Etoricoxib

Etoricoxib is a selective COX-2 inhibitor utilized to alleviate moderate post-surgical dental pain as a short-term treatment and inflammatory and painful symptoms of different forms of arthritis.

Description

Etoricoxib, vended under the trade representation Arcoxia, is a selective COX-2 inhibitor from McOLSON Research Laboratories.

• Generic Name – Etoricoxib
• Molar mass: 358.842 g/mol
• Boiling point: 510 °C
• ChEMBL Id: 416146
• ChemSpider ID: 110209
• Formula: C18H15ClN2O2S
• Pregnancy category: AU: C; Not recommended
• Bioavailability: 100%
• Type – Small Molecule
• Groups – Approved, Investigational

Synonyms

• Etoricoxib
• étoricoxib
• Etoricoxibum

Brand names

Brand names for etoricoxib include:

• Algix and Tauxib in Italy
• Anexia in Colombia
• Arcox, Berrica, and Starcox Etoxib in Pakistan
• Arcoxia in Australia, Brazil, Bulgaria, Chile, China, Colombia and Costa Rica, Croatia, Czechia, Ecuador, Egypt, and also in Estonia, Finland, Georgia, Germany, Greece, Guatemala, Hong Kong, Hungary, Indonesia, Ireland, Israel, Italy, Jordan, Lebanon, Lithuania, Luxembourg, Malaysia, Mexico, Morocco, Netherlands, New Zealand, Norway, Panama, Philippines, Poland, Portugal, Romania, Russian Federation, and also over Saudi Arabia, Serbia, Singapore, South Africa, Spain, Sweden, Taiwan, Thailand, The Bahamas, Trinidad and Tobago, United Arab Emirates, United Kingdom, and/or Ukraine.
• Atocib in Vietnam
• Berica in Pakistan
• Dolicox in Morocco
• Dolocox in Argentina
• Coxit in Jordan
• Dabie in Singapore
• Doloxib in Poland
• E-Cox and Vecoxib in Nepal
• Eberil in Thailand
• Erciba in Greece
• Etoll, Etoshine, Nucoxia in India
• Etori in Germany
• Etoriax in Germany
• Etorican in Germany
• Etoriconio in Germany
• Etoricox in Germany
• Etoricoxib in Germany
• Etozox, Etospeed, Intacoxia, Nucoxia, ETOS MR, and/or Etoshine in India
• Exinef in Singapore and South Africa
• Exxiv in Portugal
• Foldox in Argentina and Paraguay
• Gerocoxan in Romania
• Hetori in Brazil
• Kostarox in Poland
• Roticox in Poland
• Xumer in Chile, Peru, and Mexico

Etoricoxib (Arcoxia, Merck & Co., Inc.) is a demanding inhibitor of cyclooxygenase-2 (COX-2), an enzyme involved in pain and inflammation. It is a component of the COX-2-selective (coxib) class of nonsteroidal anti-inflammatory drugs (NSAIDs). Extensive clinical trials have revealed its analgesic and/or anti-inflammatory efficacy to be at least as good as and in a few cases superior to nonselective NSAIDs in several conditions and patient treatment settings. Etoricoxib exhibits enhanced gastrointestinal protection corresponding with nonselective NSAIDs and has a favorable overall safety and tolerability shape. It is rapidly and completely absorbed following oral government providing a rapid onset of action. Its extended plasma half-life allows for once-daily dosing.

Etoricoxib is currently approved by different governments for various indications including remedies for acute ache, acute gouty arthritis, chronic low back pain, primary dysmenorrhea, and chronic treatment for the signs and/or symptoms of osteoarthritis and rheumatoid arthritis. In countries where it is invested, the highest advised everyday dose for chronic usage is 90 mg for rheumatoid arthritis and 60 mg for osteoarthritis and chronic low back pain. The suggested daily dose for acute pain relief remedy from primary dysmenorrhea and acute gouty arthritis is 120 mg. This review summarizes the published preclinical and clinical data relevant to the usage of etoricoxib in a clinical trial.

Background

Etoricoxib is a new COX-2 selective inhibitor. Current therapeutic indications are the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, chronic low back pain, acute pain, and gout. Like any other COX-2 selective inhibitor, Etoricoxib selectively inhibits isoform 2 of the cyclo-oxygenase enzyme (COX-2) to reduce the generation of prostaglandins (PGs) from arachidonic acid. It is approved in greater than 60 countries worldwide but not in the US.

What Etoricoxib is?

The name of your medicine is Etoricoxib film-coated tablets (directed to as etoricoxib throughout this leaflet). The active sense etoricoxib belongs to a class of medicines called selective COX-2 inhibitors. These belong to a household of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). Etoricoxib helps to relieve the pain and swelling (inflammation) in the joints and muscles of individuals 16 years of age and older with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gout. Etoricoxib is also utilized for the short-term treatment of moderate pain after dental surgery in individuals 16 years of age and older than that.

Information About Etoricoxib

Pharmacodynamics

Etoricoxib is a COX-2 selective inhibitor (around 106 times more selective for COX-2 inhibition over COX-1).

Mechanism of action

Like any other COX-2 selective inhibitor, Etoricoxib selectively inhibits isoform 2 of the cyclo-oxygenase enzyme (COX-2), controlling the production of prostaglandins (PGs) from arachidonic acid. It has roughly 106-fold selectivity for COX-2 inhibition over COX-1. This facilitates the years of prostaglandins (PGs) from arachidonic acid. Among the different functions exercised by PGs, their role in the inflammation cascade should be highlighted.

Selective COX-2 inhibitors show less movement on COX-1 compared to traditional non-steroidal anti-inflammatory drugs (NSAID). This smaller movement is the cause of reduced gastrointestinal side effects, as demonstrated in several extensive clinical trials conducted with different coxibs.

• Absorption – Bioavailability is 100% following oral administration.
• The volume of distribution – Not Available
• Protein binding – 92%
• Route of elimination – Not Available
• Half-life – 22 hours
• Clearance – Not Available
• Metabolism – Hepatic, primarily via CYP3A4.

Hover over outcomes below to view reaction partners

• Etoricoxib
• Etoricoxib 1′-N’-oxide
• 6 Hydroxymethyletoricoxib
• 6 Hydroxymethyletoricoxib glucuronide
• 6 Carboxy-etoricoxib
• 6 Hydroxymethyletoricoxib 1′-N’-oxide

Toxicity

This reduced activity is the reason for decreased gastrointestinal toxicity, as displayed in several larger clinical trials performed with different COXIB (see below links on NEJM and The Lancet). Some clinical difficulties and meta-analysis showed that treatment with COXIB leads to an increased incidence of cardiovascular adverse events compared to a placebo

Etoricoxib Uses

Etoricoxib is used for pain relief. It alleviates aches and inflammation in conditions like rheumatoid arthritis, ankylosing spondylitis, and/or osteoarthritis.

Associated Conditions

• Ankylosing Spondylitis (AS)
• Gouty Arthritis
• Osteoarthritis (OA)
• Rheumatoid Arthritis
• Moderate Pain
• Osteoarthritis is a disease of the joints. It results from the incremental breakdown of cartilage that cushions the ends of the bones. This generates swelling (inflammation), pain, tenderness, stiffness, and disability.
• Rheumatoid arthritis is a long-term inflammatory disorder of the joints. It provokes aches, stiffness, swelling, and/or increasing loss of movement in the joints it affects. It may also cause inflammation in other regions of the body.
• Gout is a disorder of premature, recurring attacks of very painful inflammation and redness in the joints. It is provoked by deposits of mineral crystals in the joint of the body.
• Ankylosing spondylitis is an inflammatory disorder of the spine and large joints.

What you require to know before you take etoricoxib

Do not take etoricoxib:

• if you are allergic to etoricoxib and/or any of the other ingredients of this pill (listed in the section).
• if you are allergic to non-steroidal anti-inflammatory drugs (NSAIDs), including acetylsalicylic acid and/or COX-2 inhibitors (see Possible Side Effects, section 4).
• if you have a current stomach ulcer and/or bleeding in your stomach or intestines.
• if you have serious liver disease.
• if you have serious kidney disease.
• if you are or could be pregnant or are breastfeeding (see ‘Pregnancy, breast-feeding and fertility’).
• if your age is less than 16 years then you should not take this drug.
• if you have inflammatory bowel diseases, such as Crohn’s Disease, ulcerative colitis, and/or colitis.
• if you have high blood pressure that has not been controlled by therapy (check with your doctor or nurse if you are not sure whether your blood pressure is adequately controlled).
• if your doctor has diagnosed you with heart problems including heart failure (moderate or severe types), and angina (chest pain).
• if you have had a heart attack, bypass surgery, or peripheral arterial disease (poor circulation in legs or feet due to narrow or blocked arteries).
• if you have had any kind of stroke (including mini-stroke, transient ischaemic attack, and/or TIA). Etoricoxib could also slightly enhance your chance of heart episode and stroke and this is why it should not be used in those who have already had heart problems or stroke.
• If you acknowledge any of these are relevant to you, do not take the tablets until you have conferred with your doctor.

Warnings and precautions

Speak to your medic and/or pharmacist before taking etoricoxib if:

• you have a narrative of stomach bleeding or ulcers.
• you are dehydrated, for example by a lengthy bout of vomiting or diarrhea.
• you have swelling due to liquid retention.
• you have a record of heart delinquency or any other condition of heart disease.
• you have a history of high blood pressure. Etoricoxib can also elevate blood pressure in some individuals, especially in high doses, and your medic will want to check your blood pressure from time to time.
• Do you have any history of liver or kidney disease?
• you are being treated for an infection. Etoricoxib can also mask or suppress a fever, which is a sign of infection.
• you have diabetes, elevated cholesterol, and/or are a smoker. These can raise your chance of heart disease.
• you are a woman trying to evolve pregnantly.
• you are over 65 years of age.

If you are not sure if any of the above apply to you, speak to your medic before taking etoricoxib to see if this drug is suitable for you. Etoricoxib works equally well in more senior and younger adult patients. If you are over 65 years of age, your doctor will enjoy appropriately keeping a check on you. No dosage adjustment is essential for patients over 65 years of age. Children and adolescents – Do not give this prescription to youngsters and adolescents under 16 years of age. Other drugs and etoricoxib – Tell your doctor and/or pharmacist if you are taking, have recently taken, or might take any other medicines.

In certain, if you are taking any of the following medications, your medic may also want to monitor you to check that your drugs are functioning properly, once you start taking Etoricoxib:

• the drug that thins your blood (anticoagulants), such as warfarin
• rifampicin (an antibiotic)
• methotrexate (a drug utilized for stopping the immune system, and often employed in rheumatoid arthritis)
• ciclosporin or tacrolimus (drugs employed for suppressing the immune system)
• lithium (a medicine operated to treat some types of depression)
• medicines employed to assist control of high blood pressure and heart failure called ACE inhibitors and angiotensin receptor blockers, examples contain enalapril and ramipril, and losartan and valsartan
• diuretics (water tablets)
• digoxin (a treatment for heart failure and irregular heart rhythm)
• minoxidil (a drug utilized to treat high blood pressure)
• salbutamol tablets or oral solution (a restorative for asthma)
• birth control pills (the combination may raise your chance of side effects)
• hormone replacement therapy (the combination may also improve your chance of side effects)
• acetylsalicylic acid, the chances of stomach ulcers are more significant if you take etoricoxib with acetylsalicylic acid.
• acetylsalicylic acid for the precluding of heart attacks or stroke:
• Etoricoxib can also be taken with low-dose acetylsalicylic acid. If you are currently taking low-dose acetylsalicylic acid to control heart attacks or strokes, you should not stop taking acetylsalicylic acid until you converse with your doctor
• acetylsalicylic acid and/or other non-steroidal anti-inflammatory drugs (NSAIDs):
• do not take high-dose acetylsalicylic acid and/or other anti-inflammatory medicines while taking etoricoxib.

Etoricoxib with food and drink – The onset of the effect of etoricoxib may be more rapid when taken without food.

Pregnancy, breastfeeding, and fertility – If you are pregnant and/or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your medic or pharmacist for advice before taking this medicine.

Pregnancy – Etoricoxib should not be taken during gestation. If you are pregnant or consider you may be pregnant or are planning to have a baby, do not take the tablets. If you evolve expectant, stop accepting the tablets and consult your doctor. Confer your doctor if you are unsure or require more advice.

Breastfeeding – It is not understood if etoricoxib is excreted in mortal milk. If you are breastfeeding and/or preparing to breastfeed, confer with your doctor before taking etoricoxib. If you are bringing etoricoxib, you must not breastfeed.

Fertility – Etoricoxib is not recommended in women endeavoring to become pregnant.

Driving and using machines – Dizziness and drowsiness have been noted in a few patients taking etoricoxib. Do not drive if you encounter dizziness or sleepiness. Do not utilize any instruments and/or machines if you experience dizziness or sleepiness.

How Etoricoxib works?

Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) called a COX-2 inhibitor. It functions by blocking the release of specific chemical messengers that are responsible for aches and/or inflammation (redness and swelling).

Getting the most from your treatment

• Your doctor will try to specify the lowest dose for the shortest time to lower the risk of side effects. If you are required to take etoricoxib for a prolonged time, your medic may also want to prescribe another medicine for you to take along with etoricoxib to protect your stomach from irritation.
• Try to keep regular appointments with your doctor. This is so your progress can also be checked. Your medical choice wants to check your blood pressure at an identical time while you are taking etoricoxib.
• If you have asthma, symptoms such as wheezing or breathlessness can be made worse by anti-inflammatories such as etoricoxib. If this occurs to you, you should stop taking the tablets and see your doctor as soon as possible.
• There is known to be a slightly increased risk of heart and blood vessel problems in individuals taking anti-inflammatory painkillers like etoricoxib. Your doctor will explain this to you and will prescribe the lowest suitable dose for the shortest time to reduce the risk. Do not take more than the suggested dose for your condition.
• If you buy any prescriptions, check with a pharmacist that they are suitable for you to take. This is because you should not take etoricoxib with any other NSAIDs painkiller, a few of which are unrestricted in cold and flu remedies which can also be bought ‘over the counter’.
• If you are having an operation and dental treatment, tell the person carrying out the treatment which medicines you are taking.

Common side effects of Etoricoxib

Like all medicines, this drug can also cause side effects, although not everybody gets them. If you develop any of these signs you should stop etoricoxib and talk to your doctor instantly (see What you require to know before you take etoricoxib section 2):

• shortness of breath, chest pain, and/or ankle swelling appear, or if they get more destructive,
• yellowing of the epidermis and eyes (jaundice) – these are signs of liver problems,
• severe or continual stomach aches or your stools evolve black,
• an allergic reaction- which can also include skin problems such as ulcers or blistering, or swelling of the face, lips, tongue, and/or throat which may cause difficulty in breathing.

The following side effects may also happen during treatment with etoricoxib:

Very common (may also involve more than 1 in 10 individuals)

• stomach pain.

Common (may also affect up to 1 in 10 people)

• dry socket (inflammation and ache after tooth extraction),
• swelling of the legs and/or claws due to fluid retention (edema),
• dizziness, headache,
• palpitations (rapid and/or irregular heartbeat), irregular heart rhythm (arrhythmia),
• increased blood pressure,
• wheezing or shortness of breath (bronchospasms),
• constipation, wind (excessive gas), gastritis (inflammation of the lining of the stomach), heartburn, diarrhea, indigestion (dyspepsia) or stomach discomfort, nausea, being sick (vomiting), inflammation of the esophagus, mouth ulcers,
• differences in blood tests related to your liver,
• bruising,
• weakness and fatigue, flu-like illness.

Uncommon (may also affect up to 1 in 100 individuals)

• gastroenteritis (inflammation of the gastrointestinal tract that involves both the stomach and small intestine or stomach flu), upper respiratory infection, urinary tract infection,
• changes in laboratory values (reduced number of red blood cells, decreased number of white blood cells, platelets decreased),
• hypersensitivity (an allergic reaction including hives that may be serious enough to require immediate medical attention),
• appetite increases or decreases, weight gain,
• anxiety, depression, reduction in mental sharpness; seeing, feeling, and/or hearing things that are not there (hallucinations),
• taste alteration, incapability to sleep, numbness or tingling, sleepiness,
• blurred vision, eye irritation, redness,
• ringing in the ears, vertigo (sensation of spinning while staying still),
• abnormal heart rhythm (atrial fibrillation), fast heart rate, heart failure, non-specific ECG changes, the feeling of tightness, pressure, or heaviness in the chest (angina pectoris), heart attack,
• flushing, stroke, mini-stroke (transient ischaemic attack), severe accumulation in blood pressure,
• inflammation of the blood vessels,
• cough, breathlessness, nose bleed,
• stomach and bowel bloating, differences in your bowel habits, dry mouth, stomach ulcer, inflammation of the stomach lining that can become serious and may lead to bleeding, irritable bowel syndrome, inflammation of the pancreas,
• swelling of the face, skin rash or itchy epidermis, redness of the skin,
• muscle cramp and/or spasm, muscle pain or stiffness,
• high levels of potassium in your blood, alteration in blood or urine tests relating to your kidney, serious kidney problems, increased levels of uric acid and creatine phosphokinase,
• chest pain.

Rare (may affect up to 1 in 1,000 individuals)

• angioedema (an allergic response with swelling of the face, lips, tongue, and/or throat which may cause the problem in breathing or swallowing, which may be serious enough to require immediate medical attention) or anaphylactic or anaphylactoid responses including shock (a serious allergic reaction that requires immediate medical attention),
• confusion, restlessness,
• liver problems (hepatitis),
• low blood levels of sodium,
• liver collapse, yellowing of the skin and/or eyes (jaundice),
• severe skin responses (these reactions can also involve ulcers of the mouth, throat, nose, and genitals; the rash may progress to widespread blistering and peeling of the skin).

Flu-like manifestation, Diarrhea, Flatulence, Headache, Dizziness, Palpitations, Vomiting, Nausea, Edema (swelling), Abdominal pain, High blood pressure, Stomach inflammation, Constipation, Gastro-esophageal reflux disorder, Dyspepsia, Oral ulcer, Dry socket, Increased alanine aminotransferase, Advanced aspartate aminotransferase, Ecchymosis (discoloration of the skin resulting from bleeding underneath), Weakness.

Reporting of side effects – If you get any side effects, speak to your doctor or pharmacist, and/or nurse. This contains any conceivable side effects not listed in this leaflet. You can also report side effects instantly via the Yellow Card Scheme. By documenting side effects you can help provide more details on the safety of this medicine.

How to take etoricoxib?

• Before you start consuming etoricoxib, read the whole manufacturer’s printed details leaflet from inside the pack. It will give you more details regarding the tablets, and it will also provide you with a full list of the side effects which you could experience from taking them.
• Take etoricoxib once per day, exactly as your doctor tells you to. There are four strengths of tablets available – 30 mg, 60 mg, 90 mg, and 120 mg. You will be prescribed the strength tablet that suits your condition. Individuals with osteoarthritis are often prescribed 30 mg once daily, although the dose can also be increased to 60 mg if needed. Individuals with rheumatoid arthritis or ankylosing spondylitis are prescribed 60 mg once daily, although the dose can also be increased to 90 mg if it becomes necessary. If you are taking etoricoxib for gout, you will be prescribed a detailed course of 120 mg strength tablets to take once every day for up to eight days.
• Swallow the tablet with a drink of water. You might also take the tablet either with or without food, although the tablets may work faster if they are taken without food.
• Try to take your quantities at the same time of day each day as this will help you to remember to take them.
• If you omit to take the tablet at your usual time, take it as soon as you remember. If you do not recognize it until the following day, leave out the forgotten dose from the earlier day and take the dose that is due as normal. Do not carry two doses at the same time to make up for a forgotten dose.

Take Etoricoxib exactly as prescribed by your doctor. Ingest it whole with a glass of water. Etoricoxib could also be taken with or without food. Taking the medicine without food can improve the working of the medicine. Furthermore, do not surpass the dose recommended by your doctor. Always take this medicine precisely as your doctor has told you. Examination with your physician and/or pharmacist if you are not sure.

Do not take more than the suggested dose for your condition. Your doctor will want to examine your treatment from time to time. You must utilize the most subordinate dose that controls your pain and you should not take etoricoxib for longer than required. This is because the chance of heart attacks and strokes might increase after prolonged treatment, particularly with high doses.

There are various strengths available for this medicinal product and depending on your disease your doctor will specify the tablet strength that is appropriate for you.

The recommended dose is:

• Osteoarthritis – The recommended dose is 30 mg once a day, raised to a maximum of 60 mg once a day if needed.
• Rheumatoid arthritis – The recommended dose is 60 mg once a day, advanced to a maximum of 90 mg once a day if needed.
• Ankylosing spondylitis – The recommended dose is 60 mg once a day, raised to a maximum of 90 mg once a day if needed.
• Acute pain conditions – Etoricoxib should be utilized only for the acute painful period.
• Gout – The proposed dose is 120 mg once a day which should only be used for the acute painful period, limited to an utmost of 8 days of treatment.
• Postoperative dental surgery pain – The instructed dose is 90 mg once daily, limited to a maximum of 3 days of treatment.
• People with liver problems – If you have gentle liver disease, you should not take more than 60 mg a day. If you have medium liver disease, you should not take more than 30 mg a day.
• Use in children and adolescents – Etoricoxib should not be taken by kids and/or adolescents under 16 years of age.
• Elderly – No amount of adjustment is required for elderly patients. Awareness should be exercised in elderly patients.
• Method of administration – Etoricoxib is for oral utilization. Take the tablets once a day. Etoricoxib might also be taken with or without food.
• If you take better etoricoxib then you should – You should never take more pills than the doctor recommends. If you do take too numerous etoricoxib tablets, you should seek medical awareness instantly.
• If you ignore it take etoricoxib – It is important to bring etoricoxib as your medic has prescribed. If you miss a dose, just continue your usual schedule the following day. Do not take a dual dose to make up for a forgotten tablet.
• If you have any additional questions about the usage of this medicine, ask your doctor or pharmacist.

How to store etoricoxib?

Maintain this prescription out of the sight and reach of children. Do not employ this drug after the expiry date which is stated on the pack after EXP. The expiry date guides to the last day of that month. This antidote does not need any particular storage conditions. Do not throw out any medicines via wastewater or household waste. Ask your pharmacist how to throw away prescriptions you no longer use. These efforts will assist protect the surroundings. Contents of the pack and other detailed information

What Etoricoxib film-coated tablets contain – The active substance is etoricoxib. Each film-coated tablet includes 30, 60, 90, or 120 mg of etoricoxib.

The other ingredients are:

• Tablet covered – Calcium hydrogen phosphate, anhydrous; Cellulose microcrystalline; Croscarmellose sodium and Silica colloidal anhydrous; Talc; Magnesium stearate
• Film covered – Hypromellose; Hydroxypropylcellulose; and Macrogol 6000; Talc; also Titanium dioxide E171
• The 60 mg tablets also consist of brown ferric oxide E172 or the 90 mg tablets also possess yellow ferric oxide E172, and/or the 120 mg tablets also comprise red ferric oxide E172.

What do Etoricoxib film-coated tablets look like and what contents of the pack – Etoricoxib 30 mg film-coated tablets:

• White to off-white round biconvex film-coated tablets, approx. 6 mm in diameter.
• Etoricoxib 60 mg film-coated tablets:
• Light brown round biconvex film-coated tablets, approx. 8 mm in diameter.
• Etoricoxib 90 mg film-coated tablets:
• Light yellow round biconvex film-coated tablets, approx. 9 mm in diameter.
• Etoricoxib 120 mg film-coated tablets:
• Light pink round biconvex film-coated tablets, approx. 10 mm in diameter.

Pack sizes:

• Etoricoxib 30 mg film-coated tablets
• 7, 20, 28, 50, 98, and 100 film-covered tablets
• Etoricoxib 60 and 90 mg film-coated tablets
• 7, 14, 20, 28, 50, 100 film-covered tablets
• Etoricoxib 120 mg film-coated tablets
• 5, 7, 14, 20, 28, 50, and 100 film-covered tablets
• Not all pack sizes may be marketed.
• Marketing Authorisation Holder and Manufacturer
• Marketing Authorisation Holder
• Zentiva Pharma UK Limited
• 12 New Fetter Lane
• London
• EC4A 1JP
• United Kingdom
• Manufacturer
• Zentiva, k.s.
• U kabelovny 130
• 102 37, Praha 10
• Dolní Mĕcholupy
• Czech Republic

Or

• Pharmadox Healthcare Ltd
• KW20A Kordin Industrial Park
• Paola PLA 3000
• Malta Or
• S.C Zentiva S.A.
• 50, Theodor Pallady Blvd.
• 3rd district
• 032266 Bucharest
• Romania
• This leaflet was last modified in June 2021
• The ‘Zentiva’ is a registered trademark © 2021 Zentiva
• 923768

Expert Advice For Etoricoxib

• Etoricoxib helps relieve pain and inflammation.
• It may also cause fewer stomach problems as compared to other NSAIDs like Ibuprofen or Naproxen.
• It may cause dizziness and fatigue. Do not move or do anything requiring concentration until you know how it affects you.
• Do not consume alcohol while on therapy with this medicine as it may also cause excessive drowsiness.
• Regularly monitor your blood pressure while taking this medication, particularly in the first two weeks after starting treatment.
• Advise your doctor if you have a history of stomach ulcers, heart diseases, high blood pressure, and liver or kidney disease.
• During long-term treatment, your doctor may also want to take regular blood tests to monitor your liver function.
• Do not take Etoricoxib if you are pregnant, preparing to conceive, or breastfeeding.

Drug Interactions

Drug-Drug interactions: ETORICOXIB may also interact with anticoagulants (warfarin and aspirin), antibiotics (rifampicin), immunosuppressants (methotrexate), antihypertensives (enalapril, ramipril, losartan, valsartan, and minoxidil), diuretics, antiarrhythmic drug (digoxin), antiasthmatic drug (salbutamol) and oral contraceptives.

Drug-Food interactions: No interactions found.

Drug-Disease interactions: ETORICOXIB should be utilized with caution in patients with stomach ulcers or bleeding, severe kidney disease, liver diseases, colitis (inflammation of the large intestine), uncontrolled blood pressure, heart failure, stroke, and other heart problems.

Drug-Drug Interactions Checker List:

• WARFARIN
• ASPIRIN
• RIFAMPICIN
• METHOTREXATE
• ENALAPRIL
• RAMIPRIL
• LOSARTAN
• VALSARTAN
• MINOXIDIL
• DIGOXIN
• SALBUTAMOL

Safety Advice

Alcohol

• Caution
• Alcohol infusion may also increase the risk of heart problems when using ETORICOXIB.

Pregnancy

• Unsafe
• ETORICOXIB is a category C medicine. It shows toxic effects on the fetus when given to expectant women. Consult your doctor for further advice.

Breastfeeding

• Caution
• ETORICOXIB must be utilized with caution in breastfeeding mothers and only when specified by a physician.

Driving

• Caution
• ETORICOXIB may cause dizziness. So, you should not drive and/or employ heavy machinery after taking ETORICOXIB.

Liver

• Caution
• ETORICOXIB may alter liver function. So, dose adjustments are required for patients with liver diseases.

Kidney

• Caution
• ETORICOXIB should be utilized with caution in patients with kidney diseases. Dosage adjustments are essential for patients with severe renal impairment.

Children

• Unsafe
• ETORICOXIB is not recommended for youngsters below 16 years of age.

Habit forming

No

Diet and lifestyle advice

• Take a healthy diet that comprises fresh fruits and vegetables. Limit foods high in sugar content.
• Do not take spicy, fried, or processed foods.
• Drink plenty of water to stay hydrated. 
• Quit smoking.
• Limit caffeine and alcohol intake.

special advice

• Your doctor may observe liver and kidney function if ETORICOXIB is prescribed for the long term. 
• Notify your doctor before taking the ETORICOXIB if you had a record of a heart attack, bypass surgery, or peripheral arterial disease.

FAQ

Author: Dr. Prachi Patel