Etorgin
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| etorgin 120 mg tablet | ৳ 14.00 | N/A |
Description
Overview of the medicine
Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation in various conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis. It selectively inhibits the enzyme cyclooxygenase-2 (COX-2), which is involved in prostaglandin synthesis, leading to anti-inflammatory, analgesic, and antipyretic effects.
Uses & Indications
Dosage
Adults
Acute pain and primary dysmenorrhea: 120 mg once daily. Acute gouty arthritis: 120 mg once daily for a maximum of 8 days. Osteoarthritis: 30-60 mg once daily. Rheumatoid arthritis/Ankylosing spondylitis: 60-90 mg once daily.
Elderly
No specific dose adjustment is required; however, caution is advised due to increased risk of side effects.
Renal_impairment
No dose adjustment needed for mild to moderate renal impairment (creatinine clearance 30-80 mL/min). Not recommended for severe renal impairment (<30 mL/min).
How to Take
Oral. Can be taken with or without food. To minimize GI upset, consider taking with food. Swallow the tablet whole with a glass of water.
Mechanism of Action
Etoricoxib is a selective inhibitor of cyclooxygenase-2 (COX-2). COX-2 is primarily responsible for the synthesis of prostaglandins involved in pain, inflammation, and fever. By inhibiting COX-2, etoricoxib reduces prostaglandin production, thereby alleviating symptoms of inflammation and pain.
Pharmacokinetics
Onset
Within 24 minutes for acute pain, with sustained effect for 24 hours.
Excretion
Primarily excreted in the urine (70%) and feces (20%) as metabolites.
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 1 hour after oral administration. Bioavailability is about 100%.
Metabolism
Extensively metabolized by cytochrome P450 (CYP) 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 impairment
- Severe uncontrolled heart failure
- Ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have recently undergone coronary artery bypass graft surgery)
- Creatinine clearance <30 mL/min
Drug Interactions
Lithium
Increased plasma lithium levels. Monitor lithium levels.
Warfarin
Increased risk of bleeding. Close INR monitoring is required.
Diuretics
May reduce natriuretic effect of diuretics and increase risk of renal impairment.
Methotrexate
Increased plasma methotrexate concentrations. Use with caution.
ACE inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Oral contraceptives
May increase plasma concentrations of ethinyl estradiol.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include gastrointestinal disturbances (e.g., dyspepsia, abdominal pain), renal impairment, and cardiovascular events. Management is symptomatic and supportive; there is no specific antidote. Gastric lavage or activated charcoal may be considered within an hour of ingestion.
Pregnancy & Lactation
Pregnancy Category C (first and second trimester), Category D (third trimester). Avoid during late pregnancy due to potential for premature closure of the fetal ductus arteriosus and inhibition of uterine contractions. Not recommended during breastfeeding as it is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the formulation
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic impairment
- Severe uncontrolled heart failure
- Ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have recently undergone coronary artery bypass graft surgery)
- Creatinine clearance <30 mL/min
Drug Interactions
Lithium
Increased plasma lithium levels. Monitor lithium levels.
Warfarin
Increased risk of bleeding. Close INR monitoring is required.
Diuretics
May reduce natriuretic effect of diuretics and increase risk of renal impairment.
Methotrexate
Increased plasma methotrexate concentrations. Use with caution.
ACE inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Oral contraceptives
May increase plasma concentrations of ethinyl estradiol.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include gastrointestinal disturbances (e.g., dyspepsia, abdominal pain), renal impairment, and cardiovascular events. Management is symptomatic and supportive; there is no specific antidote. Gastric lavage or activated charcoal may be considered within an hour of ingestion.
Pregnancy & Lactation
Pregnancy Category C (first and second trimester), Category D (third trimester). Avoid during late pregnancy due to potential for premature closure of the fetal ductus arteriosus and inhibition of uterine contractions. Not recommended during breastfeeding as it is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months
Availability
Available in pharmacies nationwide
Approval Status
Approved by regulatory bodies (e.g., DGDA, EMA)
Patent Status
Patent expired for generic Etoricoxib
Clinical Trials
Etoricoxib has been studied in numerous clinical trials demonstrating its efficacy in various pain and inflammatory conditions and its cardiovascular safety profile relative to non-selective NSAIDs and other COX-2 inhibitors. Studies like MEDAL (Multinational Etoricoxib and Diclofenac Arthritis Long-term) trial compared its cardiovascular and GI safety to diclofenac.
Lab Monitoring
- Blood pressure (regularly)
- Renal function (e.g., serum creatinine, GFR)
- Hepatic function (e.g., ALT, AST) in long-term use
- INR (if on warfarin)
- Complete blood count (CBC)
Doctor Notes
- Consider patient's cardiovascular risk factors before prescribing, including hypertension, hyperlipidemia, and diabetes.
- Use the lowest effective dose for the shortest duration necessary to achieve treatment goals.
- Monitor blood pressure regularly, especially in hypertensive patients, and adjust antihypertensive therapy if needed.
- Avoid in patients with severe heart failure (NYHA Class II-IV) or established cardiovascular disease.
- Prescribe with caution in patients with history of GI bleeding or peptic ulcer disease, consider co-prescription of gastroprotective agents.
Patient Guidelines
- Take the lowest effective dose for the shortest duration necessary.
- Report any signs of gastrointestinal bleeding (e.g., black, tarry stools) or cardiovascular issues (e.g., chest pain, shortness of breath) immediately.
- Do not exceed the recommended dose.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Avoid concurrent use with other NSAIDs.
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
May cause dizziness or drowsiness. Patients should be cautious when driving or operating machinery until they know how etoricoxib affects them.
Lifestyle Advice
- Avoid excessive alcohol consumption.
- Maintain a healthy diet and regular exercise.
- Manage underlying conditions like hypertension or heart failure.
- Quit smoking to reduce cardiovascular risks.
- Stay hydrated by drinking plenty of water.
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