Coxtop
Generic Name
Etoricoxib
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| coxtop 60 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Coxtop 60 mg tablet contains Etoricoxib, a selective cyclooxygenase-2 (COX-2) inhibitor. It is used to relieve pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gout.
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 and dysmenorrhea: 60 mg or 120 mg once daily. Post-operative dental surgery pain: 90 mg once daily for a maximum of 3 days.
Elderly
No dose adjustment is generally required for elderly patients, but caution is advised due to increased risk of adverse effects.
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
Take orally, with or without food. Taking it with food may help reduce gastrointestinal discomfort.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins involved in pain, inflammation, and fever. By inhibiting COX-2, it reduces these symptoms.
Pharmacokinetics
Onset
Within 1 hour for pain relief.
Excretion
Approximately 70% excreted in urine and 20% in faeces, mostly as metabolites.
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed after oral administration; peak plasma concentrations reached in approximately 1 hour. Bioavailability is about 100%.
Metabolism
Extensively metabolized by cytochrome P450 enzymes (mainly CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Etoricoxib or any 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 II-IV)
- Ischemic heart disease, peripheral arterial disease, cerebrovascular disease
- Uncontrolled hypertension
- Third trimester of pregnancy
Drug Interactions
Lithium
May increase plasma lithium levels, leading to toxicity.
Warfarin
Increased risk of bleeding due to enhanced anticoagulant effect.
Methotrexate
May increase methotrexate plasma concentrations, enhancing toxicity.
Oral contraceptives
May increase plasma concentrations of ethinyl estradiol, potentially increasing adverse effects of oral contraceptives.
Cyclosporine, Tacrolimus
Increased risk of nephrotoxicity.
Diuretics, ACE inhibitors, Angiotensin II receptor antagonists
May reduce the antihypertensive effect and increase the 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 treatment should be initiated. There is no specific antidote for etoricoxib. Dialysis is not expected to significantly remove etoricoxib.
Pregnancy & Lactation
Pregnancy: Contraindicated in the third trimester due to risk of premature closure of the fetal ductus arteriosus. Use should be avoided during the first and second trimesters unless absolutely necessary. Lactation: It is not known whether etoricoxib is excreted in human milk. A decision should be made whether to discontinue nursing or to 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
- Severe hepatic dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Ischemic heart disease, peripheral arterial disease, cerebrovascular disease
- Uncontrolled hypertension
- Third trimester of pregnancy
Drug Interactions
Lithium
May increase plasma lithium levels, leading to toxicity.
Warfarin
Increased risk of bleeding due to enhanced anticoagulant effect.
Methotrexate
May increase methotrexate plasma concentrations, enhancing toxicity.
Oral contraceptives
May increase plasma concentrations of ethinyl estradiol, potentially increasing adverse effects of oral contraceptives.
Cyclosporine, Tacrolimus
Increased risk of nephrotoxicity.
Diuretics, ACE inhibitors, Angiotensin II receptor antagonists
May reduce the antihypertensive effect and increase the 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 treatment should be initiated. There is no specific antidote for etoricoxib. Dialysis is not expected to significantly remove etoricoxib.
Pregnancy & Lactation
Pregnancy: Contraindicated in the third trimester due to risk of premature closure of the fetal ductus arteriosus. Use should be avoided during the first and second trimesters unless absolutely necessary. Lactation: It is not known whether etoricoxib is excreted in human milk. A decision should be made whether to discontinue nursing or to 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
Typically 24 to 36 months from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities (e.g., DGDA)
Patent Status
Off-patent in many regions; generic versions available
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy and safety in various inflammatory and painful conditions, including osteoarthritis, rheumatoid arthritis, and acute gout. Studies have compared its efficacy and gastrointestinal safety profile with other NSAIDs.
Lab Monitoring
- Blood pressure monitoring
- Renal function tests (e.g., serum creatinine, GFR)
- Hepatic function tests (e.g., ALT, AST) particularly during long-term therapy
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration consistent with individual patient treatment goals.
- Monitor blood pressure regularly, especially in patients with pre-existing hypertension.
- Assess cardiovascular risk factors before and during treatment.
- Consider gastroprotective agents in patients at high risk of GI complications.
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, skin reactions, or signs of heart problems, to your doctor immediately.
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.
Driving Precautions
Etoricoxib may cause dizziness or somnolence in some patients. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid alcohol consumption while taking this medicine.
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, to support overall health.
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