Recox
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| recox 120 mg tablet | ৳ 14.00 | ৳ 140.00 |
Description
Overview of the medicine
Etoricoxib is a COX-2 selective non-steroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation in various conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis.
Uses & Indications
Dosage
Adults
Osteoarthritis: 60 mg once daily. Rheumatoid arthritis, Ankylosing spondylitis: 90 mg once daily. Acute gouty arthritis: 120 mg once daily for a maximum of 8 days. Acute pain: 120 mg once daily for a maximum of 8 days.
Elderly
No dose adjustment is generally required in the elderly, but caution should be exercised due to increased risk of adverse effects. Start with the lowest effective dose.
Renal_impairment
Mild to moderate renal impairment (CrCl 30-80 mL/min): No dose adjustment. Severe renal impairment (CrCl <30 mL/min): Not recommended.
How to Take
Recox-120 mg Tablet may be taken with or without food. Swallow the tablet whole with a glass of water. Do not crush or chew.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins, mediators of pain and inflammation. This selective inhibition reduces inflammation and pain with a potentially lower risk of gastrointestinal side effects compared to non-selective NSAIDs.
Pharmacokinetics
Onset
Analgesic effects typically begin within 24 minutes for acute pain conditions.
Excretion
Approximately 70% of the dose is excreted in the urine as metabolites, and 30% is excreted in the feces as metabolites.
Half life
The elimination half-life is approximately 22 hours, allowing for once-daily dosing.
Absorption
Etoricoxib is rapidly absorbed from the gastrointestinal tract following oral administration, with peak plasma concentrations (Cmax) achieved in approximately 1 hour. The oral bioavailability is about 100%.
Metabolism
Etoricoxib is extensively metabolized in the liver, primarily via cytochrome P450 enzymes (CYP3A4) to form inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any excipients
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Severe hepatic dysfunction
- Severe renal impairment (CrCl <30 mL/min)
- Congestive heart failure (NYHA Class II-IV)
- Established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have recently undergone coronary artery bypass graft (CABG) surgery)
- Uncontrolled hypertension (blood pressure consistently >140/90 mmHg)
Drug Interactions
Lithium
Etoricoxib may increase lithium plasma levels, leading to potential toxicity. Monitor lithium levels.
Warfarin
May increase the anticoagulant effect of warfarin and increase the risk of bleeding. Close monitoring of INR is recommended.
Diuretics
Etoricoxib may reduce the natriuretic effect of diuretics, requiring blood pressure and renal function monitoring.
Methotrexate
May increase plasma concentrations of methotrexate, enhancing its toxicity. Use with caution.
ACE inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment, especially in elderly or dehydrated patients.
Oral contraceptives
May increase the plasma concentrations of ethinyl estradiol, potentially increasing the risk of adverse events associated with oral contraceptives.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach and sight of children.
Overdose
In case of an overdose, symptoms may include gastrointestinal disturbances (e.g., nausea, vomiting, abdominal pain), somnolence, and rarely, more serious effects like renal failure. Management involves symptomatic and supportive care. Gastric lavage or activated charcoal may be considered if ingestion is recent (within 1 hour). Hemodialysis is not effective in removing etoricoxib.
Pregnancy & Lactation
Etoricoxib is not recommended during pregnancy, especially in the third trimester, due to potential adverse effects on the fetus, including premature closure of the ductus arteriosus and impaired renal function. Avoid during breastfeeding as it is excreted in breast milk and may harm the infant.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any excipients
- Active peptic ulceration or gastrointestinal (GI) bleeding
- Severe hepatic dysfunction
- Severe renal impairment (CrCl <30 mL/min)
- Congestive heart failure (NYHA Class II-IV)
- Established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have recently undergone coronary artery bypass graft (CABG) surgery)
- Uncontrolled hypertension (blood pressure consistently >140/90 mmHg)
Drug Interactions
Lithium
Etoricoxib may increase lithium plasma levels, leading to potential toxicity. Monitor lithium levels.
Warfarin
May increase the anticoagulant effect of warfarin and increase the risk of bleeding. Close monitoring of INR is recommended.
Diuretics
Etoricoxib may reduce the natriuretic effect of diuretics, requiring blood pressure and renal function monitoring.
Methotrexate
May increase plasma concentrations of methotrexate, enhancing its toxicity. Use with caution.
ACE inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment, especially in elderly or dehydrated patients.
Oral contraceptives
May increase the plasma concentrations of ethinyl estradiol, potentially increasing the risk of adverse events associated with oral contraceptives.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach and sight of children.
Overdose
In case of an overdose, symptoms may include gastrointestinal disturbances (e.g., nausea, vomiting, abdominal pain), somnolence, and rarely, more serious effects like renal failure. Management involves symptomatic and supportive care. Gastric lavage or activated charcoal may be considered if ingestion is recent (within 1 hour). Hemodialysis is not effective in removing etoricoxib.
Pregnancy & Lactation
Etoricoxib is not recommended during pregnancy, especially in the third trimester, due to potential adverse effects on the fetus, including premature closure of the ductus arteriosus and impaired renal function. Avoid during breastfeeding as it is excreted in breast milk and may harm the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, depending on the manufacturer and specific formulation.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic available, original patent expired for many formulations
Clinical Trials
Etoricoxib has been evaluated in numerous clinical trials demonstrating its efficacy and tolerability in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute pain. These trials have shown it to be effective in reducing pain and inflammation with a favourable gastrointestinal safety profile compared to some non-selective NSAIDs, though cardiovascular risks remain a concern.
Lab Monitoring
- Blood pressure monitoring (especially in hypertensive patients or those at risk) at initiation and during treatment.
- Liver function tests (e.g., ALT, AST) periodically, particularly during long-term therapy.
- Renal function tests (e.g., serum creatinine, eGFR) periodically, especially in patients with pre-existing renal impairment or those on concomitant nephrotoxic drugs.
Doctor Notes
- Prior to initiating etoricoxib, thoroughly assess patient's cardiovascular risk factors and gastrointestinal history.
- Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals to minimize potential risks.
- Regularly monitor blood pressure, renal function, and liver function, particularly in patients on long-term therapy or with pre-existing conditions.
- Advise patients to seek immediate medical attention if they develop symptoms suggestive of cardiovascular or gastrointestinal adverse events.
Patient Guidelines
- Take Recox-120 mg exactly as prescribed by your doctor. Do not alter the dose or duration of treatment without consulting your doctor.
- Report any new or worsening symptoms, especially stomach pain, black stools, unusual bleeding/bruising, chest pain, or swelling in ankles/feet, to your doctor immediately.
- Be aware of the potential cardiovascular risks associated with NSAIDs, and discuss your medical history with your doctor before starting 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
Etoricoxib may cause dizziness, vertigo, or drowsiness in some patients. If you experience these symptoms, do not drive or operate machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a heart-healthy lifestyle, including a balanced diet low in sodium and saturated fats, regular physical activity, and weight management.
- Avoid smoking and excessive alcohol consumption, as these can increase the risk of gastrointestinal and cardiovascular side effects associated with NSAIDs.
- Manage other chronic conditions like hypertension and diabetes diligently as advised by your healthcare provider.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Recox Brand
Other medicines available under the same brand name
