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Drug Interactions With Diclofenac/Misoprostol
Certain antacids, diuretics, and cholesterol medications can cause problems when used in combination with diclofenac/misoprostol. Some of these drug interactions can interfere with the effectiveness of the medications or increase your risk for potentially serious side effects. To minimize any complications, make sure your healthcare provider has an up-to-date list of all medications, vitamins, and supplements you are taking.
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Diclofenac/misoprostol (Arthrotec®) can potentially react with a number of other medications. Some of the products that may lead to drug interactions with diclofenac/misoprostol include but are not limited to:
- ACE inhibitors, such as:
- Benazepril (Lotensin®, Lotensin® HCT, Lotrel®)
- Captopril (Capoten®, Capozide®)
- Enalapril (Vasotec®, Vaseretic®, Lexxel®)
- Fosinopril (Monopril®, Monopril-HCT®)
- Lisinopril (Prinivil®, Prinizide®, Zestril®, Zestoretic®)
- Quinapril (Accupril®, Accuretic®)
- Ramipril (Altace®)
- Angiotensin II receptor blockers (ARBs), such as:
- Candesartan (Atacand®, Atacand HCT™)
- Eprosartan (Teveten®, Teveten® HCT)
- Irbesartan (Avapro®, Avalide®)
- Losartan (Cozaar®, Hyzaar®)
- Olmesartan (Benicar®, Benicar HCT®)
- Telmisartan (Micardis®, Micardis® HCT)
- Valsartan (Diovan®, Diovan HCT®)
- Beta blockers, such as:
- Acebutolol (Sectral®)
- Atenolol (Tenormin®)
- Betaxolol (Kerlone®)
- Bisoprolol (Zebeta®)
- Carvedilol (Coreg®, Coreg CR®)
- Esmolol (Brevibloc®)
- Labetalol (Trandate®)
- Metoprolol (Lopressor®, Toprol-XL®)
- Nadolol (Corgard®)
- Nebivolol (Bystolic®)
- Penbutolol (Levatol®)
- Propranolol (Inderal®, Inderal® LA, InnoPran XL™)
- Sotalol (Betapace®)
- Timolol
- Bile acid sequestrant cholesterol medications, such as:
- Cholestyramine (Prevalite®, Questran®, Questran® Light)
- Colesevelam (WelChol®)
- Colestipol (Colestid®)
- Certain antacids
- Corticosteroids, such as:
- Betamethasone (Celestone®)
- Cortisone
- Dexamethasone (Decadron®)
- Fludrocortisone (Florinef®)
- Hydrocortisone (Cortef®)
- Methylprednisolone (Depo-Medrol®, Medrol®)
- Prednisolone (Ovapred®, Pediapred®)
- Prednisone
- Triamcinolone (Kenalog®, Aristospan®)
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- CYP 2C9 inducers, such as:
- CYP 2C9 inhibitors, such as:
- Capecitabine (Xeloda®)
- Delavirdine (Rescriptor®)
- Floxuridine
- Fluconazole (Diflucan®)
- Fluorouracil (Carac®, Efudex®, Fluoroplex®)
- Gemfibrozil (Lopid®)
- Ketoconazole (Nizoral®)
- Nicardipine (Cardene®, Cardene SR®)
- Sulfadiazine
- Sulfisoxazole (Gantrisin®)
- Tolbutamide (Orinase®)
- Amiloride (Midamor®) or amiloride-HCTZ (Moduretic®)
- Bumetanide (Bumex®)
- Chlorothiazide (Diuril®)
- Chlorthalidone (Thalitone®)
- Ethacrynic acid (Edecrin®)
- Furosemide (Lasix®)
- Hydrochlorothiazide (Esidrix®, HydroDIURIL®, Microzide®, Oretic®)
- Metolazone (Zaroxolyn®)
- Spironolactone (Aldactone®) or spironolactone-HCTZ (Aldactazide®)
- Torsemide (Demadex®)
- Triamterene (Dyrenium®) or triamterene/HCTZ (Dyazide®, Maxzide®)
- Lithium (Eskalith®, Eskalith CR®, Lithobid®)
- Medications that "thin" the blood (anticoagulant and antiplatelet drugs), such as:
- Antithrombin (ATryn®, Thrombate III®)
- Argatroban
- Aspirin (Bayer® and others)
- Bivalirudin (Angiomax®)
- Cilostazol (Pletal®)
- Clopidogrel (Plavix®)
- Dabigatran (Pradaxa®)
- Dipyridamole (Persantine®)
- Drotrecogin alfa (Xigris®)
- Eptifibatide (Integrilin®)
- Fondaparinux (Arixtra®)
- Heparin or heparin-like products, including dalteparin (Fragmin®), enoxaparin (Lovenox®), or tinzaparin (Innohep®)
- Lepirudin (Refludan®)
- Other nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- Celecoxib (Celebrex®)
- Diclofenac (Cambia™, Cataflam®, Flector®, Solaraze® Gel, Voltaren®, Voltaren® Gel, Voltaren®-XR, Voltaren Ophthalmic®, Zipsor™)
- Etodolac (Lodine®, Lodine® XL)
- Ibuprofen (Motrin®, Advil®, Nuprin®)
- Indomethacin (Indocin®, Indocin SR®)
- Ketoprofen (Orudis®, Actron®, Oruvail®)
- Ketorolac (Toradol®)
- Meloxicam (Mobic®)
- Nabumetone (Relafen®)
- Naproxen (Naprosyn®) or naproxen sodium (Aleve®, Anaprox®, Naprelan®)
- Oxaprozin (Daypro®)
- Piroxicam (Feldene®)
- Others (see List of NSAIDs for a more complete list of these medications)
- Rivaroxaban (Xarelto®)
- Thrombolytics, such as:
- Alteplase (Activase®)
- Reteplase (Retavase®)
- Streptokinase (Streptase®)
- Tenecteplase (TNKase®)
- Methotrexate (Rheumatrex®)
- Oxytocin (Pitocin®)
- Pemetrexed (Alimta®)
- SSRI or SNRI medications, such as:
- Citalopram (Celexa®)
- Duloxetine (Cymbalta®)
- Desvenlafaxine (Pristiq®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Fluvoxamine (Luvox®, Luvox® CR)
- Milnacipran (Savella™)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®)
- Sertraline (Zoloft®)
- Venlafaxine (Effexor®, Effexor XR®)
- Voriconazole (VFEND®).
Written by/reviewed by: Susan Lakey, PharmD, MPH, BCPP
Last reviewed by: Kristi Monson, PharmD