e-coxib
Generic Name
Etoricoxib 90 mg tablet
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| e coxib 90 mg tablet | ৳ 12.00 | ৳ 120.00 |
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 gout.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30-60 mg once daily. Rheumatoid Arthritis, Ankylosing Spondylitis: 60-90 mg once daily. Acute Pain & Dysmenorrhea: 90-120 mg once daily for a maximum of 8 days. Acute Gout: 120 mg once daily for a maximum of 8 days.
Elderly
No dosage adjustment is generally required for elderly patients, but caution is advised due to potential age-related renal impairment. Monitor blood pressure and renal function.
Renal_impairment
Mild renal impairment (creatinine clearance 30-80 mL/min): No dosage adjustment required. Moderate to severe renal impairment (creatinine clearance <30 mL/min): Use with caution and lower dose or avoid. Consult a physician.
How to Take
E-coxib tablet should be taken orally, with or without food. It can be taken once daily. Do not exceed the recommended dose.
Mechanism of Action
Etoricoxib is a potent, orally active, non-acidic, highly selective cyclooxygenase-2 (COX-2) inhibitor. It reduces the synthesis of prostaglandins by inhibiting COX-2, which is involved in inflammatory responses, thus reducing pain and inflammation.
Pharmacokinetics
Onset
Within 24 minutes for acute pain conditions; within a few hours for chronic pain conditions.
Excretion
Mainly excreted via urine (approximately 70%) and feces (approximately 20%) as metabolites.
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations (Cmax) achieved in approximately 1 hour.
Metabolism
Extensively metabolized, primarily by cytochrome P450 enzymes (CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Severe hepatic dysfunction (Child-Pugh score >9)
- 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
- History of asthma, urticaria, or allergic reactions after taking aspirin or other NSAIDs
Drug Interactions
Aspirin
Co-administration with low-dose aspirin for cardiovascular prophylaxis does not significantly increase the anti-thrombotic effect but may increase the risk of GI ulceration or other complications.
Lithium
Increased plasma lithium levels, leading to toxicity.
Warfarin
Increased risk of bleeding.
Diuretics
Reduced diuretic and antihypertensive effect.
Methotrexate
Increased plasma methotrexate levels and potential toxicity.
Oral Contraceptives
Increased plasma concentration of estrogen, potentially increasing risk of adverse effects.
Cyclosporine/Tacrolimus
Increased nephrotoxicity.
ACE Inhibitors/Angiotensin II Antagonists
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive measures should be taken. There is no specific antidote. Hemodialysis does not significantly remove etoricoxib.
Pregnancy & Lactation
Pregnancy Category C/D (depending on trimester). Not recommended during pregnancy, especially in the third trimester due to potential premature closure of the ductus arteriosus and increased risk of bleeding. Avoid during lactation as it is unknown if etoricoxib is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Severe hepatic dysfunction (Child-Pugh score >9)
- 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
- History of asthma, urticaria, or allergic reactions after taking aspirin or other NSAIDs
Drug Interactions
Aspirin
Co-administration with low-dose aspirin for cardiovascular prophylaxis does not significantly increase the anti-thrombotic effect but may increase the risk of GI ulceration or other complications.
Lithium
Increased plasma lithium levels, leading to toxicity.
Warfarin
Increased risk of bleeding.
Diuretics
Reduced diuretic and antihypertensive effect.
Methotrexate
Increased plasma methotrexate levels and potential toxicity.
Oral Contraceptives
Increased plasma concentration of estrogen, potentially increasing risk of adverse effects.
Cyclosporine/Tacrolimus
Increased nephrotoxicity.
ACE Inhibitors/Angiotensin II Antagonists
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive measures should be taken. There is no specific antidote. Hemodialysis does not significantly remove etoricoxib.
Pregnancy & Lactation
Pregnancy Category C/D (depending on trimester). Not recommended during pregnancy, especially in the third trimester due to potential premature closure of the ductus arteriosus and increased risk of bleeding. Avoid during lactation as it is unknown if etoricoxib is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals
Approval Status
Approved in many countries (e.g., Bangladesh, India, EU)
Patent Status
Generic available
Clinical Trials
Etoricoxib has been evaluated in numerous clinical trials demonstrating its efficacy and safety profile for various indications. Post-marketing surveillance data also contributes to its safety assessment.
Lab Monitoring
- Blood pressure monitoring (especially in hypertensive patients)
- Renal function tests (e.g., serum creatinine, eGFR)
- Liver function tests (e.g., ALT, AST) in patients with pre-existing hepatic impairment or prolonged therapy
- Complete blood count (CBC) for signs of GI bleeding or blood dyscrasias
Doctor Notes
- Carefully assess cardiovascular and gastrointestinal risk factors before prescribing, especially for long-term use.
- Use the lowest effective dose for the shortest possible duration.
- Monitor blood pressure regularly, particularly in patients with pre-existing hypertension.
- Avoid in patients with severe heart failure or established cardiovascular disease.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not exceed the recommended dose or duration of treatment.
- Report any unusual bleeding, persistent stomach pain, or swelling to your doctor 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. If it is almost time for your 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
Etoricoxib may cause dizziness in some patients. If you experience dizziness or visual disturbances, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise.
- Monitor your blood pressure regularly if you have hypertension or are at risk.
- Limit alcohol consumption while on this medication.
- Avoid smoking, as it can increase cardiovascular risks.
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