España
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| espana 90 mg tablet | ৳ 11.00 | ৳ 110.00 |
Description
Overview of the medicine
Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gout. It selectively inhibits the COX-2 enzyme.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30 mg or 60 mg once daily. Rheumatoid arthritis and Ankylosing Spondylitis: 60 mg or 90 mg once daily. Acute Gouty Arthritis: 120 mg once daily for a maximum of 8 days. Acute Pain/Dental Surgery Pain: 90 mg once daily for a maximum of 3-8 days.
Elderly
No specific dose adjustment is generally needed, but caution should be exercised due to increased risk of side effects, especially cardiovascular and gastrointestinal events.
Renal_impairment
Moderate renal impairment (creatinine clearance 30-60 ml/min): Max 60 mg once daily. Not recommended for severe renal impairment (CrCl <30 ml/min).
How to Take
Take orally, with or without food. To minimize GI upset, it may be taken with food. Swallow the tablet whole with a glass of water.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2) enzyme, leading to a reduction in prostaglandin synthesis. Prostaglandins are mediators of pain, inflammation, and fever.
Pharmacokinetics
Onset
Analgesic effect typically observed within 30-45 minutes after a single dose.
Excretion
Approximately 70% of the dose is excreted in the urine as metabolites, and about 20% is excreted in the feces as metabolites. Less than 1% is excreted unchanged.
Half life
The elimination half-life is approximately 22 hours, allowing for once-daily dosing.
Absorption
Rapidly absorbed from the gastrointestinal tract. Oral bioavailability is approximately 100%. Peak plasma concentration (Tmax) is reached in approximately 1 hour.
Metabolism
Extensively metabolized in the liver, primarily via CYP3A4, forming inactive metabolites. Renal excretion is the main route of elimination for metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any other 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)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
- Pregnancy and lactation
Drug Interactions
Lithium
May increase plasma lithium levels, potentially leading to toxicity.
Warfarin
Increased risk of bleeding; monitor INR closely.
Diuretics
May reduce diuretic and antihypertensive effects.
Methotrexate
May increase methotrexate plasma levels and enhance its toxicity.
Oral Contraceptives
May increase the plasma concentrations of oral contraceptive hormones.
Cyclosporine / Tacrolimus
Increased risk of nephrotoxicity.
ACE Inhibitors / Angiotensin Receptor Blockers (ARBs)
May decrease the antihypertensive effect and increase the risk of renal impairment.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include gastrointestinal disturbances (e.g., nausea, vomiting, abdominal pain), somnolence, and in rare cases, acute renal failure. Management involves symptomatic and supportive care. Gastric lavage and activated charcoal may be considered soon after ingestion.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester, due to potential risks to the fetus, including premature closure of the ductus arteriosus. Avoid during lactation as Etoricoxib is excreted in breast milk and may pose risks to the infant.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any other 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)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
- Pregnancy and lactation
Drug Interactions
Lithium
May increase plasma lithium levels, potentially leading to toxicity.
Warfarin
Increased risk of bleeding; monitor INR closely.
Diuretics
May reduce diuretic and antihypertensive effects.
Methotrexate
May increase methotrexate plasma levels and enhance its toxicity.
Oral Contraceptives
May increase the plasma concentrations of oral contraceptive hormones.
Cyclosporine / Tacrolimus
Increased risk of nephrotoxicity.
ACE Inhibitors / Angiotensin Receptor Blockers (ARBs)
May decrease the antihypertensive effect and increase the risk of renal impairment.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include gastrointestinal disturbances (e.g., nausea, vomiting, abdominal pain), somnolence, and in rare cases, acute renal failure. Management involves symptomatic and supportive care. Gastric lavage and activated charcoal may be considered soon after ingestion.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester, due to potential risks to the fetus, including premature closure of the ductus arteriosus. Avoid during lactation as Etoricoxib is excreted in breast milk and may pose risks to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, when stored under recommended conditions.
Availability
Pharmacies, hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Expired for generic versions
Clinical Trials
Etoricoxib has been evaluated in numerous clinical trials for its efficacy and safety in various pain and inflammatory conditions, demonstrating comparable efficacy to non-selective NSAIDs with a potentially improved gastrointestinal safety profile, but with cardiovascular risks.
Lab Monitoring
- Regular monitoring of blood pressure, especially at the start of treatment and periodically thereafter.
- Monitor renal function (serum creatinine, BUN, GFR) in patients at risk, particularly with long-term use.
- Monitor liver function tests (ALT, AST) periodically, especially in patients with pre-existing hepatic impairment or prolonged therapy.
- Monitor for signs of gastrointestinal bleeding (e.g., CBC for anemia, occult blood in stool).
Doctor Notes
- Prior to initiating Etoricoxib, thoroughly assess patient's cardiovascular risk factors and gastrointestinal history.
- Use the lowest effective dose for the shortest possible duration to achieve treatment goals, particularly in patients at risk.
- Monitor blood pressure closely, especially in patients with pre-existing hypertension or those initiating long-term therapy.
- Counsel patients on the signs and symptoms of cardiovascular and gastrointestinal adverse events and advise them to seek immediate medical attention if these occur.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor. Do not change the dose or stop taking it without consulting your doctor.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs, herbal supplements, and vitamins.
- Report any new or worsening symptoms, especially chest pain, shortness of breath, sudden weakness, slurred speech, stomach pain, or black/tarry stools.
- Do not exceed the recommended dose or duration of treatment, as this may increase the risk of side effects.
- If you have a history of heart disease, high blood pressure, or kidney problems, discuss this with your doctor before starting Etoricoxib.
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 take a double dose to make up for a missed one.
Driving Precautions
Etoricoxib may cause dizziness, vertigo, or drowsiness in some patients. If you experience these effects, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, to support overall health.
- Avoid smoking and limit alcohol consumption, as these can increase the risk of cardiovascular and gastrointestinal side effects associated with NSAIDs.
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Global Brand Names
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