Etoricoxib
Indications
Etoricoxib is an anti-inflammatory painkiller. It is used to relieve pain and swelling in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis (inflammation of the spine) and acute gout attacks, and for short-term moderate pain after dental surgery.
How It Works
Etoricoxib is a selective COX-2 inhibitor. It blocks the COX-2 enzyme, which makes prostaglandins, the chemicals that cause pain and inflammation. Because it affects the stomach-protecting COX-1 enzyme much less, it causes fewer stomach ulcers than older anti-inflammatory medicines, but the risk is not zero.
Dosage and Administration
- Osteoarthritis: 30 to 60 mg once a day.
- Rheumatoid arthritis and ankylosing spondylitis: 60 to 90 mg once a day.
- Acute gout: 120 mg once a day, only during the attack and for no more than 8 days.
- Pain after dental surgery: as prescribed, for a short time only.
Take by mouth with or without food. Use the lowest dose for the shortest time that controls symptoms. Not for children under 16 years. People with liver problems need a lower dose, as the doctor advises.
Interactions
It can increase bleeding risk with Warfarin and other blood thinners, and stomach bleeding with Aspirin, other anti-inflammatory medicines, steroids and some antidepressants. It can reduce the effect of blood pressure medicines (ACE inhibitors such as Enalapril, ARBs such as Losartan, and water tablets) and harm the kidneys when combined with them. It can raise levels of Lithium, Methotrexate and the hormones in oral contraceptives. Rifampicin lowers etoricoxib levels.
Contraindications
- Allergy to etoricoxib, or asthma, nasal polyps, hives or swelling after Aspirin or other anti-inflammatory medicines.
- Heart disease (angina, heart attack, heart failure), stroke or mini-stroke, or blocked arteries in the legs.
- High blood pressure that is not controlled.
- Active stomach ulcer or bleeding, or inflammatory bowel disease.
- Severe liver disease or serious kidney disease.
- Pregnancy and breastfeeding; children under 16.
Side Effects
Common: indigestion, stomach pain, heartburn, nausea, diarrhoea, swelling of the ankles, raised blood pressure, dizziness and headache.
Get urgent medical help if you have chest pain, sudden weakness or numbness of one side, trouble speaking, black or bloody stools, vomiting blood, shortness of breath, swelling of the face, lips or throat, a blistering or peeling rash, yellow skin or eyes, or much less urine than usual.
Pregnancy and Lactation
Do not use in pregnancy, especially in the last three months, as it can harm the baby and affect labour. It may also make it harder to get pregnant. Do not use while breastfeeding.
Precautions and Warnings
Like other anti-inflammatory medicines, it can raise the risk of heart attack and stroke, especially at high doses or with long use. Blood pressure should be checked within about 2 weeks of starting and regularly after that. Take extra care in older people, people with diabetes, high cholesterol, smoking, dehydration, kidney or liver problems, or a past stomach ulcer. Do not take with other anti-inflammatory painkillers.
Overdose
Overdose may cause stomach pain, nausea, vomiting, drowsiness and, in serious cases, kidney or heart problems. Get medical help promptly.
Therapeutic Class
Non-steroidal anti-inflammatory drug (NSAID), selective COX-2 inhibitor.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Etoricoxib