Ezepain
Generic Name
Etoricoxib
Manufacturer
Popular Pharmaceutical Ltd.
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 |
Description
Overview of the medicine
Ezepain 90 mg Tablet contains Etoricoxib, a selective cyclooxygenase-2 (COX-2) inhibitor. It belongs to the class of non-steroidal anti-inflammatory drugs (NSAIDs) and is primarily used to relieve pain and inflammation associated with various conditions.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30-60 mg once daily. Rheumatoid Arthritis, Ankylosing Spondylitis, Chronic Musculoskeletal Pain: 60-90 mg once daily. Acute Gouty Arthritis: 120 mg once daily for a maximum of 8 days. Post-operative dental pain: 90 mg once daily for a maximum of 3 days.
Elderly
No dosage adjustment is generally required for elderly patients, but caution should be exercised due to increased risk of side effects.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). No dosage adjustment is needed for mild to moderate renal impairment (creatinine clearance 30-80 mL/min).
How to Take
Ezepain tablets should be swallowed whole with a glass of water, with or without food. Taking it with food may help reduce gastrointestinal upset.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2), an enzyme responsible for the synthesis of prostaglandins, which are mediators of pain and inflammation. By inhibiting COX-2, Etoricoxib reduces the production of these prostaglandins, thereby alleviating pain and inflammation.
Pharmacokinetics
Onset
Onset of action for pain relief is approximately 24 minutes.
Excretion
Approximately 70% is excreted in the urine and 20% in feces, primarily as metabolites.
Half life
The elimination half-life is approximately 22 hours.
Absorption
Rapidly and well absorbed after oral administration, with an absolute bioavailability of approximately 100%. Peak plasma concentrations are reached in about 1 hour.
Metabolism
Extensively metabolized by cytochrome P450 enzymes (primarily CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the formulation
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe heart failure (NYHA Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
Drug Interactions
Lithium
May increase plasma lithium levels, leading to toxicity. Monitor lithium levels carefully.
Warfarin
May increase the risk of bleeding. Close monitoring of INR is recommended.
Diuretics
May reduce the effect of diuretics and increase the risk of renal impairment.
Methotrexate
May increase methotrexate plasma concentrations, leading to toxicity. Exercise caution.
Oral Contraceptives
May increase the plasma concentrations of ethinyl estradiol, potentially increasing adverse effects associated with oral contraceptives.
ACE Inhibitors/Angiotensin II Antagonists
May reduce the antihypertensive effect and increase the 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
In case of an overdose, symptomatic and supportive measures should be taken. Gastric lavage and activated charcoal may be considered if ingestion is recent. Hemodialysis is unlikely to be effective in removing etoricoxib.
Pregnancy & Lactation
Pregnancy Category C in early pregnancy; contraindicated in the third trimester. Should not be used during lactation as it is unknown if etoricoxib is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the formulation
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe heart failure (NYHA Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Uncontrolled hypertension
Drug Interactions
Lithium
May increase plasma lithium levels, leading to toxicity. Monitor lithium levels carefully.
Warfarin
May increase the risk of bleeding. Close monitoring of INR is recommended.
Diuretics
May reduce the effect of diuretics and increase the risk of renal impairment.
Methotrexate
May increase methotrexate plasma concentrations, leading to toxicity. Exercise caution.
Oral Contraceptives
May increase the plasma concentrations of ethinyl estradiol, potentially increasing adverse effects associated with oral contraceptives.
ACE Inhibitors/Angiotensin II Antagonists
May reduce the antihypertensive effect and increase the 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
In case of an overdose, symptomatic and supportive measures should be taken. Gastric lavage and activated charcoal may be considered if ingestion is recent. Hemodialysis is unlikely to be effective in removing etoricoxib.
Pregnancy & Lactation
Pregnancy Category C in early pregnancy; contraindicated in the third trimester. Should not be used during lactation as it is unknown if etoricoxib is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, consult the packaging for specific expiry.
Availability
Available in pharmacies nationwide
Approval Status
Approved by regulatory authorities (e.g., DGDA in Bangladesh)
Patent Status
Off-patent (for generic Etoricoxib)
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy and safety in various pain and inflammatory conditions. Studies have compared its efficacy to other NSAIDs and placebo, particularly focusing on its gastrointestinal safety profile.
Lab Monitoring
- Renal function tests (creatinine, BUN)
- Liver function tests (ALT, AST)
- Blood pressure monitoring
- Complete Blood Count (CBC) for prolonged use
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration consistent with individual patient treatment goals.
- Monitor patients for signs and symptoms of cardiovascular and gastrointestinal adverse events, especially in patients with pre-existing conditions or risk factors.
- Use with caution in patients with a history of hypertension, heart failure, or other edema-related conditions.
- Assess renal function regularly during prolonged therapy.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Do not exceed the recommended dose or duration of treatment.
- Report any unusual symptoms or side effects to your doctor immediately.
- Do not crush or chew the tablet; swallow it whole.
- Inform your doctor about all other medications you are taking.
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 two doses at once to make up for a missed dose.
Driving Precautions
Etoricoxib may cause dizziness, vertigo, or drowsiness in some patients. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid or limit alcohol consumption as it may increase the risk of stomach bleeding.
- Maintain a healthy diet and lifestyle.
- If you have a history of heart disease, discuss treatment options with your doctor.
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