Ezepain
Generic Name
Etoricoxib
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ezepain 90 mg tablet | ৳ 10.00 | ৳ 100.00 |
| ezepain 120 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Ezepain (Etoricoxib) is a non-steroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2). It is used to relieve pain and inflammation associated with various conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gouty arthritis, and acute pain.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30-60 mg once daily. Rheumatoid Arthritis, Ankylosing Spondylitis: 60-90 mg once daily. Acute Gouty Arthritis: 120 mg once daily for a maximum of 8 days. Acute Pain (including dental surgery, dysmenorrhea): 90 mg once daily.
Elderly
No dosage adjustment is generally required, but caution is advised due to increased risk of side effects.
Renal_impairment
For moderate renal impairment (CrCl 30-60 mL/min), maximum dose is 60 mg/day. Contraindicated in severe renal impairment (CrCl < 30 mL/min).
How to Take
Ezepain tablets are for oral administration and can be taken with or without food.
Mechanism of Action
Etoricoxib selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins involved in pain, inflammation, and fever. By inhibiting COX-2, it reduces the production of these inflammatory mediators.
Pharmacokinetics
Onset
Onset of analgesia typically occurs within 24 minutes for acute pain conditions.
Excretion
Approximately 70% of the dose is excreted in the urine and 20% in the feces, predominantly as metabolites.
Half life
The elimination half-life is approximately 22 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract, with an absolute bioavailability of approximately 100%. Peak plasma concentrations (Tmax) are reached within 1 hour.
Metabolism
Extensively metabolized by the liver, primarily via cytochrome P450 (CYP) enzymes, particularly CYP3A4, to form inactive metabolites, followed by sulfation.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the formulation
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Severe hepatic dysfunction
- Severe renal impairment (CrCl < 30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Warfarin
Increased INR (International Normalized Ratio), monitor anticoagulant activity.
Diuretics
May reduce the natriuretic effect of loop, thiazide, and potassium-sparing diuretics.
Rifampicin
Decreased etoricoxib plasma concentrations.
Methotrexate
Increased methotrexate plasma concentrations, potential for toxicity.
ACE inhibitors/ARBs
May attenuate the antihypertensive effect; increased risk of renal impairment.
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In cases of overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for etoricoxib. Hemodialysis is unlikely to be effective in removing etoricoxib.
Pregnancy & Lactation
Pregnancy: Should be avoided in the third trimester due to potential risks to the fetus. Use in first and second trimesters only if potential benefit justifies potential risk. Lactation: 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 (GI) bleeding
- Severe hepatic dysfunction
- Severe renal impairment (CrCl < 30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Warfarin
Increased INR (International Normalized Ratio), monitor anticoagulant activity.
Diuretics
May reduce the natriuretic effect of loop, thiazide, and potassium-sparing diuretics.
Rifampicin
Decreased etoricoxib plasma concentrations.
Methotrexate
Increased methotrexate plasma concentrations, potential for toxicity.
ACE inhibitors/ARBs
May attenuate the antihypertensive effect; increased risk of renal impairment.
Storage
Store below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In cases of overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for etoricoxib. Hemodialysis is unlikely to be effective in removing etoricoxib.
Pregnancy & Lactation
Pregnancy: Should be avoided in the third trimester due to potential risks to the fetus. Use in first and second trimesters only if potential benefit justifies potential risk. Lactation: Not recommended during breastfeeding as it is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, specific to batch.
Availability
Available in pharmacies and hospitals in Bangladesh
Approval Status
Approved in Bangladesh (DGDA)
Patent Status
Expired
Clinical Trials
Etoricoxib has been extensively studied in various clinical trials demonstrating its efficacy and safety in treating pain and inflammation associated with different musculoskeletal conditions.
Lab Monitoring
- Blood pressure monitoring
- Renal function tests (e.g., serum creatinine, BUN)
- Liver function tests (e.g., ALT, AST)
- Complete blood count (CBC)
- INR (International Normalized Ratio) if on concomitant warfarin therapy
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration to minimize cardiovascular and gastrointestinal risks.
- Carefully assess patient's cardiovascular risk factors before prescribing and periodically during treatment.
- Monitor for signs of GI bleeding, especially in elderly patients or those with a history of GI events.
Patient Guidelines
- Do not exceed the prescribed dose or duration of treatment.
- Report any symptoms of gastrointestinal bleeding (e.g., black, tarry stools) or cardiovascular events (e.g., chest pain, shortness of breath) immediately.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Patients with a history of cardiovascular disease or risk factors should use with caution and under medical supervision.
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 your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Ezepain may cause dizziness, vertigo, or drowsiness in some patients. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including regular exercise and a balanced diet.
- Avoid smoking and excessive alcohol consumption, as these can increase the risk of side effects.
- Manage underlying conditions like hypertension and diabetes.
- Discuss weight management strategies if overweight or obese.
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