Coxia
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| coxia 120 mg tablet | ৳ 14.09 | ৳ 56.36 |
Description
Overview of the medicine
Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) of the coxib class, which is a selective cyclooxygenase-2 (COX-2) inhibitor. It is used for the symptomatic relief of various inflammatory and painful conditions.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30-60 mg once daily. Rheumatoid Arthritis, Ankylosing Spondylitis: 60-90 mg once daily. Acute Gout: 120 mg once daily for a maximum of 8 days. Acute Pain: 60 mg once daily (max 120 mg once daily for dental surgery for up to 3 days).
Elderly
No dose adjustment is generally required, but caution is advised in elderly patients, especially those with renal or hepatic impairment.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). Dose reduction may be considered for moderate impairment.
How to Take
Take orally, with or without food. Can be taken once daily. Swallow the tablet whole with a glass of water.
Mechanism of Action
Etoricoxib selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins involved in pain, inflammation, and fever. By inhibiting COX-2, etoricoxib reduces the production of these inflammatory mediators.
Pharmacokinetics
Onset
Analgesic effects typically begin within 30-60 minutes.
Excretion
Approximately 70% of the dose is excreted in the urine (as metabolites) and 20% in the feces (as metabolites).
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed after oral administration; peak plasma concentrations (Cmax) are reached approximately 1 hour post-dose.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 (CYP) enzymes, particularly CYP3A4, to form inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any excipients
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have undergone coronary artery bypass graft surgery or angioplasty)
- Uncontrolled hypertension
- Inflammatory bowel disease
Drug Interactions
Lithium
Increased plasma lithium levels, leading to potential toxicity.
Warfarin
Increased INR (International Normalized Ratio) and bleeding risk; monitor closely.
Methotrexate
Increased methotrexate plasma concentrations and potential toxicity.
Oral contraceptives
Increased exposure to ethinyl estradiol, potentially increasing adverse effects of oral contraceptives.
Acetylsalicylic Acid (low-dose)
May be taken with low-dose aspirin for cardiovascular prophylaxis, but etoricoxib does not substitute for aspirin's anti-platelet effect.
Diuretics, ACE inhibitors, Angiotensin II antagonists
Reduced antihypertensive effect and increased risk of renal impairment, especially in dehydrated or elderly patients.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for etoricoxib.
Pregnancy & Lactation
Not recommended during pregnancy, especially during the third trimester, due to potential risks to the fetus (e.g., premature closure of the ductus arteriosus). Use during lactation is also not recommended, as etoricoxib is excreted in the milk of lactating rats, and it is unknown if it is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any excipients
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have undergone coronary artery bypass graft surgery or angioplasty)
- Uncontrolled hypertension
- Inflammatory bowel disease
Drug Interactions
Lithium
Increased plasma lithium levels, leading to potential toxicity.
Warfarin
Increased INR (International Normalized Ratio) and bleeding risk; monitor closely.
Methotrexate
Increased methotrexate plasma concentrations and potential toxicity.
Oral contraceptives
Increased exposure to ethinyl estradiol, potentially increasing adverse effects of oral contraceptives.
Acetylsalicylic Acid (low-dose)
May be taken with low-dose aspirin for cardiovascular prophylaxis, but etoricoxib does not substitute for aspirin's anti-platelet effect.
Diuretics, ACE inhibitors, Angiotensin II antagonists
Reduced antihypertensive effect and increased risk of renal impairment, especially in dehydrated or elderly patients.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for etoricoxib.
Pregnancy & Lactation
Not recommended during pregnancy, especially during the third trimester, due to potential risks to the fetus (e.g., premature closure of the ductus arteriosus). Use during lactation is also not recommended, as etoricoxib is excreted in the milk of lactating rats, and it is unknown if it is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Pharmacies, Hospitals
Approval Status
Approved in many countries
Patent Status
Generic versions available
Clinical Trials
Etoricoxib has been evaluated in numerous clinical trials demonstrating its efficacy in various painful and inflammatory conditions. Studies have also focused on its cardiovascular safety profile compared to other NSAIDs.
Lab Monitoring
- Blood pressure monitoring (regularly, especially in patients with pre-existing hypertension or cardiovascular risk factors).
- Renal function tests (e.g., serum creatinine, eGFR) periodically, especially in elderly or patients with pre-existing renal impairment.
- Liver function tests (e.g., ALT, AST) if long-term use or symptoms of hepatic dysfunction occur.
- INR for patients on concomitant warfarin therapy.
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Carefully assess the patient's cardiovascular risk factors before initiating and during treatment.
- Avoid use in patients with established ischemic heart disease, peripheral arterial disease, or cerebrovascular disease.
- Monitor blood pressure regularly in all patients, especially those with pre-existing hypertension.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not exceed the recommended dose or duration of treatment.
- Inform your doctor about any pre-existing medical conditions, especially heart disease, high blood pressure, stomach ulcers, or kidney/liver problems.
- Report any unusual symptoms such as chest pain, shortness of breath, severe stomach pain, or black/tarry stools immediately.
- If you are taking low-dose aspirin for heart protection, continue to take it as prescribed by your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness, vertigo, or somnolence. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise.
- Avoid smoking and limit alcohol consumption, as these can increase the risk of gastrointestinal and cardiovascular side effects.
- Regularly monitor your blood pressure if you have hypertension or are at risk.
- Discuss with your doctor any concerns about long-term use, especially if you have cardiovascular risk factors.
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