Tory
Generic Name
Etoricoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tory 120 mg tablet | ৳ 15.00 | ৳ 150.00 |
Description
Overview of the medicine
Tory 120 mg tablet contains Etoricoxib, a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain and reduce 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/Dental Surgery: 60 mg or 90 mg once daily for up to 3-5 days. Primary Dysmenorrhea: 120 mg once daily for up to 3 days.
Elderly
No dose adjustment generally required based on age; however, caution should be exercised.
Renal_impairment
Mild to moderate renal impairment: No dose adjustment. Severe renal impairment (CrCl <30 mL/min): Not recommended.
How to Take
Take orally once daily, with or without food. Swallow the tablet whole with water. Do not chew or crush.
Mechanism of Action
Etoricoxib is a selective cyclooxygenase-2 (COX-2) inhibitor. It inhibits the synthesis of prostaglandins, which are mediators of pain, inflammation, and fever, by selectively blocking the COX-2 enzyme without significantly affecting COX-1.
Pharmacokinetics
Onset
Pain relief typically begins within 24 minutes to 1 hour after administration.
Excretion
Primarily excreted in urine (about 70%) and feces (about 20%) as metabolites.
Half life
Approximately 22 hours.
Absorption
Rapidly absorbed after oral administration, peak plasma concentration (Tmax) reached in approximately 1 hour.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 enzymes (CYP3A4), to inactive metabolites.
Side Effects
Contraindications
- Known 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 Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Warfarin
Increased INR and bleeding risk.
Diuretics
Reduced natriuretic effect and increased risk of renal impairment.
Rifampicin
Decreased etoricoxib plasma concentrations.
Methotrexate
Increased plasma methotrexate levels, potentially increasing toxicity.
ACE Inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Oral Contraceptives
Increased exposure to oral contraceptive hormones.
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, and cardiovascular effects. In case of overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation. NSAIDs, including etoricoxib, may cause premature closure of the ductus arteriosus in the fetus if used during the third trimester of pregnancy. Avoid use unless clearly necessary and the potential benefit outweighs the potential risk to the fetus/infant.
Side Effects
Contraindications
- Known 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 Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease
- Pregnancy and lactation
Drug Interactions
Lithium
Increased plasma lithium levels, leading to toxicity.
Warfarin
Increased INR and bleeding risk.
Diuretics
Reduced natriuretic effect and increased risk of renal impairment.
Rifampicin
Decreased etoricoxib plasma concentrations.
Methotrexate
Increased plasma methotrexate levels, potentially increasing toxicity.
ACE Inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Oral Contraceptives
Increased exposure to oral contraceptive hormones.
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, and cardiovascular effects. In case of overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation. NSAIDs, including etoricoxib, may cause premature closure of the ductus arteriosus in the fetus if used during the third trimester of pregnancy. Avoid use unless clearly necessary and the potential benefit outweighs the potential risk to the fetus/infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities (e.g., DGDA)
Patent Status
Generic available, patent expired for active ingredient
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of etoricoxib in various inflammatory conditions, comparing it with other NSAIDs and placebo. Studies often focus on cardiovascular safety profiles.
Lab Monitoring
- Blood pressure monitoring (especially at initiation and during treatment)
- Liver function tests (periodically, especially with long-term use)
- Renal function tests (periodically, especially with long-term use and in at-risk patients)
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration.
- Assess cardiovascular risk factors before and during treatment.
- Monitor blood pressure regularly, especially in hypertensive patients.
- Avoid in patients with established cardiovascular disease or significant risk factors.
- Educate patients on symptoms of GI and CV adverse events.
Patient Guidelines
- Do not exceed the recommended dose.
- Take the lowest effective dose for the shortest duration necessary.
- Report any signs of gastrointestinal bleeding (e.g., black, tarry stools) or cardiovascular issues (e.g., chest pain, shortness of breath) immediately.
- Avoid alcohol while taking this medicine.
- Inform your doctor about all other medications you are taking.
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
May cause dizziness, vertigo, or somnolence. Patients should be cautious when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain a healthy weight to reduce joint stress.
- Engage in regular, low-impact exercise.
- Follow a balanced diet rich in fruits, vegetables, and lean protein.
- Avoid smoking.
- Limit alcohol intake.
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