Caroline P replied: "If you are pre-menopausal you shouldn't be taking arthrotec. Misoprostol is the drug used for medical abortion, therefore it is not recommended for women of child bearing age (I had a GP try to put me on it once and I refused on this basis - I was 23 at the time).
Diclofenac is an NSAID, and therefore damages gastric lining (I have seen a lot of patients with GI bleeds from taking these drugs - I even lost my darling Grandad to it (in case you were wondering I'm an endoscopy sister)), so you should be on ideally a PPI (something like losec (omeprazole)) with it.
The tramadol can constipate, so you need to make sure you have a good fluid intake.
Amitriptyline in some extreme cases can cause jaundice, so I would think that your liver function may be off slightly.
You didn't give your age, but if you are pre-menopausal I would ask for a drug review and come off the arthrotec, and get some losec added in to the mix to help your stomach.
You are also entitled to know what your GP is querying as a diagnosis, so make an appointment and ask him at the same time."
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