| Composition Misoprostol 100 mcg Diclofenac Sodium 50 mg Product Description Misonac is a combination product containing diclofenac sodium, a nonsteroidal

anti-inflammatory drug (NSAID) with analgesic properties, and misoprostol, a gastrointestinal mucosal protective prostaglandin E 1 analog. Mechanism of Action NSAID acts by decreasing the level of Prostaglandins in Cyclo-oxygenase pathway Diclofenac is a potent and highly preferred NSAID it is very effective in relieving pain but the problem is causes gastric ulcer (side effect) Diclofenac Indications Osteo-arthritis Rheumatoid arthritis Cancer pain Dosage Thrice Daily

Contra Indication Allergic reaction to other NSAIDs should not take Misonac. Misonac should be avoided in those with a history of peptic ulcer or GI bleeding and with renal disorder should be used cautiously. Misonac should NOT be taken by pregnant women or women who could potentially become pregnant and nursing mothers. It should be used with caution in patients with preexisting asthma.

decreases the level of both PGE1 (Prostaglandin E1) and PGE2 (Prostaglandin E2) Decrease in Prostaglandin E2 decreases pain but decrease in Prostaglandin E1 causes decrease in mucus secretion in stomach. Mucus secretion prevents the stomach cells from gastric acid when mucus secretion is decreased gastric acid damages stomach cell which causes ulcer (that is how diclofenac causes it gastric side effects like ulcer).Misoprostol is a PGE1 (Prostaglandin E1) analogue. Thus by giving Misprostol the level of PGE1 is increased thus mucus secretion loss caused by diclofenac (NSAID) is restored. That is by giving Misoprostol with diclofenac helpful in relieving chronic pain without side effects (ulcer and gastric cell damage). Pharmaco Kinetics Oral administration of Misonac pharmacokinetic profile is similar to the two individual components, Diclofenac and

Drug Interactions Misonac can increase the effect of anticoagulants and digoxin., inhibit the activity of antihypertensives, it should not be taken with any other NSAIDs. Magnesium containing antacids may increase the risk of diarrhea side effect. Misonac may affect renal function and increase the toxicity of certain drugs such as methotrexate. Special Precautions Diarrhea and abdominal pain noted in the first couple days of therapy may resolve on it's own after 2-7 days. If you get black, tarry stools or vomit up what looks like coffee grounds, call your doctor at once. You may have a bleeding ulcer. Packing A strip of 10 tablets. In a box of 10 x 10 strips.

Misoprostol. Diclofenac is completely absorbed from GI tract, only 50% of the absorbed dose is systematically available due to first pass metabolism. Peak plasma levels are achieved within 2 hours, more than 99% of Diclofenac is reversibly bound to plasma albumin and it is eliminated through metabolism and subsequent urinary and biliary excretion approximately 65% of the drug is excreted in the urine and 35% in the bile. Misoprostol Misoprostol is rapidly and extensively absorbed after oral administration and it undergoes rapid metabolism to biologically active metabolite, Misoprostol Acid, it reaches the peak plasma concentration in about 20 minutes, less than 90% of misoprostol is bind to serum protein and 70% of misoprostol are excreted in the urine.