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Etoricoxib – Uses, Dosage and Side Effects

Etoricoxib is a prescription medication belonging to the class of COX-2 inhibitors, used to relieve pain and inflammation in conditions such as osteoarthritis, rheumatoid arthritis, and gout.

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Things worth knowing about "Etoricoxib"

Etoricoxib is a prescription medication belonging to the class of COX-2 inhibitors, used to relieve pain and inflammation in conditions such as osteoarthritis, rheumatoid arthritis, and gout.

What is Etoricoxib?

Etoricoxib is an anti-inflammatory and analgesic (pain-relieving) drug classified as a selective Cyclooxygenase-2 (COX-2) inhibitor. It belongs to the broader family of nonsteroidal anti-inflammatory drugs (NSAIDs) and is marketed under the brand name Arcoxia in many countries. Etoricoxib is available by prescription only and is used to manage pain and inflammation associated with various musculoskeletal and joint conditions.

Indications (Uses)

Etoricoxib is approved for the treatment of the following conditions:

Osteoarthritis (degenerative joint disease)
Rheumatoid arthritis (chronic inflammatory joint disease)
Ankylosing spondylitis (a form of inflammatory spinal arthritis)
Acute gouty arthritis
Chronic musculoskeletal pain

Mechanism of Action

Etoricoxib works by selectively inhibiting the enzyme Cyclooxygenase-2 (COX-2), which plays a key role in the production of prostaglandins – signaling molecules that promote inflammation, pain, and fever in the body. By targeting COX-2 specifically, etoricoxib reduces inflammatory responses and pain without significantly affecting COX-1. Since COX-1 helps protect the stomach lining, selective COX-2 inhibitors like etoricoxib generally carry a lower risk of gastrointestinal ulcers compared to traditional NSAIDs.

Dosage and Administration

Etoricoxib is taken orally as a film-coated tablet. The recommended dose depends on the condition being treated:

Osteoarthritis: 30–60 mg once daily
Rheumatoid arthritis / Ankylosing spondylitis: 60–90 mg once daily
Acute gout attack: 120 mg once daily (for a maximum of 8 days)

The lowest effective dose should always be used for the shortest possible duration. Etoricoxib can be taken with or without food.

Side Effects

Like all medications, etoricoxib can cause side effects. Common and clinically important side effects include:

High blood pressure (hypertension) – one of the most frequently reported side effects
Edema (fluid retention in the legs and ankles)
Gastrointestinal complaints (nausea, abdominal pain, dyspepsia)
Elevated liver enzyme levels
Increased risk of cardiovascular events (heart attack, stroke) with prolonged use
Headache and dizziness

Contraindications

Etoricoxib must not be used in patients with:

Known hypersensitivity to the active substance
Established or prior coronary artery disease, heart failure, peripheral arterial disease, or stroke
Uncontrolled high blood pressure
Severe hepatic (liver) impairment
Severe renal (kidney) impairment
Active gastrointestinal ulcers or bleeding
Pregnancy (third trimester) and breastfeeding
Children and adolescents under 16 years of age

Drug Interactions

Etoricoxib may interact with a number of other medications:

Anticoagulants (e.g., warfarin): Increased bleeding risk – regular INR monitoring is recommended
Diuretics and antihypertensives: Reduced blood pressure-lowering effect possible
Lithium: Increased lithium plasma levels possible
Methotrexate: Increased methotrexate toxicity possible
Other NSAIDs or aspirin: Increased risk of gastrointestinal side effects

References

European Medicines Agency (EMA): Arcoxia – Summary of Product Characteristics (SmPC). Available at: www.ema.europa.eu
Patrignani P, Patrono C. Selective COX-2 inhibitors, aspirin-insensitive atherothrombosis, and risk of myocardial infarction. Journal of Thrombosis and Haemostasis. 2005;3(8):1568–1574.
Patrono C, Baigent C. Nonsteroidal anti-inflammatory drugs and the heart. Circulation. 2014;129(8):907–916. doi:10.1161/CIRCULATIONAHA.113.004480

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