Coxsafe
Generic Name
Etoricoxib
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| coxsafe 120 mg tablet | ৳ 14.00 | ৳ 140.00 |
Description
Overview of the medicine
Coxsafe 120 mg Tablet contains Etoricoxib, a selective COX-2 inhibitor, used for the relief of pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gouty arthritis, and for acute pain management.
Uses & Indications
Dosage
Adults
Acute gouty arthritis: 120 mg once daily. Max duration 8 days. Acute pain (e.g., dental surgery): 120 mg once daily. Max duration 8 days. Other indications (OA, RA, AS): Dose generally 60 mg or 90 mg once daily, not 120 mg for long term use.
Elderly
No specific dose adjustment is generally necessary based on age, but caution is advised due to potential age-related decrease in renal function.
Renal_impairment
Mild to moderate (creatinine clearance 30-80 mL/min): No adjustment needed. Severe (creatinine clearance <30 mL/min): Not recommended.
Hepatic_impairment
Mild (Child-Pugh score 5-6): Max 60 mg once daily. Moderate (Child-Pugh score 7-9): Max 60 mg every other day or 30 mg once daily. Severe (Child-Pugh score >9): Not recommended.
How to Take
Take orally, with or without food. For acute pain conditions, Etoricoxib should be used for the shortest possible duration.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins, mediators of pain, inflammation, and fever. By inhibiting COX-2, it reduces prostaglandin production, leading to anti-inflammatory, analgesic, and antipyretic effects.
Pharmacokinetics
Onset
Within 24 minutes for acute pain, generally 1 hour.
Excretion
Excreted predominantly by the kidneys (approximately 70% as metabolites) and via feces (approximately 20% as metabolites).
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract; peak plasma concentration (Tmax) is reached in approximately 1 hour. Absolute bioavailability is about 100%.
Metabolism
Extensively metabolized in the liver, primarily by CYP3A4, to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Patients with severe hepatic dysfunction (Child-Pugh score >9)
- Patients with estimated creatinine clearance <30 mL/min
- Patients with congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
Drug Interactions
Lithium
Etoricoxib may increase plasma lithium levels, leading to toxicity.
Warfarin
Increased prothrombin time (INR); monitor INR carefully.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Methotrexate
Etoricoxib may increase methotrexate plasma concentrations, enhancing toxicity.
Oral contraceptives
May increase plasma concentrations of ethinyl estradiol, increasing the risk of adverse events associated with oral contraceptives.
ACE inhibitors/Angiotensin II receptor antagonists (ARBs)
May reduce the antihypertensive effect; concomitant use should be cautious.
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, supportive and symptomatic treatment should be initiated. There is no specific antidote. Due to extensive protein binding, hemodialysis is unlikely to be effective. Closely monitor for gastrointestinal, renal, and cardiovascular effects.
Pregnancy & Lactation
Pregnancy: Not recommended during pregnancy, especially during the third trimester, due to potential premature closure of the fetal ductus arteriosus and effects on labor. Lactation: It is not known whether Etoricoxib is excreted in human milk. A decision must be made whether to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.
Side Effects
Contraindications
- Hypersensitivity to Etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Patients with severe hepatic dysfunction (Child-Pugh score >9)
- Patients with estimated creatinine clearance <30 mL/min
- Patients with congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
Drug Interactions
Lithium
Etoricoxib may increase plasma lithium levels, leading to toxicity.
Warfarin
Increased prothrombin time (INR); monitor INR carefully.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Methotrexate
Etoricoxib may increase methotrexate plasma concentrations, enhancing toxicity.
Oral contraceptives
May increase plasma concentrations of ethinyl estradiol, increasing the risk of adverse events associated with oral contraceptives.
ACE inhibitors/Angiotensin II receptor antagonists (ARBs)
May reduce the antihypertensive effect; concomitant use should be cautious.
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, supportive and symptomatic treatment should be initiated. There is no specific antidote. Due to extensive protein binding, hemodialysis is unlikely to be effective. Closely monitor for gastrointestinal, renal, and cardiovascular effects.
Pregnancy & Lactation
Pregnancy: Not recommended during pregnancy, especially during the third trimester, due to potential premature closure of the fetal ductus arteriosus and effects on labor. Lactation: It is not known whether Etoricoxib is excreted in human milk. A decision must be made whether to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
Approved by national regulatory bodies (e.g., DGDA)
Patent Status
Patent expired, generic versions available
Clinical Trials
Extensive clinical trials have demonstrated Etoricoxib's efficacy and safety for its approved indications. Post-marketing surveillance continues to monitor long-term safety, particularly cardiovascular risks.
Lab Monitoring
- Regular monitoring of blood pressure, especially during initial treatment and periodically thereafter.
- Liver function tests (ALT, AST) periodically, especially with long-term use.
- Renal function tests (serum creatinine, BUN) periodically.
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Assess cardiovascular risk factors before and during treatment.
- Monitor for signs of GI bleeding, especially in patients with a history of GI events.
- Consider alternative therapies in patients with significant cardiovascular or renal impairment.
Patient Guidelines
- Take exactly as prescribed by your doctor. Do not exceed the recommended dose.
- Report any unusual symptoms or side effects, especially signs of stomach bleeding or heart problems.
- Inform your doctor if you have a history of heart disease, high blood pressure, or kidney/liver problems.
- Do not use for more than 8 days for acute pain conditions unless directed by a 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 resume your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Etoricoxib may cause dizziness or drowsiness in some patients. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Limit alcohol intake 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 causing pain.
- Monitor your blood pressure regularly if you have hypertension.
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