Indications

Etorix 90 is used to treat the symptoms of-

• Osteoarthritis is a kind of arthritis that affects the joints (OA)
• Rheumatoid arthritis is a kind of arthritis that affects the joints (RA)
• Ankylosing spondylitis, as well as
• The pain and inflammatory symptoms associated with acute gouty arthritis.
• For the short-term relief of mild discomfort caused by dental surgery.

Pharmacology

Within and substantially above the therapeutic dosage range, etoricoxib is a strong, orally active cyclooxygenase-2 (COX-2) selective inhibitor. Cyclooxygenase has two isoforms: cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) (COX-2). COX-1 is responsible for normal physiologic activities mediated by prostaglandins, such as gastric cytoprotection and platelet aggregation. Nonselective NSAIDs that inhibit COX-1 have been linked to stomach damage and platelet aggregation inhibition. COX-2 has been demonstrated to be the primary enzyme responsible for the production of prostanoid pain, inflammation, and fever mediators. Etoricoxib’s selective inhibition of COX-2 (within the therapeutic dosage range) reduces these clinical signs and symptoms while also lowering the risk of Gl toxicity and platelet aggregation. At dosages up to 150 mg daily, etoricoxib caused dose-dependent inhibition of COX-2 without inhibiting COX-1. Etoricoxib had no effect on the production of stomach prostaglandins.

Dosage & Administration

Adult and adolescent over 16 years:

• Osteoarthritis: The recommended dose is 30 mg once daily. In some patients with insufficient relief from symptoms, an increased dose of 60 mg once daily may increase efficacy.
• Rheumatoid arthritis: The recommended dose is 90 mg once daily.
• Ankylosing spondylitis: The recommended dose is 90 mg once daily.
• Acute gouty arthritis: The recommended dose is 120 mg once daily. In clinical trials for acute gouty arthritis, Etoricoxib was given for 8 days.
• Postoperative dental surgery pain: The recommended dose is 90 mg once daily, limited to a maximum of 3 days.

Some patients may require additional postoperative analgesia. As the cardiovascular risks of Etoricoxib may increase with dose and duration of exposure, the shortest duration possible and the lowest effective daily dose should be used. The patient’s need for symptomatic relief and response to therapy should be re-evaluated periodically, especially in patients with osteoarthritis.

Interaction

When it comes to medicine:

• Oral anticoagulants: Etoricoxib administration was linked with an increase in prothrombin time in patients stable on longterm warfarin treatment.
• Diuretics, ACE inhibitors, and Angiotensin II Antagonists: NSAIDs can decrease the effectiveness of diuretics and other hypertension medications.
• Acetylsalicylic Acid: At cardiovascular prophylaxis dosages, etoricoxib can be administered in conjunction with acetylsalicylic acid (low-dose acetylsalicylic acid).
• Ciclosporin with tacrolimus: Although this interaction has not been investigated with Etoricoxib, coadministration of ciclosporin or tacrolimus with any NSAID may enhance ciclosporin or tacrolimus’s nephrotoxic impact.
• Lithium: NSAIDs reduce lithium renal excretion, which raises lithium plasma levels.

With relation to food and others: Take without consideration to meals.

Contraindications

• Hypersensitivity to the active ingredient or any of the excipients
• Active peptic ulcer or active gastro-intestinal (Gl) hemorrhage
• Patients who had bronchospasm, acute rhinitis, nasal polyps, angioneurotic oedema, urticaria, or allergic-type responses after using acetylsalicylic acid or NSAIDs that contained COX-2 (cyclooxygenase-2) inhibitors.
• Lactation and pregnancy
• Severe hepatic impairment (serum albumin level of 25 g/l or Child-Pugh score of 10)
• Renal creatinine clearance is estimated to be 30 ml/min.
• Children and teenagers under the age of 16.
• Inflammatory bowel disease is a condition in which the bowels become inflamed
• Heart failure with congestive heart failure (NYHA ll-IV).
• Patients with hypertension whose blood pressure is consistently higher than 140/90 mmHg and is not effectively managed.
• Ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular illness that has progressed.

Side Effects

Palpitation, fatigue, influenza-like symptoms, and ecchymosis are common side effects; less common side effects include dry mouth, taste disturbance, mouth ulcer, appetite and weight change, atrial fibrillation, transient ischaemic attack, chest pain, flushing, cough, dyspnoea, epistaxis, anxiety, mental acuity impairment, paraesthesia, electrolyte disturbance, myalgia, and arthralgia; very rarely confusion and hall

Pregnancy & Lactation

Etoricoxib, like any other medication that inhibits COX-2, is not suggested for women who are trying to conceive. Etoricoxib is not known to be eliminated in human milk. Lactating rats excrete etoricoxib in their milk. Breastfeeding is not recommended for women who take Etoricoxib.

Precautions & Warnings

• Patients most at risk of developing a gastrointestinal problem from NSAIDs should be treated with caution, including the elderly, those using another NSAID or acetylsalicylic acid concurrently, and those having a history of gastrointestinal illness, such as ulceration and Gl hemorrhage.
• Patients with substantial cardiovascular risk factors (e.g., hypertension, hyperlipidaemia, diabetes mellitus, smoking) should be treated with Etoricoxib only after careful evaluation.
• Etoricoxib use may reduce prostaglandin production and, indirectly, renal blood flow, impairing renal function. Renal function monitoring in such individuals should be explored.
• Patients having a history of heart failure, left ventricular dysfunction, or hypertension, as well as those with pre-existing edema for whatever cause, should proceed with caution.
• Patients who exhibit symptoms and/or indications of liver impairment, or who have an abnormal liver function test, should be closely watched. If symptoms of hepatic insufficiency appear, or if consistently abnormal liver function tests (three times the upper limit of normal) are found, Etoricoxib should be stopped.
• Etoricoxib should be stopped as soon as a skin rash, mucosal sores, or any other symptom of hypersensitivity appears.
• Etoricoxib has the potential to conceal fever and other indications of inflammation. When taking Etoricoxib with warfarin or other oral anticoagulants, use extreme caution.

Therapeutic Class

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Storage Conditions

Protect from light and moisture by storing at a temperature below 30°C. Keep out of children’s reach.

Pharmaceutical Name

Eskayef Pharmaceuticals Ltd

Generic