Prostaglandin analog to prevent NSAID-induced peptic ulcer

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Prostaglandin analog to prevent NSAID-induced peptic ulcer


Generic Name

Combination medicines

Generic NameBrand Name
misoprostol and diclofenacArthrotec

Misoprostol is taken two times a day, or four times a day in divided doses.

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).

Misoprostol does not reduce the effectiveness of NSAIDs in treating arthritis or other painful, long-term (chronic) diseases.

Why It Is Used

Misoprostol is sometimes used to decrease 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.2

But the side effects of this medicine 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.1

Side Effects

The side effects of misoprostol include:

  • Diarrhea. Diarrhea can be prevented by using a lower dose, but a lower dose may not be as effective.
  • Belly pain.
  • Indigestion (dyspepsia).
  • Nausea.
  • Gas (flatulence).
  • Fatigue.

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

What To Think About

Misoprostol should not be used during pregnancy, because it can cause miscarriage. Women who could become pregnant are given the medicine only after they are tested and found to not be pregnant. Women must use a reliable method of contraception while taking this medicine.

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



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


By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Last Revised February 25, 2010

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.