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 60 mg tablet | ৳ 7.05 | ৳ 70.50 |
Description
Overview of the medicine
Coxia 60 mg tablet contains Etoricoxib, a selective COX-2 inhibitor, used to relieve pain and inflammation associated with various musculoskeletal and joint conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30 mg or 60 mg once daily. Rheumatoid Arthritis & Ankylosing Spondylitis: 60 mg or 90 mg once daily. Acute Gouty Arthritis: 120 mg once daily for a maximum of 8 days. Acute Pain: 60 mg or 120 mg once daily (short-term use).
Elderly
No specific dosage adjustment is generally required, but caution is advised. Initiate at the lowest effective dose.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). Use with caution in moderate renal impairment.
How to Take
Coxia tablets can be taken orally, with or without food. Taking with food may delay absorption slightly but does not significantly affect overall bioavailability.
Mechanism of Action
Etoricoxib selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins, mediators of pain and inflammation. By inhibiting COX-2, it reduces prostaglandin production, leading to anti-inflammatory, analgesic, and antipyretic effects.
Pharmacokinetics
Onset
Analgesic effect typically within 24 minutes for acute pain. Anti-inflammatory effects for chronic conditions may take longer.
Excretion
Approximately 70% of the dose is excreted in the urine and 30% in feces, primarily as metabolites.
Half life
Mean elimination half-life is approximately 22 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations (Tmax) achieved in approximately 1 hour. Oral bioavailability is about 100%.
Metabolism
Extensively metabolized by cytochrome P450 enzymes (primarily CYP3A4) to inactive metabolites. Less than 1% is recovered in urine as the parent drug.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any other component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension (blood pressure consistently >140/90 mmHg)
Drug Interactions
Lithium
Etoricoxib may increase plasma lithium levels, leading to lithium toxicity.
Warfarin
Increased prothrombin time/INR, increasing bleeding risk.
Diuretics
May reduce the natriuretic and antihypertensive effects of loop and thiazide diuretics.
Methotrexate
Increased plasma methotrexate concentrations, potentially increasing toxicity.
ACE inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment, especially in elderly or dehydrated patients.
Oral Contraceptives
May increase plasma concentrations of estrogen and progestin, requiring consideration for contraceptive dosage.
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 measures should be taken. There is no specific antidote. Dialysis is unlikely to remove etoricoxib significantly due to high protein binding.
Pregnancy & Lactation
Pregnancy: Avoid during the third trimester due to potential adverse effects on the fetal cardiovascular system (premature closure of the ductus arteriosus). Use during the first and second trimesters only if the potential benefit outweighs the risk. Lactation: Not recommended during breastfeeding 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 other component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension (blood pressure consistently >140/90 mmHg)
Drug Interactions
Lithium
Etoricoxib may increase plasma lithium levels, leading to lithium toxicity.
Warfarin
Increased prothrombin time/INR, increasing bleeding risk.
Diuretics
May reduce the natriuretic and antihypertensive effects of loop and thiazide diuretics.
Methotrexate
Increased plasma methotrexate concentrations, potentially increasing toxicity.
ACE inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment, especially in elderly or dehydrated patients.
Oral Contraceptives
May increase plasma concentrations of estrogen and progestin, requiring consideration for contraceptive dosage.
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 measures should be taken. There is no specific antidote. Dialysis is unlikely to remove etoricoxib significantly due to high protein binding.
Pregnancy & Lactation
Pregnancy: Avoid during the third trimester due to potential adverse effects on the fetal cardiovascular system (premature closure of the ductus arteriosus). Use during the first and second trimesters only if the potential benefit outweighs the risk. Lactation: Not recommended during breastfeeding 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
Typically 24-36 months from the manufacturing date. Check the expiry date on the packaging.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by DGDA
Patent Status
Off-patent (Generic available)
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy and safety in various pain and inflammatory conditions. Post-marketing surveillance continues to monitor its long-term effects.
Lab Monitoring
- Blood pressure monitoring (especially in hypertensive patients)
- Liver function tests (LFTs) periodically, especially with long-term use
- Renal function tests (RFTs) periodically, especially in patients with pre-existing renal impairment or those at risk
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Monitor blood pressure regularly, especially in patients with pre-existing hypertension or those at risk.
- Exercise caution in patients with a history of gastrointestinal ulceration or bleeding.
- Assess cardiovascular risk factors before prescribing and periodically during treatment.
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 all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Report any unusual symptoms, especially gastrointestinal bleeding or cardiovascular issues, to your doctor immediately.
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 resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Etoricoxib may cause dizziness or somnolence in some patients. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, as advised by your healthcare provider.
- Avoid smoking and excessive alcohol consumption, as these can increase the risk of gastrointestinal side effects.
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