Artorix
Generic Name
Etoricoxib
Manufacturer
Aristopharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| artorix 120 mg tablet | ৳ 14.00 | ৳ 140.00 |
Description
Overview of the medicine
Artorix 120 mg Tablet contains Etoricoxib, a selective COX-2 inhibitor, which is a non-steroidal anti-inflammatory drug (NSAID). It is primarily used to relieve pain and inflammation associated with conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis. It works by blocking the COX-2 enzyme, reducing the production of prostaglandins that cause pain and inflammation.
Uses & Indications
Dosage
Adults
Acute Gouty Arthritis: 120 mg once daily. Maximum 8 days. Post-dental surgery pain: 90 mg or 120 mg once daily, for a maximum of 3-5 days. For other indications, lower strengths (e.g., 60 mg or 90 mg) are usually prescribed. Always follow doctor's advice.
Elderly
No dosage adjustment is generally required for elderly patients, but caution is advised due to potential age-related decrease in renal function and increased risk of cardiovascular events. Monitor closely.
Renal_impairment
Mild to moderate renal impairment (creatinine clearance 30-60 mL/min): No dose adjustment required. Severe renal impairment (creatinine clearance <30 mL/min): Not recommended for use as clinical experience is limited.
How to Take
Take orally, with or without food. For acute pain, taking it without food may lead to a faster onset of action. Swallow the tablet whole with a glass of water.
Mechanism of Action
Etoricoxib is a potent, orally active, selective cyclooxygenase-2 (COX-2) inhibitor. Cyclooxygenase is responsible for the synthesis of prostaglandins, which are key mediators of pain, inflammation, and fever. By selectively inhibiting the COX-2 enzyme, etoricoxib reduces the production of these prostaglandins, thus providing analgesic, anti-inflammatory, and antipyretic effects while minimizing gastrointestinal side effects associated with non-selective NSAIDs.
Pharmacokinetics
Onset
Analgesic effect typically observed within 24 minutes for acute pain conditions.
Excretion
Excreted primarily through the urine (approximately 70%) and feces (approximately 20%) as metabolites.
Half life
The elimination half-life is approximately 22 hours, allowing for once-daily dosing.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations (Tmax) achieved in approximately 1 hour. Oral bioavailability is about 100%.
Metabolism
Extensively metabolized in the liver, primarily via cytochrome P450 (CYP) enzymes, particularly CYP3A4, to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any components of the tablet
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Severe hepatic dysfunction or severe renal impairment (creatinine clearance <30 mL/min)
- Pregnancy and lactation
- Children and adolescents under 16 years of age
Drug Interactions
Aspirin
Concomitant administration with low-dose aspirin increases the risk of gastrointestinal adverse events. Etoricoxib does not substitute for aspirin in cardiovascular prophylaxis.
Lithium
May increase plasma lithium levels, leading to toxicity. Monitor lithium levels.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Methotrexate
May increase plasma methotrexate concentrations, enhancing its toxicity. Caution advised.
Oral contraceptives
May increase plasma concentrations of ethinyl estradiol, potentially increasing the risk of adverse events associated with oral contraceptives.
Warfarin and other oral anticoagulants
May increase the anticoagulant effect of warfarin, leading to an increased risk of bleeding. Close monitoring of INR is recommended.
ACE inhibitors and Angiotensin Receptor Blockers (ARBs)
May reduce the antihypertensive effect of these drugs and increase the risk of renal impairment, especially in dehydrated or elderly patients.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptoms may include gastrointestinal disturbances (e.g., nausea, vomiting, abdominal pain), and drowsiness. Management should be supportive and symptomatic. There is no specific antidote. Gastric lavage and activated charcoal may be considered if ingestion is recent.
Pregnancy & Lactation
Etoricoxib is contraindicated during pregnancy, particularly in the third trimester due to the risk of premature closure of the fetal ductus arteriosus and potential renal dysfunction. It is also contraindicated during lactation as it is excreted in human milk and could harm the nursing infant. Women who are pregnant, planning to become pregnant, or breastfeeding should not use this medicine.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any components of the tablet
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Severe hepatic dysfunction or severe renal impairment (creatinine clearance <30 mL/min)
- Pregnancy and lactation
- Children and adolescents under 16 years of age
Drug Interactions
Aspirin
Concomitant administration with low-dose aspirin increases the risk of gastrointestinal adverse events. Etoricoxib does not substitute for aspirin in cardiovascular prophylaxis.
Lithium
May increase plasma lithium levels, leading to toxicity. Monitor lithium levels.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Methotrexate
May increase plasma methotrexate concentrations, enhancing its toxicity. Caution advised.
Oral contraceptives
May increase plasma concentrations of ethinyl estradiol, potentially increasing the risk of adverse events associated with oral contraceptives.
Warfarin and other oral anticoagulants
May increase the anticoagulant effect of warfarin, leading to an increased risk of bleeding. Close monitoring of INR is recommended.
ACE inhibitors and Angiotensin Receptor Blockers (ARBs)
May reduce the antihypertensive effect of these drugs and increase the risk of renal impairment, especially in dehydrated or elderly patients.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptoms may include gastrointestinal disturbances (e.g., nausea, vomiting, abdominal pain), and drowsiness. Management should be supportive and symptomatic. There is no specific antidote. Gastric lavage and activated charcoal may be considered if ingestion is recent.
Pregnancy & Lactation
Etoricoxib is contraindicated during pregnancy, particularly in the third trimester due to the risk of premature closure of the fetal ductus arteriosus and potential renal dysfunction. It is also contraindicated during lactation as it is excreted in human milk and could harm the nursing infant. Women who are pregnant, planning to become pregnant, or breastfeeding should not use this medicine.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Patent expired (for generic Etoricoxib)
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy in various inflammatory and painful conditions, particularly for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis. Studies have also compared its gastrointestinal safety profile with non-selective NSAIDs.
Lab Monitoring
- Regular monitoring of blood pressure, especially in patients with pre-existing hypertension.
- Periodic assessment of liver function tests (LFTs) and renal function tests (RFTs) for long-term therapy.
- Monitoring for signs of gastrointestinal bleeding.
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Consider patient's cardiovascular and gastrointestinal risk factors before prescribing, and monitor during treatment.
- Etoricoxib is not recommended for patients with significant cardiovascular disease or risk factors.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor. Do not exceed the recommended dose or duration.
- Inform your doctor if you have a history of heart disease, high blood pressure, stomach ulcers, kidney or liver problems, or asthma.
- Report any unusual bleeding, persistent stomach pain, black stools, or severe skin reactions immediately to your doctor.
- Do not take this medicine if you are pregnant or breastfeeding.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness, vertigo, or drowsiness in some individuals. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid excessive alcohol consumption while taking this medicine, as it may increase the risk of stomach problems.
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, which can help manage underlying conditions like osteoarthritis.
- Stop smoking to reduce cardiovascular risks.
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