Flexirun Plus
Generic Name
Etoricoxib
Manufacturer
Healthcare Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| flexirun plus 40 mg capsule | ৳ 40.00 | ৳ 240.00 |
Description
Overview of the medicine
Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2). It is used to relieve pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30 mg or 60 mg once daily. For acute conditions, 40 mg may be prescribed as per physician's discretion, generally within the recommended range. Maximum 120 mg/day for acute pain for a maximum of 8 days.
Elderly
No specific dose adjustment is generally required, but caution is advised due to increased susceptibility to adverse effects.
Renal_impairment
Mild to moderate renal impairment: No dose adjustment needed. Severe renal impairment (creatinine clearance <30 mL/min): Use with caution and consider lower doses.
How to Take
Take Flexirun Plus 40 mg capsule orally, once daily. It can be taken with or without food. Swallow the capsule whole with a glass of water; do not crush, chew, or break it.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2), leading to reduced synthesis of prostaglandins involved in inflammation, pain, and fever. Unlike non-selective NSAIDs, it has a lower potential for gastrointestinal side effects due to its COX-1 sparing effect.
Pharmacokinetics
Onset
Pain relief may begin within 24 minutes for acute pain conditions.
Excretion
Approximately 70% is excreted in the urine (as metabolites) and 20% in the faeces (as metabolites).
Half life
The elimination half-life is approximately 22 hours, allowing for once-daily dosing.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentration (Tmax) occurring at approximately 1 hour post-dose. Bioavailability is about 100%.
Metabolism
Extensively metabolized by cytochrome P450 (CYP) enzymes, primarily CYP3A4, to inactive metabolites. Less than 1% is excreted as the parent drug.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the capsule.
- Active peptic ulceration or gastrointestinal bleeding.
- Severe hepatic dysfunction.
- Severe renal dysfunction (creatinine clearance <30 mL/min).
- Patients with established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease.
- Uncontrolled hypertension (blood pressure consistently above 140/90 mmHg).
- Congestive heart failure (NYHA Class II-IV).
Drug Interactions
Lithium
Increased plasma lithium levels.
Warfarin
Increased risk of bleeding, monitor INR.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Methotrexate
Increased plasma concentration and toxicity of methotrexate.
Low-dose Aspirin
Increased risk of GI adverse events; concurrent use is not recommended.
Oral Contraceptives
Increased plasma levels of estrogens, potentially increasing adverse effects.
Ciclosporin / Tacrolimus
Increased nephrotoxicity risk.
ACE Inhibitors / Angiotensin Receptor Blockers (ARBs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive measures should be initiated. There is no specific antidote. Gastric emptying (e.g., emesis, gastric lavage) and charcoal may be considered if ingestion is recent.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester, due to potential risks to the fetus (e.g., premature closure of the ductus arteriosus). Avoid during lactation as Etoricoxib is excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the capsule.
- Active peptic ulceration or gastrointestinal bleeding.
- Severe hepatic dysfunction.
- Severe renal dysfunction (creatinine clearance <30 mL/min).
- Patients with established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease.
- Uncontrolled hypertension (blood pressure consistently above 140/90 mmHg).
- Congestive heart failure (NYHA Class II-IV).
Drug Interactions
Lithium
Increased plasma lithium levels.
Warfarin
Increased risk of bleeding, monitor INR.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Methotrexate
Increased plasma concentration and toxicity of methotrexate.
Low-dose Aspirin
Increased risk of GI adverse events; concurrent use is not recommended.
Oral Contraceptives
Increased plasma levels of estrogens, potentially increasing adverse effects.
Ciclosporin / Tacrolimus
Increased nephrotoxicity risk.
ACE Inhibitors / Angiotensin Receptor Blockers (ARBs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive measures should be initiated. There is no specific antidote. Gastric emptying (e.g., emesis, gastric lavage) and charcoal may be considered if ingestion is recent.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester, due to potential risks to the fetus (e.g., premature closure of the ductus arteriosus). Avoid during lactation as Etoricoxib is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, refer to the product packaging for exact date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved
Patent Status
Off-patent
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy and safety for various pain and inflammatory conditions, including comparisons with other NSAIDs.
Lab Monitoring
- Blood pressure monitoring (especially in hypertensive patients)
- Liver function tests (periodically during long-term therapy)
- Renal function tests (for patients with pre-existing renal impairment or during long-term therapy)
- Complete Blood Count (CBC) (for long-term use)
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration to minimize cardiovascular and gastrointestinal risks.
- Assess cardiovascular risk factors (e.g., hypertension, dyslipidemia, diabetes) and gastrointestinal risk factors (e.g., history of ulcer, concomitant aspirin use) before initiating and periodically during therapy.
- Avoid use in patients with significant cardiovascular disease or uncontrolled hypertension.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Report any unusual symptoms (e.g., severe abdominal pain, black stools, swelling) to your doctor immediately.
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements.
- Do not exceed the recommended dose or duration of treatment.
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
Flexirun Plus 40 mg capsule may cause dizziness, drowsiness, or blurred vision in some individuals. If you experience these effects, avoid driving or operating machinery until you feel normal again.
Lifestyle Advice
- Avoid or limit alcohol consumption as it may increase the risk of stomach problems.
- Maintain a healthy diet and lifestyle.
- Regular exercise may help manage conditions like osteoarthritis.
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