Coxitor
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| coxitor 120 mg tablet | ৳ 14.00 | ৳ 140.00 |
Description
Overview of the medicine
Coxitor 120 mg tablet contains Etoricoxib, a selective cyclooxygenase-2 (COX-2) inhibitor. It is used for the relief of pain and inflammation in various conditions.
Uses & Indications
Dosage
Adults
For acute pain conditions (e.g., acute gout, post-operative dental pain): 120 mg once daily. Max 8 days of treatment. For chronic low back pain, ankylosing spondylitis, rheumatoid arthritis: 90 mg once daily. For osteoarthritis: 30 mg or 60 mg once daily. Do not exceed 120 mg/day.
Elderly
No dosage adjustment is generally required, but caution is advised due to potential age-related decrease in renal or hepatic function.
Renal_impairment
For moderate renal impairment (creatinine clearance 30-80 mL/min), no dosage adjustment is required. For severe renal impairment (creatinine clearance <30 mL/min), use is not recommended.
How to Take
Take orally, with or without food. For acute conditions, Etoricoxib 120 mg should be used for the shortest possible duration.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2), an enzyme responsible for the synthesis of prostaglandins, which are mediators of pain and inflammation. By inhibiting COX-2, it reduces prostaglandin levels, thereby alleviating pain and inflammation.
Pharmacokinetics
Onset
Within 24 minutes for some acute pain conditions.
Excretion
Excreted primarily via the kidneys (70%) and in feces (20%), mainly as metabolites.
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring after approximately 1 hour. Oral bioavailability is about 100%.
Metabolism
Extensively metabolized, primarily via cytochrome P450 (CYP) enzymes, particularly CYP3A4, to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Patients who have experienced asthma, acute rhinitis, nasal polyps, angioneurotic oedema, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Severe hepatic dysfunction
- Severe renal impairment (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
Drug Interactions
Aspirin
Co-administration with aspirin for cardiovascular prophylaxis increases the risk of GI adverse events.
Lithium
May increase lithium plasma concentrations.
Warfarin
Increased prothrombin time (INR) due to altered anticoagulant effect. Monitor INR carefully.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Rifampicin
May decrease Etoricoxib plasma concentrations.
Methotrexate
May increase methotrexate plasma concentrations and toxicity.
ACE Inhibitors / Angiotensin Receptor Blockers (ARBs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
Oral Contraceptives / Hormone Replacement Therapy (HRT)
May increase plasma concentrations of estrogen and progestin.
Storage
Store below 30°C in a dry place, away from direct 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 in the third trimester due to potential adverse effects on the fetus (e.g., premature closure of ductus arteriosus). Avoid during lactation as Etoricoxib is excreted in the milk of lactating rats, and it is unknown whether it is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to Etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Patients who have experienced asthma, acute rhinitis, nasal polyps, angioneurotic oedema, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Severe hepatic dysfunction
- Severe renal impairment (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
Drug Interactions
Aspirin
Co-administration with aspirin for cardiovascular prophylaxis increases the risk of GI adverse events.
Lithium
May increase lithium plasma concentrations.
Warfarin
Increased prothrombin time (INR) due to altered anticoagulant effect. Monitor INR carefully.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Rifampicin
May decrease Etoricoxib plasma concentrations.
Methotrexate
May increase methotrexate plasma concentrations and toxicity.
ACE Inhibitors / Angiotensin Receptor Blockers (ARBs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
Oral Contraceptives / Hormone Replacement Therapy (HRT)
May increase plasma concentrations of estrogen and progestin.
Storage
Store below 30°C in a dry place, away from direct 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 in the third trimester due to potential adverse effects on the fetus (e.g., premature closure of ductus arteriosus). Avoid during lactation as Etoricoxib is excreted in the milk of lactating rats, and it is unknown whether it is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months (varies by manufacturer, check packaging)
Availability
Available in pharmacies and hospitals
Approval Status
Approved (e.g., DGDA, EMA)
Patent Status
Off-patent (for generic formulations)
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy and safety in various pain and inflammatory conditions, including osteoarthritis, rheumatoid arthritis, and acute pain.
Lab Monitoring
- Regular monitoring of blood pressure, especially at the start of treatment and periodically thereafter.
- Liver function tests (LFTs) should be monitored periodically.
- Renal function should be monitored in patients with pre-existing renal impairment.
Doctor Notes
- Assess cardiovascular risk factors and GI history before prescribing Etoricoxib.
- Use 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.
- Consider alternative therapies for patients with high cardiovascular or GI risk.
Patient Guidelines
- Take Coxitor 120 mg exactly as prescribed by your doctor and do not exceed the recommended dose.
- 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, sudden weakness, GI bleeding (black stools, vomiting blood) immediately.
- Do not take with other NSAIDs (e.g., ibuprofen, naproxen) without consulting your doctor.
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 continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Etoricoxib may cause dizziness or somnolence. Patients should be aware of how they react to the medication before driving or operating machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, which can help manage pain and inflammation.
- Limit alcohol consumption, especially if you have a history of gastrointestinal issues, as it can increase the risk of GI side effects with Etoricoxib.
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