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Etoricoxib

 

1. Generic Name & Brand Names

  • Generic Name: Etoricoxib

  • Brand Names:

    • Arcoxia® (Global: EU, Asia, LATAM)

    • Tauxib® (India)

    • Etosa® (Middle East)

    • Not FDA-approved in USA/Canada

2. Dosage Forms

  • Oral Tablets: 60 mg, 90 mg, 120 mg

  • No IV/topical forms

3. Drug Class

  • COX-2 Selective NSAID

  • Analgesic, Anti-inflammatory

  • *Minimal effect on COX-1 → lower GI risk vs. traditional NSAIDs*

4. Uses

  • Chronic Inflammatory Conditions:

    • Osteoarthritis (OA), Rheumatoid Arthritis (RA), Ankylosing Spondylitis

  • Acute Pain:

    • Gout flares, Dental surgery pain

  • Not for fever or non-inflammatory pain

5. Side Effects

Common (≥1%)Serious (Stop Immediately)
Headache, dizzinessHeart Attack/Stroke
Indigestion, nauseaGI Bleeding (rare but possible)
Edema (swollen limbs)Severe Hypertension
FatigueHepatotoxicity (jaundice)
Kidney Failure
Allergy/SJS/TEN (skin blistering)

6. Warnings Before Taking

  • Absolute Contraindications:

    • Ischemic heart disease, stroke, PAD

    • Active GI bleeding

    • Severe heart/kidney/liver failure

    • 3rd trimester pregnancy

    • Allergy to sulfonamides/NSAIDs

  • High-Risk Groups:

    • Hypertension (↑ BP risk), smokers, >65 years

    • Avoid in CABG surgery patients

  • Drug Interactions:

    • ⚠️ Warfarin (↑ bleeding)

    • ⚠️ Lithium, SSRIs, Diuretics (↑ toxicity)

7. How to Take It

ConditionDoseMax Duration
Osteoarthritis30–60 mg dailyLong-term*
Rheumatoid Arthritis90 mg dailyLong-term*
Ankylosing Spondylitis90 mg dailyLong-term*
Acute Gout120 mg daily≤8 days

  • Key Instructions:

    • Take once daily with/without food

    • Avoid alcohol (↑ hypertension/GI risk)

    • Long-term use requires BP/kidney monitoring

8. Uses in Adults

  • Chronic arthritis: Lowest effective dose (e.g., 30 mg for OA)

  • Short-term: Acute gout (max 120 mg × 8 days)

  • Not for children/adolescents

9. Missed Dose

  • Take ASAP if <12 hours late

  • Skip if >12 hours; resume next day

  • Never double dose

10. Overdose

  • Symptoms: Nausea, lethargy, GI bleeding, kidney failure

  • Action:

    • Call emergency services

    • Supportive care (no antidote)

11. Avoid While Taking

  • Other NSAIDs (ibuprofen, naproxen)

  • ACE Inhibitors (lisinopril) – ↓ effectiveness

  • Corticosteroids (prednisone) – ↑ GI bleeding

  • Alcohol – ↑ hypertension/GI risk

12. Storage

  • Temperature: Below 30°C (86°F)

  • Humidity: Keep in original blister pack

  • Safety: Child-resistant container

Critical Safety Notes:

⚠️ Cardiovascular Risk:

  • Black Box Warning (EU): ↑ Risk of thrombotic events (MI/stroke) – avoid in CVD patients.

  • Monitor BP weekly initially.

⚠️ Kidney/Hepatic Monitoring:

  • Check serum creatinine/LFTs at baseline and annually.

⚠️ Shortest Duration Principle:

  • Use lowest dose for shortest time (e.g., 120 mg only for acute gout ≤8 days).

⚠️ Pregnancy:

  • Contraindicated in 3rd trimester (premature ductus arteriosus closure).

Prescription Required: Not available OTC. Regular medical review mandatory for chronic use

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