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

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2. Dosage Forms

• Oral Tablets: 60 mg, 90 mg, 120 mg

• No IV/topical forms

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3. Drug Class

• COX-2 Selective NSAID

• Analgesic, Anti-inflammatory

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

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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

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5. Side Effects

Common (≥1%)	Serious (Stop Immediately)
Headache, dizziness	Heart Attack/Stroke
Indigestion, nausea	GI Bleeding (rare but possible)
Edema (swollen limbs)	Severe Hypertension
Fatigue	Hepatotoxicity (jaundice)
	Kidney Failure
	Allergy/SJS/TEN (skin blistering)

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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)

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7. How to Take It

Condition	Dose	Max Duration
Osteoarthritis	30–60 mg daily	Long-term*
Rheumatoid Arthritis	90 mg daily	Long-term*
Ankylosing Spondylitis	90 mg daily	Long-term*
Acute Gout	120 mg daily	≤8 days

• Key Instructions:

  • Take once daily with/without food

  • Avoid alcohol (↑ hypertension/GI risk)

  • Long-term use requires BP/kidney monitoring

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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

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9. Missed Dose

• Take ASAP if <12 hours late

• Skip if >12 hours; resume next day

• Never double dose

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10. Overdose

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

• Action:

  • Call emergency services

  • Supportive care (no antidote)

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11. Avoid While Taking

• Other NSAIDs (ibuprofen, naproxen)

• ACE Inhibitors (lisinopril) – ↓ effectiveness

• Corticosteroids (prednisone) – ↑ GI bleeding

• Alcohol – ↑ hypertension/GI risk

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12. Storage

• Temperature: Below 30°C (86°F)

• Humidity: Keep in original blister pack

• Safety: Child-resistant container

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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