient, history of asthma or urticaria triggered by aspirin or NSAIDs, and the perioperative period of coronary artery bypass surgery.
Cardiovascular risk applies. The diclofenac component is associated with a small but real increase in cardiovascular events including heart attack and stroke, particularly at higher doses and with longer-term use. Some evidence suggests diclofenac may carry slightly higher cardiovascular risk than some other NSAIDs. People with established cardiovascular disease, uncontrolled hypertension, or significant risk factors should only use Arthrotec after careful clinical consideration.
Kidney function should be considered. NSAIDs reduce kidney blood flow and can precipitate acute kidney injury. Older adults, people with existing kidney disease, heart failure, dehydration, or those on ACE inhibitors, ARBs, or diuretics are at higher risk. Regular monitoring may be advised for long-term users.
Hepatic effects can occur with diclofenac. Liver enzyme elevations are common and usually mild, but rare cases of severe hepatic reactions including hepatitis and liver failure have been reported. Anyone developing symptoms of liver problems (jaundice, dark urine, unexplained tiredness, right-sided abdominal pain) should stop the medicine and seek medical advice. Periodic liver function monitoring may be advised for long-term users.
Side effects of Arthrotec 75 tablets
The most common side effects of Arthrotec relate to the misoprostol component. Diarrhoea is reported by up to 1 in 4 people, especially in the first few weeks of treatment. Abdominal cramps, wind, and nausea are also common, affecting more than 1 in 100 people. Taking the tablet with food often helps these settle, and many people find symptoms improve after a few weeks. If diarrhoea is persistent or severe, switching to Arthrotec 50 (which contains the same misoprostol dose but less diclofenac per tablet, with more doses per day) can sometimes help.
Other common side effects, more than 1 in 100 people, include headache, dizziness, indigestion, constipation (less commonly than diarrhoea), stomach pain, fluid retention, raised blood pressure, and rash. Sleep disturbance and mood changes are also reported.
Uncommon side effects, between 1 in 100 and 1 in 1,000 people, include drowsiness, palpitations, peripheral oedema, gastritis, vomiting, oesophagitis, mouth ulcers, increased liver enzymes, itching, hair loss, blurred vision, vertigo, tinnitus, and muscle cramps.
Rare but serious side effects, fewer than 1 in 1,000 people, need urgent attention. These include heart attack, stroke, heart failure exacerbation, GI bleeding (vomiting blood, black tarry stools), peptic ulceration despite the misoprostol protection, severe hepatic reactions (jaundice, hepatitis), acute kidney injury, and serious skin reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis. Any blistering or peeling skin needs immediate medical attention.
Very rarely, Arthrotec can cause severe allergic reactions including anaphylaxis with swelling of lips, mouth, throat, difficulty breathing, and a drop in blood pressure. This is a medical emergency; call 999. People with aspirin-sensitive asthma can have severe bronchospasm triggered by Arthrotec.
If you experience any side effect that worries you, you can report it directly to the MHRA’s Yellow Card scheme. This helps improve safety data for everyone who uses the medicine. Our pharmacy team are happy to help you submit a Yellow Card report if you’d like assistance.
Drug interactions with Arthrotec 75 tablets
Arthrotec interacts with a range of other medicines. The diclofenac component is metabolised primarily through CYP2C9 in the liver, and like all NSAIDs, it has clinically important interactions affecting bleeding, kidney function, and cardiovascular outcomes.
Combining Arthrotec with anticoagulants (warfarin, apixaban, rivaroxaban, dabigatran) significantly increases bleeding risk, particularly GI bleeding. The misoprostol component provides some protection against ulcers but doesn’t eliminate bleeding risk from systemic anticoagulant effects. Aspirin, even at low cardioprotective doses, increases ulcer and bleeding risk. Other NSAIDs (ibuprofen, naproxen, celecoxib, meloxicam) should not be combined with Arthrotec.
ACE inhibitors, ARBs, and diuretics can have reduced blood pressure and kidney effects when combined with Arthrotec. The triple combination of NSAID, ACE inhibitor/ARB, and diuretic is particularly hazardous for kidney function and should be avoided where possible. Lithium and methotrexate levels can rise with NSAIDs, increasing toxicity risk.
SSRIs (sertraline, citalopram, fluoxetine) combined with NSAIDs increase GI bleeding risk; this is a common combination worth flagging to your prescriber. Corticosteroids significantly increase GI ulceration and bleeding risk when combined with NSAIDs. Ciclosporin and tacrolimus levels can be affected, and kidney function should be monitored when these are combined.
Antacids containing magnesium can worsen misoprostol-related diarrhoea; non-magnesium-containing antacids are preferred. CYP2C9 inhibitors like fluconazole can raise diclofenac levels; CYP2C9 inducers like rifampicin can reduce them. Always tell your prescriber and pharmacist about everything you take, including over-the-counter medicines, vitamins, and herbal supplements, before starting Arthrotec.
Frequently asked questions about Arthrotec 75 tablets
What is Arthrotec made of?
Arthrotec 75 contains two active ingredients: diclofenac sodium 75mg (an NSAID) and misoprostol 200 micrograms (a prostaglandin that protects the stomach lining). They work together to reduce inflammation while protecting against the stomach ulcers NSAIDs can cause.
Can I take Arthrotec if I’m pregnant or trying to conceive?
No. Arthrotec is strictly contraindicated in pregnancy. Misoprostol can cause miscarriage, premature birth, birth defects, and uterine rupture. If you are or could become pregnant, Arthrotec should not be used. Reliable contraception is essential while taking it.
How quickly will Arthrotec work?
Pain relief usually begins within a few hours of the first dose, with steady anti-inflammatory effect building over several days. The stomach-protective effect of misoprostol is immediate from the first dose.
Why does Arthrotec give me diarrhoea?
Misoprostol commonly causes diarrhoea, especially in the first few weeks, because of its effect on the gut. Taking the tablet with food helps; symptoms often settle over a few weeks. If diarrhoea is persistent or severe, switching to Arthrotec 50 or considering an alternative may be appropriate.
Can I take Arthrotec long-term?
Some people with chronic inflammatory arthritis need long-term NSAID treatment, and Arthrotec can be part of that. Regular review is essential to check cardiovascular risk, kidney function, blood pressure, and continued need. For osteoarthritis flares, shorter courses are often preferable.
Why must I take Arthrotec with food?
Taking with food reduces stomach irritation and slows misoprostol absorption, which helps reduce diarrhoea and cramping. Food also helps maintain steady absorption of diclofenac from the gastro-resistant core.
Can I crush or split Arthrotec tablets?
No. Arthrotec has a complex two-layer design: the misoprostol is in the outer mantle for immediate release in the stomach, the diclofenac is in a gastro-resistant inner core for release in the small intestine. Crushing or splitting destroys this design.
Can I drink alcohol while on Arthrotec?
Moderate alcohol is usually acceptable. Heavy or regular drinking significantly increases the risk of stomach bleeding and liver problems with diclofenac. If you drink regularly, mention this to your prescriber.
What about Arthrotec 50? When would I use that instead?
Arthrotec 50 contains 50mg diclofenac plus 200 micrograms misoprostol per tablet and is taken two to three times daily. It’s the lower-dose option, useful when Arthrotec 75 causes diarrhoea or when a smaller diclofenac dose is sufficient. Your prescriber will recommend the right strength for you.
Can I take Arthrotec if I have a stomach ulcer history?
Arthrotec was specifically designed for patients at high risk of NSAID-induced ulcers, including those with a previous ulcer. However, active ulcer disease is a contraindication; the ulcer needs to be healed first. Discuss with your prescriber, who will assess your specific situation.
Does Arthrotec affect kidney function?
The diclofenac component can affect kidney function, particularly in older adults, those with existing kidney disease, heart failure, or those on ACE inhibitors or diuretics. Regular monitoring may be advised for long-term users.
Will Arthrotec raise my blood pressure?
NSAIDs including diclofenac can raise blood pressure modestly, particularly with long-term use. If you have hypertension, regular monitoring is important. Your prescriber may adjust other medications or switch to alternatives where blood pressure rises.
Can I take Arthrotec if I’ve had a heart attack?
Arthrotec is generally avoided in established cardiovascular disease, particularly because diclofenac may carry slightly higher cardiovascular risk than some alternatives. The decision is individual; discuss with a clinician who knows your full cardiac history.
Can I take Arthrotec with paracetamol?
Yes. Paracetamol works differently and can be combined safely with Arthrotec for additional pain relief. Stick to the licensed paracetamol dose (maximum 4g daily for adults).
Why is Arthrotec not available without a prescription?
The combination of NSAID and uterotonic prostaglandin requires careful clinical assessment, particularly around pregnancy risk, GI risk-benefit, and cardiovascular considerations. This level of assessment isn’t appropriate for over-the-counter sale.
Can I take Arthrotec while breastfeeding?
Both diclofenac and misoprostol pass into breast milk in small amounts. Use is generally not recommended during breastfeeding, and alternative pain relief is usually preferred. Discuss with your prescriber.
Can men take Arthrotec safely?
Yes. The pregnancy contraindication applies specifically to anyone who could become pregnant. Men can take Arthrotec without the contraception requirements, though the cardiovascular, GI, and kidney warnings apply equally.
How does Arthrotec compare to taking diclofenac with a separate PPI?
Both approaches aim to provide NSAID effect with stomach protection. Arthrotec offers convenience in one tablet. A separate diclofenac and PPI combination (such as pantoprazole) allows independent dose adjustment and may avoid misoprostol’s GI side effects. The right choice depends on individual circumstances.
Can I take Arthrotec if I’m allergic to aspirin?
No, not if your aspirin reaction involved asthma symptoms, hives, or other allergic-type reactions. NSAID cross-reactivity is real and can cause severe reactions including anaphylaxis. Mild rash with aspirin needs prescriber assessment.
What should I do if I think I’m pregnant while taking Arthrotec?
Stop taking the medicine immediately and contact your prescriber or seek urgent medical advice. Misoprostol exposure in early pregnancy carries serious risks; medical assessment is essential.
Disclaimer: This article is for information only and isn’t a substitute for personal medical advice. Always speak to a qualified prescriber before starting or changing treatment.
References
Electronic Medicines Compendium (2024) Arthrotec 75 modified-release Tablets: Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1144/smpc (Accessed: 14 May 2026).
