Coxpar
Generic Name
Etoricoxib
Manufacturer
Drug International Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Coxpar contains Etoricoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, used for the symptomatic relief of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and for the treatment of acute pain and primary dysmenorrhoea.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30-60 mg once daily. Rheumatoid arthritis, ankylosing spondylitis: 90 mg once daily. Acute pain, primary dysmenorrhoea: 120 mg once daily for a maximum of 8 days. Acute gouty arthritis: 120 mg once daily for a maximum of 8 days.
Elderly
No dosage adjustment generally required, but caution is advised due to increased risk of side effects.
Renal_impairment
Mild to moderate renal impairment: caution, usually no dose adjustment. Severe renal impairment: not recommended.
How to Take
Oral administration. Can be taken with or without food. For faster onset of action, it may be taken without food.
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, etoricoxib reduces pain and inflammation.
Pharmacokinetics
Onset
Pain relief typically within 24 minutes for acute pain, and longer for chronic inflammatory conditions.
Excretion
Mainly via urine (70%) and feces (20%) as metabolites.
Half life
Approximately 22 hours.
Absorption
Well absorbed orally, with a bioavailability of approximately 100%.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 (CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the formulation
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal impairment (creatinine clearance <30 mL/min)
- Inflammatory bowel disease
- Congestive heart failure (NYHA Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Diuretics
Reduced diuretic and antihypertensive effects, increased risk of renal toxicity.
Methotrexate
Increased plasma methotrexate levels, leading to toxicity.
Oral contraceptives
Increased plasma concentration of ethinyl estradiol, potentially increasing adverse effects of oral contraceptives.
Warfarin and other anticoagulants
Increased risk of bleeding.
ACE inhibitors / Angiotensin II Receptor Blockers (ARBs)
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 overdose, symptomatic and supportive measures should be initiated. There is no specific antidote for etoricoxib. Gastric lavage and activated charcoal may be considered within the first few hours.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation. NSAIDs may cause premature closure of the ductus arteriosus in the fetus in the third trimester and may inhibit labor.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the formulation
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal impairment (creatinine clearance <30 mL/min)
- Inflammatory bowel disease
- Congestive heart failure (NYHA Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Diuretics
Reduced diuretic and antihypertensive effects, increased risk of renal toxicity.
Methotrexate
Increased plasma methotrexate levels, leading to toxicity.
Oral contraceptives
Increased plasma concentration of ethinyl estradiol, potentially increasing adverse effects of oral contraceptives.
Warfarin and other anticoagulants
Increased risk of bleeding.
ACE inhibitors / Angiotensin II Receptor Blockers (ARBs)
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 overdose, symptomatic and supportive measures should be initiated. There is no specific antidote for etoricoxib. Gastric lavage and activated charcoal may be considered within the first few hours.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation. NSAIDs may cause premature closure of the ductus arteriosus in the fetus in the third trimester and may inhibit labor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved by various international regulatory bodies and national drug administrations (e.g., DGDA in Bangladesh).
Patent Status
Generic versions available, original patent expired.
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy and safety in various indications, including studies like the MEDAL (Multinational Etoricoxib and Diclofenac Arthritis Long-term) study for cardiovascular safety.
Lab Monitoring
- Blood pressure monitoring
- Liver function tests (LFTs)
- Renal function tests (e.g., serum creatinine, BUN)
- Complete blood count (CBC) for long-term use
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.
- Use with caution in patients with a history of GI bleeding or peptic ulcer disease.
- Consider alternative therapies for patients with established cardiovascular disease or significant cardiovascular risk factors.
Patient Guidelines
- Take as directed by your doctor.
- Do not exceed the recommended dose.
- Report any unusual symptoms, especially gastrointestinal bleeding or cardiovascular issues.
- Do not use for self-treatment of prolonged pain or fever.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the 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
May cause dizziness or somnolence. Patients should be cautious when driving or operating machinery until they know how etoricoxib affects them.
Lifestyle Advice
- Maintain a healthy diet and regular exercise.
- Avoid smoking and excessive alcohol consumption, as these can increase risks associated with NSAIDs.
- Manage underlying conditions like hypertension or diabetes effectively.
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International brand names for this medicine. Click a brand to search for detailed information.
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