Etorgin
Generic Name
Etoricoxib
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| etorgin 90 mg tablet | ৳ 12.00 | N/A |
Description
Overview of the medicine
Etoricoxib is a selective cyclooxygenase-2 (COX-2) inhibitor, used for the symptomatic relief of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and the pain and signs of inflammation associated with acute gouty arthritis and primary dysmenorrhea. It is also used for the short-term treatment of moderate pain after dental surgery.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30 mg or 60 mg once daily. Rheumatoid arthritis/Ankylosing spondylitis: 60 mg or 90 mg once daily. Acute gouty arthritis: 120 mg once daily for a maximum of 8 days. Post-dental surgery pain: 90 mg once daily for a maximum of 3 days. Primary Dysmenorrhea: 120 mg once daily for a maximum of 8 days.
Elderly
No dosage adjustment is generally required based on age; however, caution is advised.
Renal_impairment
For moderate renal impairment (creatinine clearance 30-60 mL/min), a maximum dose of 60 mg once daily is recommended. Not recommended for severe renal impairment (creatinine clearance < 30 mL/min).
How to Take
Administer orally, with or without food. Taking it with food may reduce gastrointestinal upset, but it does not significantly affect absorption.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2), which is responsible for the synthesis of prostaglandins, key mediators of pain and inflammation. By inhibiting COX-2, etoricoxib reduces prostaglandin production, thereby alleviating pain and inflammation.
Pharmacokinetics
Onset
Onset of action is typically within 24 minutes to 2 hours, depending on the condition being treated.
Excretion
Approximately 70% of the dose is excreted in the urine as metabolites, and about 20% is excreted in the feces, predominantly as metabolites.
Half life
The elimination half-life is approximately 22 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations (Tmax) achieved in approximately 1 hour. Oral bioavailability is approximately 100%.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 (CYP) enzymes, mainly CYP3A4, to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any excipients
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Previous history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
- Pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels, potentially leading to toxicity.
Warfarin
Increased risk of bleeding due to enhanced anticoagulant effect.
Methotrexate
Increased plasma methotrexate levels, potentially leading to toxicity.
Oral Contraceptives
Increased plasma concentrations of estrogen and norethindrone, consider contraceptive dose adjustment.
Diuretics, ACE Inhibitors, Angiotensin II Antagonists
May reduce the natriuretic effect of diuretics and the antihypertensive effect of ACE inhibitors/angiotensin II antagonists. 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
In case of overdose, supportive measures should be initiated immediately. There is no specific antidote for etoricoxib overdose. Symptoms may include gastrointestinal disturbances, renal toxicity, and cardiovascular effects. Monitor vital signs and provide symptomatic treatment.
Pregnancy & Lactation
Etoricoxib is contraindicated during pregnancy and lactation. NSAIDs, including etoricoxib, should be avoided in the third trimester of pregnancy due to the risk of premature closure of the fetal ductus arteriosus. It is unknown whether etoricoxib is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any excipients
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Previous history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
- Pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels, potentially leading to toxicity.
Warfarin
Increased risk of bleeding due to enhanced anticoagulant effect.
Methotrexate
Increased plasma methotrexate levels, potentially leading to toxicity.
Oral Contraceptives
Increased plasma concentrations of estrogen and norethindrone, consider contraceptive dose adjustment.
Diuretics, ACE Inhibitors, Angiotensin II Antagonists
May reduce the natriuretic effect of diuretics and the antihypertensive effect of ACE inhibitors/angiotensin II antagonists. 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
In case of overdose, supportive measures should be initiated immediately. There is no specific antidote for etoricoxib overdose. Symptoms may include gastrointestinal disturbances, renal toxicity, and cardiovascular effects. Monitor vital signs and provide symptomatic treatment.
Pregnancy & Lactation
Etoricoxib is contraindicated during pregnancy and lactation. NSAIDs, including etoricoxib, should be avoided in the third trimester of pregnancy due to the risk of premature closure of the fetal ductus arteriosus. It is unknown whether etoricoxib is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture
Availability
Available in pharmacies nationwide
Approval Status
Approved by regulatory authorities in many countries including Bangladesh
Patent Status
Generic available, patents expired in most regions
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of etoricoxib in various inflammatory and painful conditions, comparing it with other NSAIDs and placebo. Studies have focused on cardiovascular safety profiles, especially compared to non-selective NSAIDs.
Lab Monitoring
- Blood pressure monitoring (especially in patients with pre-existing hypertension)
- Renal function tests (e.g., serum creatinine, BUN) periodically
- Liver function tests (e.g., ALT, AST) if symptoms of hepatic dysfunction appear
- Complete Blood Count (CBC) if long-term therapy
Doctor Notes
- Consider the patient's overall cardiovascular risk profile before initiating etoricoxib.
- Use the lowest effective dose for the shortest possible duration.
- Regularly monitor blood pressure and renal function, especially in patients at risk.
- Educate patients about signs of cardiovascular and gastrointestinal adverse events.
Patient Guidelines
- Take the lowest effective dose for the shortest duration necessary to control symptoms.
- Do not exceed the recommended daily dose.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Report any signs of gastrointestinal bleeding (e.g., black, tarry stools) or cardiovascular issues (e.g., chest pain, shortness of breath) immediately.
- Avoid during pregnancy and breastfeeding.
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
Patients who experience dizziness, vertigo, or somnolence while taking etoricoxib should avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy weight to reduce stress on joints.
- Engage in regular, low-impact exercise as advised by your doctor.
- Avoid smoking and excessive alcohol consumption, as these can worsen cardiovascular and gastrointestinal risks.
- Follow a balanced diet.
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