drugs

Etoricoxib

Generality

Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID), belonging to the group of selective COX-2 inhibitors (or cyclooxygenase 2) and has anti-inflammatory and analgesic properties.

Etoricoxi - Chemical Structure

Etoricoxib is used in the treatment of pain and inflammation caused by different types of diseases.

Examples of medicinal specialties containing Etoricoxib

  • Algix ®
  • Arcoxia ®
  • Tauxib ®

Indications

For what it uses

The use of etoricoxib is indicated for the symptomatic treatment of pain and inflammation caused by diseases such as:

  • Osteoarthritis;
  • Rheumatoid arthritis;
  • Ankylosing spondylitis;
  • Gout.

In addition, etoricoxib can also be used for the short-term treatment of moderate pain that is generated following dental surgery.

Warnings

Before starting therapy with etoricoxib it is necessary to inform your doctor if you are in one of the following conditions:

  • If in the past you suffered from ulceration and / or gastrointestinal bleeding;
  • If you are dehydrated;
  • If you suffer from fluid retention;
  • If you have a history of cardiovascular diseases (heart failure, hypertension, etc.);
  • If you have a history of liver and / or kidney disease;
  • If you are already on treatment for an infection, as etoricoxib can mask the symptoms (such as fever);
  • If you have diabetes;
  • If you suffer from hypercholesterolemia;
  • If you have a smoking habit;
  • If you are over 65 years old.

The etoricoxib can negatively interfere with female fertility, therefore, women who intend to start a pregnancy and who need to start a therapy based on etoricoxib, should talk to their doctor about it.

The etoricoxib can manifest its effect more quickly when taken on an empty stomach. Taking the drug on a full stomach does not reduce its effectiveness, but decreases the speed with which it exerts its anti-inflammatory and analgesic effect.

Finally, etoricoxib can cause undesirable effects that can alter the ability to drive and / or use machinery, so great care should be taken.

Interactions

Because of the drug interactions that could occur, before starting treatment with etoricoxib, you must tell your doctor if you are already taking any of the following drugs:

  • Anticoagulant drugs, such as, for example, warfarin;
  • Rifampicin, an antibiotic;
  • ACE inhibitors and angiotensin II antagonists (antihypertensive drugs);
  • Methotrexate, an anticancer;
  • Lithium salts, drugs used in the treatment of bipolar disorder;
  • Diuretics ;
  • Cyclosporine and tacrolimus, immunosuppressive drugs;
  • Minoxidil ;
  • Digoxin, a drug used to treat heart failure and cardiac arrhythmias;
  • Oral salbutamol, a bronchodilator anti-asthmatic drug;
  • Oral contraceptives;
  • Hormone replacement therapy ;
  • Acetylsalicylic acid .

In fact, etoricoxib can be taken in conjunction with acetylsalicylic acid but only if the latter is used at low doses.

In any case, it is a good idea to inform your doctor if you are taking - or have recently taken - any type of medication, including prescription-free medicines and herbal and homeopathic products.

Side effects

Etoricoxib can cause several side effects, although not all patients experience them.

The type of adverse effects and the intensity with which they occur depend on the sensitivity that each individual has towards the drug.

Listed below are the main side effects that may occur during therapy with etoricoxib.

Gastrointestinal disorders

During treatment with etoricoxib may occur:

  • Pain, swelling or burning in the stomach;
  • Constipation or diarrhea;
  • Flatulence;
  • Dyspepsia;
  • Gastritis;
  • Nausea;
  • He retched;
  • Inflammation of the esophagus;
  • Irritable bowel syndrome;
  • Pancreatitis;
  • Gastroenteritis;
  • Ulceration and / or bleeding of the stomach.

Cardiovascular disorders

Therapy with etoricoxib may cause:

  • Palpitations;
  • Flushing;
  • cardiac arrhythmias;
  • Heart failure;
  • Angina pectoris;
  • Stroke;
  • Transient ischemic attack;
  • Hypertension;
  • Inflammation of blood vessels.

Nervous system disorders

Treatment with etoricoxib may promote the onset of:

  • dizziness;
  • Dizziness;
  • Headache;
  • Drowsiness;
  • Difficulty in falling asleep;
  • Tingling or numbness;
  • Alterations in the sense of taste.

Psychiatric disorders

Treatment with etoricoxib can cause anxiety, depression, confusion, restlessness and hallucinations. Furthermore, the drug can cause a reduction in mental acuity.

Hepatobiliary disorders

Treatment with etoricoxib may cause abnormal liver function tests, liver failure, hepatitis and jaundice.

Kidney and urinary tract disorders

Treatment with etoricoxib may cause abnormal renal function tests and serious kidney damage.

Lung and respiratory tract disorders

Treatment with etoricoxib may cause:

  • Cough;
  • Shortness of breath;
  • bronchospasm;
  • Nose blood.

Blood and lymphatic system disorders

The therapy based on etoricoxib can lead to:

  • Reduced number of red blood cells in the bloodstream;
  • Leukopenia, ie the decrease in the number of leukocytes in the bloodstream;
  • Plateletopenia, ie the decrease in the number of platelets in the blood.

Other side effects

Other side effects that may occur during treatment with etoricoxib are:

  • Allergic reactions, even serious, in sensitive individuals;
  • Angioedema;
  • Edema;
  • alveolitis;
  • Even severe skin reactions;
  • Weakness and fatigue;
  • Flu-like symptoms;
  • Increase or decrease in appetite;
  • Increased body weight;
  • Blurred vision;
  • Redness or irritation of the eyes;
  • Tinnitus;
  • Chest pain;
  • Cramps or muscle spasms;
  • Muscle pain or stiffness;
  • Increased blood levels of potassium (hyperkalemia);
  • Decreased blood levels of sodium (hyponatremia).

Overdose

If you suspect you have taken an overdose of medication, you must contact your doctor immediately or go to the nearest hospital.

Action mechanism

Etoricoxib is a selective COX-2 inhibitor and, as such, exerts its anti-inflammatory and analgesic activity by inhibiting cyclooxygenase 2.

COX-2 is one of three known isoforms (COX-1, COX-2 and COX-3) of the cyclooxygenase enzyme.

COX-1 is a constitutive isoform, normally present in cells and involved in the mechanisms of cellular homeostasis.

COX-2, on the other hand, is an inducible isoform, which is produced by inflammatory cells (inflammatory cytokines) activated. The task of these enzymes is to convert arachidonic acid into prostaglandins, prostacyclines and thromboxanes.

Prostaglandins - and in particular prostaglandins G2 and H2 (PGG2 and PGH2) - are involved in inflammatory processes and mediate pain responses. While type E prostaglandins (PGE) induce an increase in body temperature.

Therefore - through the selective inhibition of COX-2 - etoricoxib hinders the synthesis of prostaglandins responsible for inflammation and pain. In doing so, the drug is able to give relief to patients suffering from pathologies such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis or gout and to relieve post-operative pain in those patients who have undergone dental surgery.

Mode of Use - Posology

Etoricoxib is available for oral administration in the form of coated tablets.

During treatment with etoricoxib it is essential to scrupulously follow the instructions given by the doctor, both as regards the amount of drug to be taken and the duration of the treatment itself.

Following are some indications on the doses of etoricoxib usually used in therapy.

Patients with liver disease may need a reduction in the dose of medication usually administered.

Furthermore, it should be remembered that etoricoxib should only be used for the treatment of acute and non-chronic pain.

Symptomatic treatment of osteoarthritis

For the treatment of pain and inflammation caused by osteoarthritis, the usual dose of etoricoxib is 30 mg, to be taken once a day. If necessary, your doctor may increase the dose of medication up to a maximum of 60 mg a day.

Symptomatic treatment of rheumatoid arthritis and ankylosing spondylitis

For the treatment of inflammation and pain caused by rheumatoid arthritis or ankylosing spondylitis, the dose of etoricoxib usually used is 90 mg, to be taken once a day.

Symptomatic treatment of gout

For the treatment of pain caused by gout, the dose of etoricoxib usually administered is 120 mg a day. The duration of treatment should not exceed eight days.

Treatment of post-operative pain following dental surgery

For the treatment of post-operative pain following dental surgery, the recommended etoricoxib dose is 120 mg per day. The duration of therapy should not exceed three days.

Pregnancy and breastfeeding

Due to the damage it could cause to the fetus or baby, the use of etoricoxib by pregnant women - whether known or presumed to be - and by breastfeeding mothers is not recommended.

In any case, before taking any type of drug, this category of patients must always seek the advice of the doctor.

Contraindications

The use of etoricoxib is contraindicated in the following cases:

  • In patients with known hypersensitivity to etoricoxib itself or to other selective COX-2 inhibitors;
  • In patients with known hypersensitivity to other NSAIDs;
  • In patients with ulcer and / or gastrointestinal bleeding;
  • In patients suffering from liver and / or kidney diseases;
  • In patients suffering from heart disease (heart failure, angina pectoris, myocardial infarction);
  • In patients who have suffered from stroke;
  • In patients who have suffered from peripheral arterial disease;
  • In patients with uncontrolled hypertension;
  • In patients with ulcerative colitis or Crohnmorbo's;
  • In patients less than 16 years of age;
  • Pregnant;
  • During breastfeeding.