Tolec
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tolec 60 mg injection | ৳ 95.29 | N/A |
Description
Overview of the medicine
Tolec 60 mg Injection contains Etoricoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, used for the symptomatic relief of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and for the treatment of acute pain and primary dysmenorrhea. As an injection, it's typically used when rapid onset of action or oral administration is not feasible.
Uses & Indications
Dosage
Adults
Acute pain and primary dysmenorrhea: 60 mg once daily. Post-operative dental pain: 90 mg once daily for a maximum of 3 days. Doses should be individualised based on patient response and tolerability. For injection, typically 60 mg once daily for short-term use.
Elderly
No specific dose adjustment is generally required, but caution is advised due to potential age-related decrease in renal function and increased risk of adverse effects.
Renal_impairment
Patients with severe renal impairment (CrCl <30 mL/min) should not use Etoricoxib. No dose adjustment needed for mild to moderate impairment, but caution is advised.
How to Take
For intramuscular (IM) injection only. Administer slowly into a large muscle. Not for intravenous (IV) administration. Must be administered by a healthcare professional.
Mechanism of Action
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2). COX-2 is responsible for the synthesis of prostaglandins, which are mediators of pain, inflammation, and fever. By inhibiting COX-2, Etoricoxib reduces pain and inflammation.
Pharmacokinetics
Onset
Within 24 minutes for acute pain.
Excretion
Primarily excreted renally (about 70%) and fecally (about 20%) as metabolites.
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed after intramuscular administration, with peak plasma concentrations reached within approximately 1-2 hours.
Metabolism
Extensively metabolized in the liver, primarily via cytochrome P450 (CYP) enzymes, mainly CYP3A4, to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the injection
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic impairment
- 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
- Pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels.
Warfarin
Increased risk of bleeding. Monitor INR.
Methotrexate
Increased plasma methotrexate levels.
Oral Contraceptives
Increased exposure to oral contraceptive components.
Diuretics, ACE inhibitors, Angiotensin II Antagonists
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
In case of overdose, symptoms may include gastrointestinal disturbances, somnolence, and lethargy. Treatment is symptomatic and supportive. There is no specific antidote.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation. NSAIDs used in the third trimester of pregnancy may cause premature closure of the fetal ductus arteriosus. Consult a doctor before use.
Side Effects
Contraindications
- Hypersensitivity to etoricoxib or any component of the injection
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic impairment
- 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
- Pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels.
Warfarin
Increased risk of bleeding. Monitor INR.
Methotrexate
Increased plasma methotrexate levels.
Oral Contraceptives
Increased exposure to oral contraceptive components.
Diuretics, ACE inhibitors, Angiotensin II Antagonists
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store below 30°C. Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
In case of overdose, symptoms may include gastrointestinal disturbances, somnolence, and lethargy. Treatment is symptomatic and supportive. There is no specific antidote.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation. NSAIDs used in the third trimester of pregnancy may cause premature closure of the fetal ductus arteriosus. Consult a doctor before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Pharmacies, Hospitals, Clinics
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. Studies have shown its non-inferiority to other NSAIDs in pain reduction with a potentially better GI safety profile at recommended doses.
Lab Monitoring
- Renal function (creatinine, BUN)
- Liver function tests (ALT, AST)
- Blood pressure monitoring
- Complete blood count (CBC) with long-term use
Doctor Notes
- Assess cardiovascular risk factors before prescribing, especially for long-term use.
- Use the lowest effective dose for the shortest possible duration.
- Monitor for signs of GI bleeding, renal dysfunction, and hypertension.
- Avoid use in patients with significant renal, hepatic, or cardiac dysfunction.
Patient Guidelines
- Inform your doctor about all your medical conditions and medications before starting this injection.
- Report any signs of gastrointestinal bleeding or cardiovascular issues immediately.
- Do not exceed the recommended dose.
- This injection is for short-term use and severe conditions only.
Missed Dose Advice
Since this is an injection administered by a healthcare professional, missed doses are unlikely in a hospital setting. If an outpatient dose is missed, contact your doctor or nurse for advice. Do not double the dose.
Driving Precautions
Etoricoxib may cause dizziness or somnolence. Patients should exercise caution when driving or operating machinery until they are reasonably certain that Etoricoxib does not adversely affect their ability to perform such activities.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, which can help manage pain and inflammation.
- Avoid smoking and excessive alcohol consumption, especially if you have a history of GI issues.
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