Temcox
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| temcox 60 mg tablet | ৳ 6.50 | ৳ 65.00 |
Description
Overview of the medicine
Temcox 60 mg Tablet contains Etoricoxib, a selective COX-2 inhibitor, used to relieve pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, and acute gouty arthritis. It works by reducing the production of certain chemical messengers that cause pain and swelling.
Uses & Indications
Dosage
Adults
Osteoarthritis: 30 mg or 60 mg once daily. Rheumatoid Arthritis/Ankylosing Spondylitis: 60 mg or 90 mg once daily. Acute Gouty Arthritis/Acute Pain: 120 mg once daily for a maximum of 8 days. Dosage should not exceed 120 mg/day.
Elderly
No dosage adjustment is generally required for elderly patients, but caution is advised due to potential age-related decrease in renal function.
Renal_impairment
For patients with mild to moderate renal impairment, no dosage adjustment is necessary. Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min).
How to Take
Temcox tablets are for oral administration. They can be taken with or without food. For faster onset of action, it is advisable to take the tablet without food.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2) enzyme, which is responsible for the synthesis of prostaglandins involved in inflammation, pain, and fever. By inhibiting COX-2, it reduces prostaglandin production, leading to anti-inflammatory, analgesic, and antipyretic effects, while preserving the beneficial physiological functions of COX-1.
Pharmacokinetics
Onset
Analgesic effects typically begin within 1 hour after a single oral dose.
Excretion
Approximately 70% of the dose is excreted in the urine and 20% in the feces as metabolites.
Half life
The elimination half-life is approximately 20-26 hours, allowing for once-daily dosing.
Absorption
Rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 1 hour after administration. Oral bioavailability is high (approximately 100%).
Metabolism
Extensively metabolized, primarily by cytochrome P450 (CYP) enzymes, particularly CYP3A4, to 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 impairment (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
Drug Interactions
Lithium
May increase plasma lithium levels, requiring monitoring.
Warfarin
May increase the anticoagulant effect of warfarin, increasing bleeding risk.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Methotrexate
May increase methotrexate plasma concentrations, leading to increased toxicity.
Oral Contraceptives
May increase plasma concentrations of oral contraceptive hormones.
Other NSAIDs/Aspirin
Concomitant use with other NSAIDs or high-dose aspirin is not recommended due to increased risk of gastrointestinal adverse effects.
ACE Inhibitors/Angiotensin Receptor Blockers (ARBs)
May reduce the antihypertensive effect of these drugs 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 overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for etoricoxib. Hemodialysis does not effectively remove etoricoxib from the body.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential adverse effects on the fetus (premature closure of ductus arteriosus). Avoid during lactation as etoricoxib is excreted in breast milk. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the tablet
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic dysfunction
- Severe renal impairment (creatinine clearance <30 mL/min)
- Congestive heart failure (NYHA II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
Drug Interactions
Lithium
May increase plasma lithium levels, requiring monitoring.
Warfarin
May increase the anticoagulant effect of warfarin, increasing bleeding risk.
Diuretics
May reduce the natriuretic effect of loop and thiazide diuretics.
Methotrexate
May increase methotrexate plasma concentrations, leading to increased toxicity.
Oral Contraceptives
May increase plasma concentrations of oral contraceptive hormones.
Other NSAIDs/Aspirin
Concomitant use with other NSAIDs or high-dose aspirin is not recommended due to increased risk of gastrointestinal adverse effects.
ACE Inhibitors/Angiotensin Receptor Blockers (ARBs)
May reduce the antihypertensive effect of these drugs 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 overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote for etoricoxib. Hemodialysis does not effectively remove etoricoxib from the body.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential adverse effects on the fetus (premature closure of ductus arteriosus). Avoid during lactation as etoricoxib is excreted in breast milk. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture when stored under recommended conditions.
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by major regulatory authorities
Patent Status
Generic available
Clinical Trials
Etoricoxib has undergone extensive clinical trials demonstrating its efficacy and safety for various indications, including osteoarthritis, rheumatoid arthritis, and acute pain. Post-marketing surveillance data also contribute to its safety profile.
Lab Monitoring
- Regular monitoring of blood pressure, especially in patients with pre-existing hypertension.
- Periodic monitoring of renal function (e.g., serum creatinine, BUN) in patients with impaired renal function or those on long-term therapy.
- Liver function tests (e.g., ALT, AST) may be considered, particularly with prolonged use.
Doctor Notes
- Before prescribing, assess patient's cardiovascular risk factors and history of gastrointestinal issues.
- Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Monitor blood pressure regularly, especially in hypertensive patients.
- Advise patients on signs and symptoms of cardiovascular and gastrointestinal adverse events.
Patient Guidelines
- Take Temcox exactly as prescribed by your doctor. Do not exceed the recommended dose.
- Report any unusual bleeding, persistent stomach pain, or signs of allergic reaction (e.g., rash, swelling of face/throat) immediately to your doctor.
- Be aware of the potential cardiovascular risks; discuss any heart-related concerns with your doctor.
- Do not take this medicine for longer than recommended by your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, 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
Temcox may cause dizziness, vertigo, or somnolence in some individuals. Patients should be cautious when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain a healthy diet and lifestyle. Avoid excessive alcohol consumption, especially if you have a history of gastrointestinal issues.
- Regular exercise, as appropriate for your condition, can help manage pain and inflammation.
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