Medicine Information

Enofab

Name: Enofab
Brand: Enofab
Rating: 4.5 (117 reviews)

Capsule200 mgNSAIDs (Non-steroidal anti-inflammatory drugs), COX-2 InhibitorsATC: M01AH05

Generic Name

Etoricoxib

Manufacturer

Incepta Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
enofab 200 mg capsule	৳ 7.00	৳ 70.00

Description

Overview of the medicine

Etoricoxib is a selective cyclooxygenase-2 (COX-2) inhibitor, a type of NSAID, used to relieve pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis. It works by reducing the production of prostaglandins, which are responsible for pain and inflammation.

Uses & Indications

Relief of symptoms of osteoarthritis.

Relief of symptoms of rheumatoid arthritis.

Relief of symptoms of ankylosing spondylitis.

Treatment of acute gouty arthritis.

Management of acute pain, including pain associated with dental surgery.

Treatment of primary dysmenorrhea.

Dosage

Adults

Dosage varies by indication. For common conditions like osteoarthritis, 30-60 mg once daily. For rheumatoid arthritis or ankylosing spondylitis, 60-90 mg once daily. Acute gouty arthritis or acute pain, 120 mg once daily for a limited duration. A 200 mg dose is unusually high for Etoricoxib and would only be considered in specific severe cases under strict medical supervision, if at all.

Elderly

No specific dose adjustment is generally required, but caution is advised due to increased risk of side effects.

Renal_impairment

No dose adjustment is generally needed for mild to moderate renal impairment. Avoid in severe renal impairment.

How to Take

Take orally, with or without food. For faster onset of action, it may be taken without food. Swallow the capsule whole with water.

Mechanism of Action

Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2) enzymes. COX-2 is primarily responsible for the synthesis of prostaglandins involved in inflammatory responses, pain, and fever. By inhibiting COX-2, Etoricoxib reduces prostaglandin synthesis, thereby exerting anti-inflammatory, analgesic, and antipyretic effects.

Pharmacokinetics

Onset

Analgesic effect typically begins within 24 minutes.

Excretion

Primarily excreted via urine (70%) and feces (20%) as metabolites. Less than 1% is excreted as unchanged drug.

Half life

Approximately 22 hours.

Absorption

Rapidly absorbed from the gastrointestinal tract. Peak plasma concentrations are reached in approximately 1 hour. Bioavailability is about 100%.

Metabolism

Extensively metabolized by the liver, primarily via cytochrome P450 enzymes (CYP3A4, CYP2C9, CYP2D6).

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).
Congestive heart failure (NYHA Class II-IV).
Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease.
History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
Pregnancy and lactation.

Drug Interactions

Aspirin

Concomitant use with low-dose aspirin for cardiovascular protection is generally acceptable but increases GI risk.

Lithium

Increased plasma lithium levels.

Methotrexate

Increased plasma methotrexate levels and toxicity.

Oral Contraceptives

May increase plasma concentrations of oral contraceptives.

Cyclosporine/Tacrolimus

Increased nephrotoxicity.

Warfarin/Anticoagulants

Increased risk of bleeding.

Diuretics/ACE Inhibitors/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

Symptoms: Nausea, vomiting, epigastric pain, lethargy, drowsiness. In rare cases, GI bleeding, acute renal failure, hypertension, or anaphylactoid reactions. Management: Supportive and symptomatic treatment. No specific antidote. Gastric lavage or activated charcoal may be considered if ingestion is recent. Monitor renal function and blood pressure.

Pregnancy & Lactation

Contraindicated in pregnancy, especially in the third trimester due to risk of premature closure of the fetal ductus arteriosus and potential renal dysfunction. Contraindicated during breastfeeding as it is excreted in breast milk and may cause adverse effects in the infant.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 capsules per blister

Shelf Life

36 months

Availability

Pharmacies, Hospitals

Approval Status

Approved by regulatory bodies (e.g., DGDA)

Patent Status

Generic available

Clinical Trials

Extensive clinical trials have demonstrated the efficacy and safety of Etoricoxib in various inflammatory and pain conditions. Studies have compared its efficacy to other NSAIDs, with a focus on gastrointestinal and cardiovascular safety profiles.

Lab Monitoring

Regular monitoring of blood pressure, especially in patients with pre-existing hypertension.
Periodic monitoring of renal function (e.g., serum creatinine, BUN) particularly in elderly or those with impaired renal function.
Liver function tests (e.g., ALT, AST) if liver dysfunction is suspected or develops.

Doctor Notes

Carefully assess cardiovascular risk factors before prescribing, especially for long-term use.
Use the lowest effective dose for the shortest possible duration to minimize risks.
Monitor patients for signs of gastrointestinal bleeding or cardiovascular events.
Avoid in patients with significant renal or hepatic impairment.

Patient Guidelines

Take exactly as prescribed by your doctor. Do not exceed the recommended dose.
Report any signs of stomach pain, black stools, or unusual bleeding/bruising to your doctor immediately.
Be aware of potential cardiovascular risks; report chest pain, shortness of breath, or weakness.
Do not take with other NSAIDs (including aspirin, unless specifically advised by a doctor) to avoid additive side effects.
Inform your doctor or dentist that you are taking Etoricoxib before any surgery or dental procedure.

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 catch up.

Driving Precautions

May cause dizziness, vertigo, or somnolence. Patients should be cautious when driving or operating machinery until they know how the medicine affects them.

Lifestyle Advice

Avoid alcohol consumption as it may increase the risk of stomach problems.
Maintain a healthy diet and engage in regular exercise, if appropriate for your condition.
Manage existing health conditions like hypertension or heart disease closely with your doctor.