amicoxib
Generic Name
Etoricoxib 120 mg tablet
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| amicoxib 120 mg tablet | ৳ 14.00 | ৳ 140.00 |
Description
Overview of the medicine
Amicoxib 120 mg tablet contains Etoricoxib, a selective cyclooxygenase-2 (COX-2) inhibitor. It is used to relieve pain, swelling, and inflammation in various conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis.
Uses & Indications
Dosage
Adults
For acute gouty arthritis: 120 mg once daily. For acute pain/primary dysmenorrhea: 120 mg once daily for a maximum of 8 days. For osteoarthritis: 30 mg or 60 mg once daily. For rheumatoid arthritis/ankylosing spondylitis: 60 mg or 90 mg once daily. Doses should be taken for the shortest duration necessary and at the lowest effective dose.
Elderly
No specific dose adjustment required, but caution is advised due to potential age-related decrease in renal function and increased risk of cardiovascular and gastrointestinal events.
Renal_impairment
Mild renal impairment (creatinine clearance 30-80 mL/min): No dose adjustment. Moderate renal impairment (creatinine clearance <30 mL/min): Not recommended. For patients on dialysis, use with caution and under medical supervision.
How to Take
Take orally, with or without food. Swallow the tablet whole with a glass of water. Do not crush or chew.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2), an enzyme responsible for the synthesis of prostaglandins, which are mediators of pain, inflammation, and fever. By inhibiting COX-2, it reduces prostaglandin production, thereby alleviating symptoms.
Pharmacokinetics
Onset
Analgesic effect usually starts within 24 minutes to 1 hour.
Excretion
Excreted predominantly in urine (70%) and feces (20%) as metabolites.
Half life
Approximately 20-26 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract, reaching peak plasma concentrations in approximately 1 hour.
Metabolism
Extensively metabolized in the liver, primarily via cytochrome P450 (CYP) enzymes (mainly CYP3A4), forming inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal impairment (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA Class II-IV)
- Ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Late stages of pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels and potential toxicity.
Warfarin
Increased prothrombin time and bleeding risk. Monitor INR.
Diuretics
Reduced natriuretic effect and increased risk of renal impairment.
Rifampicin
Decreased plasma concentrations of etoricoxib.
Methotrexate
Increased plasma concentrations of methotrexate, potentially enhancing toxicity.
Oral Contraceptives
Increased plasma concentrations of ethinyl estradiol, potentially increasing contraceptive-related adverse effects.
ACE inhibitors/Angiotensin Receptor Blockers
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote. Dialysis is unlikely to be effective in removing etoricoxib due to high protein binding.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential adverse effects on the fetal cardiovascular system (premature closure of ductus arteriosus). Avoid during lactation as etoricoxib is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal impairment (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA Class II-IV)
- Ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Late stages of pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels and potential toxicity.
Warfarin
Increased prothrombin time and bleeding risk. Monitor INR.
Diuretics
Reduced natriuretic effect and increased risk of renal impairment.
Rifampicin
Decreased plasma concentrations of etoricoxib.
Methotrexate
Increased plasma concentrations of methotrexate, potentially enhancing toxicity.
Oral Contraceptives
Increased plasma concentrations of ethinyl estradiol, potentially increasing contraceptive-related adverse effects.
ACE inhibitors/Angiotensin Receptor Blockers
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote. Dialysis is unlikely to be effective in removing etoricoxib due to high protein binding.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential adverse effects on the fetal cardiovascular system (premature closure of ductus arteriosus). Avoid during lactation as etoricoxib is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
DGDA approved
Patent Status
Patent expired, generics available
Clinical Trials
Numerous clinical trials have been conducted to establish the efficacy and safety of etoricoxib across its approved indications, including studies comparing it to other NSAIDs and placebo. These trials have evaluated its impact on pain reduction, functional improvement, and adverse event profiles.
Lab Monitoring
- Regular monitoring of blood pressure, especially in patients with pre-existing hypertension.
- Periodic assessment of renal function (e.g., serum creatinine, BUN) and liver enzymes (e.g., ALT, AST) for long-term users.
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Monitor patients for signs of cardiovascular and gastrointestinal adverse events, especially in those with pre-existing risk factors.
- Assess renal function periodically in patients on long-term therapy or with risk factors for renal impairment.
Patient Guidelines
- Take exactly as prescribed by your doctor. Do not exceed the recommended dose or duration of treatment.
- Report any unusual symptoms, especially severe stomach pain, black stools, or signs of heart problems (chest pain, shortness of breath) to your doctor immediately.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs, supplements, and herbal remedies.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Etoricoxib may cause dizziness, vertigo, or drowsiness in some patients. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Limit alcohol intake, as it may increase the risk of stomach problems.
- Maintain a healthy diet and engage in regular physical activity as advised by your doctor.
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