Recox
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| recox 60 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Recox 60 mg tablet contains Etoricoxib, a selective cyclooxygenase-2 (COX-2) inhibitor. It is used to relieve pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30 mg or 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 (e.g., post-dental surgery): 60 mg or 90 mg once daily, for a maximum of 3-8 days respectively.
Elderly
No dose adjustment is generally necessary, but caution is advised in elderly patients due to increased risk of adverse effects.
Renal_impairment
For mild renal impairment (creatinine clearance 30-80 mL/min), no dose adjustment. For moderate renal impairment (creatinine clearance <30 mL/min), not recommended or use with extreme caution at lowest effective dose.
How to Take
Take orally, with or without food. To reduce the risk of gastrointestinal upset, it can be taken with food. Do not chew or crush the tablet; swallow whole with a glass of water.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2), which is responsible for the synthesis of prostaglandins involved in pain, inflammation, and fever. By inhibiting COX-2, it reduces prostaglandin production, leading to analgesic, anti-inflammatory, and antipyretic effects, while minimizing gastrointestinal side effects associated with non-selective NSAIDs.
Pharmacokinetics
Onset
Onset of action typically occurs within 1 hour.
Excretion
Excreted predominantly in the urine (about 70%) and feces (about 20%) as inactive metabolites. Less than 1% is excreted unchanged in urine.
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 (Cmax) are reached in approximately 1 hour.
Metabolism
Extensively metabolized, primarily via hepatic cytochrome P450 (CYP) enzymes, particularly CYP3A4, to form inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal disease (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA Class II-IV)
- Ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have recently undergone coronary artery bypass graft (CABG) surgery)
- Uncontrolled hypertension
- Pregnancy and lactation
Drug Interactions
Lithium
May increase plasma lithium levels, leading to toxicity.
Warfarin
May increase the anticoagulant effect of warfarin, requiring careful monitoring of INR.
Rifampicin
May decrease etoricoxib plasma concentrations due to enzyme induction.
Methotrexate
May increase plasma concentrations of methotrexate, leading to increased toxicity.
Oral Contraceptives
May increase plasma concentrations of ethinyl estradiol, potentially increasing adverse effects of oral contraceptives.
ACE Inhibitors/Angiotensin II Antagonists and Diuretics
May reduce the antihypertensive effect and impair renal function. Increased risk of renal impairment, especially in elderly or dehydrated patients.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote. Dialysis is unlikely to remove etoricoxib due to its high protein binding. Closely monitor vital signs and manage any arising adverse effects.
Pregnancy & Lactation
Etoricoxib is contraindicated during pregnancy, especially during the third trimester, due to the risk of premature closure of the fetal ductus arteriosus and potential renal dysfunction. It is also contraindicated during lactation as it is unknown whether 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 hepatic dysfunction
- Severe renal disease (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA Class II-IV)
- Ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have recently undergone coronary artery bypass graft (CABG) surgery)
- Uncontrolled hypertension
- Pregnancy and lactation
Drug Interactions
Lithium
May increase plasma lithium levels, leading to toxicity.
Warfarin
May increase the anticoagulant effect of warfarin, requiring careful monitoring of INR.
Rifampicin
May decrease etoricoxib plasma concentrations due to enzyme induction.
Methotrexate
May increase plasma concentrations of methotrexate, leading to increased toxicity.
Oral Contraceptives
May increase plasma concentrations of ethinyl estradiol, potentially increasing adverse effects of oral contraceptives.
ACE Inhibitors/Angiotensin II Antagonists and Diuretics
May reduce the antihypertensive effect and impair renal function. Increased risk of renal impairment, especially in elderly or dehydrated patients.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of an overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote. Dialysis is unlikely to remove etoricoxib due to its high protein binding. Closely monitor vital signs and manage any arising adverse effects.
Pregnancy & Lactation
Etoricoxib is contraindicated during pregnancy, especially during the third trimester, due to the risk of premature closure of the fetal ductus arteriosus and potential renal dysfunction. It is also contraindicated during lactation as it is unknown whether etoricoxib is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA (Bangladesh) and other international regulatory bodies
Patent Status
Off-patent (for active ingredient)
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy and safety in various pain and inflammatory conditions. Studies have compared its cardiovascular and gastrointestinal safety profile with other NSAIDs.
Lab Monitoring
- Blood pressure monitoring (especially in patients with pre-existing hypertension or those initiating treatment)
- Renal function tests (e.g., serum creatinine, BUN) periodically, especially in long-term use or in patients with risk factors for renal impairment
- Liver function tests (e.g., ALT, AST) periodically, especially in long-term use
- Complete blood count (CBC) to monitor for signs of anemia or other hematologic abnormalities
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration, consistent with individual patient treatment goals.
- Monitor blood pressure regularly, especially at initiation and throughout treatment.
- Assess patient's cardiovascular and gastrointestinal risk factors before prescribing and during treatment.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor, do not exceed the recommended dose or duration.
- Report any new or worsening symptoms, especially stomach pain, black stools, swelling, or chest pain, to your doctor immediately.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs, supplements, and herbal products.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or drowsiness in some individuals. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet and lifestyle. Avoid smoking and excessive alcohol consumption as they can worsen gastrointestinal side effects.
- Regular exercise, as advised by your doctor, can help manage pain and inflammation.
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