drugs

ARCOXIA ® Etoricoxib

ARCOXIA ® is a drug based on Etoricoxib

THERAPEUTIC GROUP: Non-steroidal anti-inflammatory and antirheumatic drugs

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications ARCOXIA ® Etoricoxib

ARCOXIA ® is indicated for the symptomatic treatment of inflammatory joint conditions associated with rheumatoid arthritis, ankylosing spondyloarthritis, osteoarthritis and acute gout attacks.

Mechanism of action ARCOXIA ® Etoricoxib

The etoricoxib, active principle of ARCOXIA ®, is a new anti-inflammatory drug characterized by the greater efficacy of action than its predecessors such as celecoxib, with which however it shares the same mechanism of action.

In fact this active principle is able to selectively inhibit cyclooxygenases 2, enzymes responsible for the conversion of arachidonic acid into chemical mediators endowed with pro-inflammatory, pain and algogenic activity commonly known as prostaglandins.

The peculiarity of this enzyme, which therefore differentiates it from cyclooxygenase 1, is its expression induced by injurious processes affecting various tissues, thus resulting in a key enzyme in the genesis of phlogistic processes.

On the contrary, the COX1, constitutively expressed by the various tissues, and in particular from the gastro-enteric tissue, mediate the synthesis of various prostanoids involved in the reduction of gastric acidity, in the increase of mucus secretion, in the control of renal homeostasis and unfortunately also in the control in positive terms of platelet aggregation and vasoconstriction.

For this reason, taking ARCOXIA ®, even though it is objectively effective and safe for the gastro-enteric mucosa, could, especially in predisposed patients, increase the risk of cardiovascular diseases.

Studies carried out and clinical efficacy

1. THE GOOD TOLERABILITY OF THE ETHORICOXIB

Eur Ann Allergy Clin Immunol. 2010 Dec; 42 (6): 216-20.

Long-term tolerability of etoricoxib in different types of NSAID-intolerant subjects.

Study demonstrating good long-term tolerability of etoricoxib in patients with a history of hypersensitivity to other non-steroidal anti-inflammatory drugs. This evidence could be important in providing a therapeutic alternative to the hypersensitive NSAID patient.

2. THE ETORICOXIB IN THE PREVENTION OF CANCER TO COLON

Eur J Cancer Prev. 2010 Jul; 19 (4): 280-7.

Chemopreventive role of etoricoxib (MK-0663) in experimental colon cancer: induction of mitochondrial proapoptotic factors.

Interesting experimental study that demonstrates how treatment with etoricoxib for six weeks may present a preventive action against colon cancer (chemically induced), modulating the various apoptotic pathways and thus balancing the proliferation / differentiation relationship.

3. THE ETHORICOXIB IN THE POST-OPERATIVE PAIN CONTROL

J Med Assoc Thai. 2008 Jan; 91 (1): 68-73.

Prevention of post operative pain after abdominal hysterectomy by single doseetoricoxib.

Work demonstrating that a single dose of 120 mg etoricoxib can be effective in reducing post-operative pain following abdominal hysterectomy, also reducing the consumption of opiate painkillers.

Method of use and dosage

ARCOXIA ®

Coated tablets of 30, 60, 90 and 120 mg of etoricoxib.

Depending on the patient's physiopathological conditions, the severity of the clinical picture and the tolerability of the drug, the usable daily dose of etoricoxib could vary from 30 to 120 mg.

Thanks to the long half-life of the drug, estimated at around 22 hours, and the relative safety for the gastro-enteric mucosa, it is possible to take the dose in a single daily dose not necessarily in conjunction with meals.

Variations in standard dosages should be considered by the doctor in the case of elderly patients or those with kidney and liver disease.

Warnings ARCOXIA ® Etoricoxib

ARCOXIA ® therapy should be considered as a short-term therapy, useful to overcome the acute pain symptomatology present during inflammatory processes at the joint level.

The need to limit both the doses and the duration of the intervention to the minimum necessary is justified by the numerous experimental evidences that show how the incidence and severity of the side effects are directly proportional to the dose and duration of administration of etoricoxib.

All treatment should be supervised by your doctor, who in turn should ascertain the overall health status of the patient and specific to organs such as the liver, kidney and cardiovascular system.

Particular caution in the administration of ARCOXIA ® should be reserved for patients suffering from gastro-intestinal, cardiovascular, hepatic and renal diseases, note the greater susceptibility to the side effects of anti-inflammatory therapy.

The possible appearance of side effects, should alarm the patient, who after consulting his doctor could consider the possibility of suspending the therapy in progress.

ARCOXIA ® contains lactose, therefore it is not recommended in patients suffering from lactose intolerance, lactase enzyme deficiency or glucose-galactose malabsorption syndrome.

Given the ability of etoricoxib to temporarily compromise the patient's alertness and concentration, it would be advisable to avoid driving cars or using machines after taking ARCOXIA ®.

PREGNANCY AND BREASTFEEDING

The absence of clinical trials able to characterize the safety profile of etoricoxib for fetal health and the presence instead of experimental data that demonstrate a potential toxic activity of coxibs against the fetus, push pharmaceutical companies and international agencies to contraindicate the intake of ARCOXIA ® during pregnancy.

Similarly, given the possibility of finding the active ingredient in significant concentrations in breast milk, it would be advisable to avoid taking this drug even during the subsequent breastfeeding period.

Interactions

The hepatic metabolism to which etoricoxib is subjected on the one hand, and the numerous biological implications of therapy with selective NSAIDs on the other, exposes the patient subjected to ARCOXIA ® therapy to numerous possible drug interactions, some of which are clinically relevant.

For this reason the patient should pay particular attention to the simultaneous assumption of:

  • Oral anticoagulants, due to possible variations due to normal coagulation processes;
  • ACE inhibitors, angiotensin II antagonists, cyclosporin and tacrolimus for their ability to enhance the nefro and hepatotoxic properties of etoricoxib;
  • Fluconazole and other active ingredients inducers or inhibitors of CYP2C9, given the ability to vary the pharmacokinetic characteristics of etoricoxib.

At the same time it would be useful to also consider the effects of etoricoxib on the metabolism of other drugs, such as antidepressants, neuroleptics and antiarrhythmics, whose simultaneous administration could significantly vary its therapeutic characteristics.

Contraindications ARCOXIA ® Etoricoxib

The use of ARCOXIA ® is contraindicated in case of hypersensitivity to the active ingredient or to one of its excipients, hepatic and renal insufficiency, chronic inflammatory diseases of the intestine, peptic ulcer, congestive heart failure, ischemic heart disease and arteriopathies and vasculopathies both central and peripherals.

Undesirable effects - Side effects

Despite the selectivity of action of etoricoxib has significantly limited the potential histological damage to the gastro-enteric mucosa, the intake of ARCOXIA ® is not without side effects, whose incidence seems to be directly proportional to the duration of the therapy and to the doses used.

Among the most frequent adverse reactions it was possible to describe the presence of dizziness, headache, palpitations, gastrointestinal disorders such as nausea, flatulence and abdominal pain, hepatotoxicity, nephrotoxicity, asthenia and flu-like symptoms, hypertension, visual and hearing disorders, cardiac and vascular pathologies and hypersensitivity reactions both cutaneous and vascular.

Note

ARCOXIA ® is a prescription-only drug.