ALGIX ® Etoricoxib

ALGIX ® 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 ALGIX ® Etoricoxib

ALGIX® is indicated in the symptomatic treatment of joint pain associated with rheumatic inflammatory diseases such as ankylosing spondylitis, rheumatoid arthritis, osteoarthritis and acute gouty attack.

Recent studies have also demonstrated the efficacy of the active ingredient etoricoxib also in the control of post-operative pain.

Mechanism of action ALGIX ® Etoricoxib

The etoricoxib, active ingredient of ALGIX ®, is a molecule obtained synthetically from pyrazoles, and considered for its therapeutic properties, among the selective non-steroidal anti-inflammatory drugs.

In fact, thanks to its particular chemical structure, it is able to penetrate and recognize only the active pocket of the induced cyclooxygenases (COX2), while sparing those constitutively expressed (COX1).

This selectivity of action allows to inhibit the activity of the enzymes involved in the genesis of the inflammatory process, thus reducing the production of prostaglandins endowed with pro-inflammatory, pyrogenic and painful activity, maintaining instead that of the enzymes constitutively expressed in various tissues, such as the gastro-enteric or renal, thus preserving the activity of prostanoids involved in the protection of the gastric mucosa, in the balance of renal function and in the regulation of vasomotor and platelet aggregating activities.

All the aforementioned biological activities materialize macroscopically into an important pharmacological efficacy of ALGIX ® both as an anti-inflammatory and as a painkiller in the face of a relative gastro-intestinal safety.

To these characteristics, however, is added the inability of etoricoxib to reduce the production of thromboxane A2, a chemical mediator obtained thanks to the activity of COX-1, endowed with vasoconstrictor and platelet pro-aggregating activity, thus increasing the risk of develop cardiovascular accidents.

Studies carried out and clinical efficacy

1. THE ETORICOXIB IN THE TREATMENT OF DISMENORREA

J Obstet Gynaecol. 2008 May; 28 (4): 424-6.

The efficacy of etoricoxib vs mefenamic acid in the treatment of primary dysmenorrhoea: a randomized comparative trial.

Interesting work that demonstrates the good efficacy of etoricoxib in reducing the pain present during primary dysmenorrhea, also reducing menstrual bleeding and its consequences.

2. ETHORICOXIB IN RHEUMATIC DISEASES: EFFECTIVENESS AND TOLERABILITY

Ther Clin Risk Manag. 2006 Mar; 2 (1): 45-57.

Etoricoxib for arthritis and pain management.

Study that demonstrates how therapy with etoricoxib can be effective in the management of joint pain present in rheumatic pathological conditions such as arthritis, but is better tolerated at the gastrointestinal level than the classic NSAIDs.

3.ETORICOXIB AND CURRETAGE

J Med Assoc Thai. 2007 Jun; 90 (6): 1053-7.

Oral etoricoxib for pain relief during fractional curettage: a randomized controlled trial.

Interesting work that demonstrates how the administration of etoricoxib together with the paracervical block can be effective and safe in reducing pain during fractionated curretage.

Method of use and dosage

ALGIX ®

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

The particular pharmacokinetic characteristics of etoricoxib, and in particular the long half-life of about 22 hours, allows the patient to be able to take the daily dose in a single administration.

The therapeutic range able to guarantee a remission of the symptomatology in the great majority of cases goes from 30 to 120 mg of etoricoxib daily; dosage that should necessarily be reviewed in patients with liver and kidney disease or in elderly patients.

Warnings ALGIX ® Etoricoxib

Treatment with ALGIX ® should be interpreted as a symptomatic therapy of short duration, necessary to guarantee a remission of the painful symptoms present during rheumatic diseases.

In order to minimize the incidence and severity of possible side effects, it would be advisable to take the drug in the minimum effective doses and for the shortest period possible.

Patients suffering from gastro-intestinal, cardiovascular, hepatic and renal diseases should pay particular attention to the intake of etoricoxib, given the greater susceptibility to the drug and its unwanted reactions.

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.

ALGIX ® contains lactose, therefore its use is not recommended in patients with lactose intolerance, lactase enzyme deficiency or glucose-galactose malabsorption syndrome.

Given the ability of etorocoxib to transiently reduce the patient's cognitive abilities, the use of machinery and driving of vehicles after taking ALGIX ® is not recommended.

PREGNANCY AND BREASTFEEDING

Taking ALGIX ® in pregnancy is contraindicated due to the absence of clinical trials capable of demonstrating the safety of etoricoxib for fetal health and the results of some experimental studies showing a potential fetotoxicity of the active ingredient.

The aforementioned contraindications also extend to the subsequent breastfeeding period due to the ability of etoricoxib to concentrate in clinically significant quantities even in breast milk.

Interactions

Taking etoricoxib, in light of its particular hepatic metabolism, exposes the drug ALGIX ® to possible drug interactions with other active ingredients, capable of varying its therapeutic efficacy and safety profile.

Particular attention should therefore be given 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.

Finally, it is necessary to consider the inhibiting properties of etoricoxib against cytochromial enzymes, such as to lengthen the half-life of some drugs including antidepressants, anticonvulsants and antiepileptics, thus varying both their therapeutic profile and their safety and tolerability.

Contraindications ALGIX ® Etoricoxib

The use of ALGIX ® 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

Although the selective activity of etoricoxib can reduce the damage to the gastro-intestinal mucosa, making the anti-inflammatory therapy better tolerated, the intake of ALGIX ® is also associated with the appearance of different side effects, whose incidence and whose severity is directly proportional to the dose used and the duration of therapy.

Among the most frequently observed adverse reactions following the intake of ALGIX ®, one could describe: dizziness, headache, palpitations, gastrointestinal disorders such as nausea, flatulence and abdominal pain, hepatotoxicity, nephrotoxicity, asthenia and flu-like symptoms, hypertension, vision and hearing disorders, cardiac and vascular diseases and hypersensitivity reactions, both cutaneous and vascular.