e-coxib
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| e coxib 60 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2). It is used to relieve pain and inflammation in conditions like 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: 90 mg once daily. Acute Gouty Arthritis: 120 mg once daily for a maximum of 8 days. Acute Pain (e.g., dental surgery): 60 mg once daily. Maximum recommended dose is 120 mg/day for short-term use.
Elderly
No dosage adjustment is generally required based on age, but caution is advised in elderly patients with comorbidities.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). For moderate renal impairment (creatinine clearance 30-60 mL/min), caution is advised and consider a lower dose.
How to Take
Take orally, with or without food. It can be taken at any time of day, but it's generally advised to take it at the same time each day.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2), which is responsible for the synthesis of prostaglandins involved in pain, inflammation, and fever. By inhibiting COX-2, etoricoxib reduces prostaglandin production, thereby alleviating symptoms.
Pharmacokinetics
Onset
Pain relief within 24 minutes for acute conditions.
Excretion
Primarily renal (70% as metabolites) and fecal (20% as metabolites) excretion. Less than 1% is excreted unchanged in urine.
Half life
Approximately 22 hours.
Absorption
Rapidly and well absorbed after oral administration. Absolute bioavailability is approximately 100%. Peak plasma concentration (Tmax) is reached in about 1 hour.
Metabolism
Extensively metabolized, primarily via cytochrome P450 enzymes (mainly 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 dysfunction (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
Lithium
May increase plasma lithium levels, leading to toxicity. Monitor lithium levels.
Warfarin
May increase international normalized ratio (INR), leading to an increased risk of bleeding. Monitor INR closely.
Methotrexate
May increase plasma methotrexate levels, enhancing its toxicity. Use with caution.
ACE Inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment, especially in dehydrated or elderly patients.
Oral Contraceptives
May increase plasma concentrations of ethinylestradiol, potentially increasing adverse effects of oral contraceptives.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for etoricoxib. Hemodialysis is unlikely to be effective in removing etoricoxib due to high protein binding.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential adverse effects on fetal cardiovascular system (premature closure of ductus arteriosus). Avoid during lactation as it may be excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the formulation
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal dysfunction (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
Lithium
May increase plasma lithium levels, leading to toxicity. Monitor lithium levels.
Warfarin
May increase international normalized ratio (INR), leading to an increased risk of bleeding. Monitor INR closely.
Methotrexate
May increase plasma methotrexate levels, enhancing its toxicity. Use with caution.
ACE Inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment, especially in dehydrated or elderly patients.
Oral Contraceptives
May increase plasma concentrations of ethinylestradiol, potentially increasing adverse effects of oral contraceptives.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for etoricoxib. Hemodialysis is unlikely to be effective in removing etoricoxib due to high protein binding.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential adverse effects on fetal cardiovascular system (premature closure of ductus arteriosus). Avoid during lactation as it may be excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Patent expired in many regions
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. These trials supported its approval for therapeutic use.
Lab Monitoring
- Blood pressure monitoring (especially in patients with pre-existing hypertension)
- Liver function tests (periodically with long-term use)
- Renal function tests (periodically, especially in high-risk patients)
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Carefully assess cardiovascular and gastrointestinal risks before initiating therapy and periodically thereafter.
- Avoid in patients with significant cardiovascular risk factors or established cardiovascular disease where possible. Monitor blood pressure closely.
Patient Guidelines
- Take exactly as prescribed by your doctor. Do not exceed the recommended dose or duration of treatment.
- Report any new or worsening chest pain, shortness of breath, unusual bleeding, or severe stomach pain immediately.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a forgotten one. Continue with your regular dosing schedule.
Driving Precautions
Etoricoxib may cause dizziness or drowsiness in some individuals. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid excessive alcohol consumption while taking this medicine, as it may increase the risk of gastrointestinal side effects.
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, as advised by your doctor.
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