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.
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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