Diclofenac-Misoprostol Coupons & Prices

A diclofenac-misoprostol coupon from Rx.com lets you pay a discounted cash price for diclofenac sodium and misoprostol delayed-release tablets, the generic form of Arthrotec, at the pharmacy counter. This prescription combines an anti-inflammatory arthritis medicine with a second ingredient that helps protect the stomach lining, and it is available as a generic from multiple FDA-approved manufacturers. Cash prices for the same tablets still swing widely from one pharmacy to the next, so it pays to compare before you fill. Enter your ZIP code above to see today's price at pharmacies near you, then show the free coupon at the counter. It works whether or not you have insurance, though it cannot be combined with an insurance benefit on the same fill.

What diclofenac-misoprostol is and how it works

Diclofenac sodium and misoprostol is a fixed-dose combination tablet sold under the brand name Arthrotec (Pfizer/Searle) and as generics from multiple FDA-approved manufacturers. It contains two active ingredients in one delayed-release tablet. Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that blocks COX enzymes to reduce joint pain, swelling, and stiffness. Misoprostol is a synthetic prostaglandin E1 analog added to help replace the protective prostaglandins that NSAIDs suppress in the stomach, lowering the chance of an NSAID-induced stomach or duodenal ulcer.

The FDA has approved it for the signs and symptoms of osteoarthritis or rheumatoid arthritis specifically in adults who are at high risk of developing NSAID-induced gastric and duodenal ulcers and their complications, such as older adults, people with a prior ulcer or GI bleed, and those also taking a corticosteroid or an anticoagulant. It is not a first-line arthritis drug for everyone. It comes as delayed-release tablets in 50 mg/200 mcg and 75 mg/200 mcg strengths. Swallow the tablets whole with food; do not crush or chew them.

Cost, coupons, and paying without insurance

Because an FDA-approved generic diclofenac sodium/misoprostol delayed-release tablet is marketed and substitutable for Arthrotec, most people are dispensed the generic. Brand savings programs, if any, are set by the manufacturer and their terms change over time, so check Pfizer's official Arthrotec site and ask your pharmacy what actually applies to your prescription.

A generic is not priced the same everywhere. Cash prices for the identical tablet, strength, and quantity can differ substantially between a big chain, a grocery pharmacy, and an independent down the street, because each sets its own cash price. Prices vary, so it is worth comparing before you fill. Rx.com compares prices across more than 60,000 U.S. pharmacies and shows you a free coupon for the lowest one we find. If you have no insurance, or a high deductible, or your plan does not cover this combination product, the coupon price is often the simpler path. Enter your ZIP above to see today's price, ask the pharmacist to run the coupon before they ring up the fill, and check both the 30-day and 90-day quantities since the per-tablet cost can differ.

How it compares to other arthritis options

The main alternative approach is to take a plain NSAID and, if stomach protection is needed, add a separate acid-reducing medicine such as omeprazole. Two prescriptions can sometimes cost less than the combination tablet, or more, depending on the pharmacy, so it is worth pricing both ways. Other NSAIDs your prescriber may consider for arthritis include:

• Diclofenac alone, the same anti-inflammatory without the misoprostol component
• Meloxicam, taken once daily
• Celecoxib, a COX-2 selective NSAID
• Naproxen and ibuprofen, widely used NSAIDs
• Indomethacin, generally used for shorter courses

Every one of these is still an NSAID and still carries NSAID cardiovascular and gastrointestinal risks. The point of the diclofenac-misoprostol combination is convenience and ulcer-risk reduction in one tablet for people who need an NSAID but are at elevated ulcer risk. Which option is right for you is a decision for your prescriber, not a price comparison.

Safety information you should know

This medicine carries a boxed warning, the FDA's strongest, covering three risks. The first is risk of uterine rupture, abortion, premature birth, and birth defects: the misoprostol component can cause abortion (sometimes incomplete), premature birth, birth defects, and uterine rupture, so it is contraindicated in pregnancy and is not recommended in women of childbearing potential. If it is prescribed, the label directs prescribers to verify the pregnancy status of females of reproductive potential before starting treatment and to advise them to use effective contraception during treatment; patients should also receive the Medication Guide and the required warning about the abortifacient property, and should never give the medicine to anyone else. The second risk is serious cardiovascular thrombotic events, including heart attack and stroke, which can be fatal; the risk can appear early in treatment and may grow with longer use, and it must not be used for pain around coronary artery bypass graft (CABG) surgery. The third is serious gastrointestinal bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal and can happen at any time without warning symptoms; older adults and people with a prior ulcer or GI bleed are at greater risk.

It is also contraindicated in active gastrointestinal bleeding, in anyone who has had asthma, hives, or another allergic-type reaction after taking aspirin or another NSAID, and in anyone with known hypersensitivity to diclofenac, misoprostol, or any component of the product. Other important risks include liver injury (diclofenac has among the higher rates of liver enzyme elevation, so your prescriber should check liver tests at baseline and periodically), high blood pressure, new or worsening heart failure and fluid retention, kidney injury including renal papillary necrosis (avoid in advanced kidney disease), high potassium, anaphylaxis, serious skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis and DRESS, anemia, and masking of the signs of infection. The most common side effects are gastrointestinal: abdominal pain, diarrhea (from the misoprostol, often early and dose-related), indigestion, nausea, and gas. Do not take it with other NSAIDs or with analgesic doses of aspirin, and tell your prescriber if you take blood thinners or antiplatelet drugs, SSRIs, corticosteroids, ACE inhibitors, ARBs, diuretics, lithium, methotrexate, cyclosporine, or magnesium-containing antacids (which can worsen the diarrhea). Use the lowest effective dose for the shortest time needed. This is general information, not medical advice; talk with your doctor or pharmacist about your own situation and read the Medication Guide that comes with your prescription.