Powercox
Generic Name
Etoricoxib
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| powercox 90 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Powercox 90 mg tablet contains Etoricoxib, a selective COX-2 inhibitor, used to relieve pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gout.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30 mg or 60 mg once daily. Rheumatoid Arthritis, Ankylosing Spondylitis: 60 mg or 90 mg once daily. Acute Gout: 120 mg once daily for a maximum of 8 days. Acute pain and primary dysmenorrhea: 120 mg once daily for a maximum of 8 days. For Powercox 90 mg tablet, common dosage is 90 mg once daily for Rheumatoid Arthritis or Ankylosing Spondylitis. For acute pain, 90 mg once daily as advised by physician, not exceeding 8 days.
Elderly
No dosage adjustment generally required, but caution is advised. Initiate at the lowest effective dose.
Renal_impairment
Patients with severe renal insufficiency (creatinine clearance <30 mL/min) should not be treated with etoricoxib. For moderate renal impairment, a lower dose might be considered.
How to Take
Powercox 90 mg tablet should be taken orally, with or without food. For faster onset of action, it can be taken without food.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins, mediators of pain, inflammation, and fever. By inhibiting COX-2, etoricoxib reduces prostaglandin production, thereby alleviating pain and inflammation.
Pharmacokinetics
Onset
Pain relief typically within 24 minutes to 1 hour.
Excretion
Primarily excreted renally (approximately 70% as metabolites) and fecally (approximately 20% as metabolites).
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed from the gastrointestinal tract; peak plasma concentrations reached in approximately 1 hour.
Metabolism
Extensively metabolized by cytochrome P450 enzymes (mainly CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Severe liver dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Inflammatory bowel disease
- Congestive heart failure (NYHA Class II-IV)
- Established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Pregnancy and lactation
- Children and adolescents under 16 years of age
Drug Interactions
Lithium
May increase lithium plasma levels, leading to toxicity. Close monitoring is required.
Warfarin
May increase the anticoagulant effect, leading to increased bleeding risk. Close monitoring of INR is required.
Methotrexate
May increase methotrexate plasma levels, potentially increasing toxicity.
Oral Contraceptives
May increase plasma concentrations of ethinyl estradiol, potentially increasing adverse effects.
Ciclosporin, Tacrolimus
Increased nephrotoxicity risk.
Diuretics, 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
Symptoms of overdose include gastrointestinal disturbances, renal toxicity. Treatment is supportive and symptomatic; there is no specific antidote. Gastric emptying (e.g., emesis, lavage) and activated charcoal may be considered.
Pregnancy & Lactation
Etoricoxib is contraindicated during pregnancy and lactation. NSAIDs, including etoricoxib, may cause premature closure of the ductus arteriosus in the fetus in the third trimester. It is unknown if etoricoxib is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Severe liver dysfunction
- Severe renal dysfunction (creatinine clearance <30 mL/min)
- Inflammatory bowel disease
- Congestive heart failure (NYHA Class II-IV)
- Established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Pregnancy and lactation
- Children and adolescents under 16 years of age
Drug Interactions
Lithium
May increase lithium plasma levels, leading to toxicity. Close monitoring is required.
Warfarin
May increase the anticoagulant effect, leading to increased bleeding risk. Close monitoring of INR is required.
Methotrexate
May increase methotrexate plasma levels, potentially increasing toxicity.
Oral Contraceptives
May increase plasma concentrations of ethinyl estradiol, potentially increasing adverse effects.
Ciclosporin, Tacrolimus
Increased nephrotoxicity risk.
Diuretics, 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
Symptoms of overdose include gastrointestinal disturbances, renal toxicity. Treatment is supportive and symptomatic; there is no specific antidote. Gastric emptying (e.g., emesis, lavage) and activated charcoal may be considered.
Pregnancy & Lactation
Etoricoxib is contraindicated during pregnancy and lactation. NSAIDs, including etoricoxib, may cause premature closure of the ductus arteriosus in the fetus in the third trimester. 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 manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved (in various countries, including Bangladesh)
Patent Status
Patent expired for generic versions
Clinical Trials
Extensive clinical trials have demonstrated etoricoxib's efficacy and safety in various inflammatory and painful conditions, often showing comparable efficacy to traditional NSAIDs with an improved gastrointestinal safety profile.
Lab Monitoring
- Blood pressure monitoring (especially at initiation and during long-term treatment)
- Renal function tests (e.g., serum creatinine, BUN) in patients at risk for renal impairment
- Liver function tests (e.g., ALT, AST) in patients with hepatic dysfunction or symptoms of liver disease
- Complete blood count (CBC) during long-term treatment
Doctor Notes
- Consider cardiovascular risk factors carefully before prescribing. Use the lowest effective dose for the shortest duration necessary.
- Monitor blood pressure regularly, especially in patients with pre-existing hypertension.
- Assess renal and hepatic function periodically, particularly in elderly patients or those with co-morbidities.
- Educate patients on symptoms of GI and CV adverse events and when to seek immediate medical attention.
Patient Guidelines
- Take exactly as prescribed by your doctor. Do not exceed the recommended dose or duration of treatment.
- 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, vomiting blood) immediately.
- Monitor for signs of swelling or sudden weight gain, especially if you have heart problems.
- Avoid alcohol consumption while taking this medicine, as it may increase the risk of stomach problems.
Missed Dose Advice
If a dose is missed, 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 double the dose.
Driving Precautions
May cause dizziness, vertigo, or somnolence. Patients should be cautioned against driving or operating machinery if they experience these effects.
Lifestyle Advice
- Maintain a healthy diet and engage in regular exercise, if appropriate for your condition.
- Quit smoking to reduce cardiovascular risks.
- Manage stress effectively to improve overall well-being.
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