Etoricoxib information from DrugsUpdate
P - Caution when used during pregnancy
L - Contraindicated in lactation
Etoricoxib is a COX-2 selective inhibitor (approx. 106.0 times more selective for COX-2 inhibition over COX-1) from Merck & Co. Doses are 60, 90 mg/day for chronic pain and 120 mg/day for acute pain. Currently it is approved in more than 60 countries worldwide but not in the US, where the Food and Drug Administration (FDA) requires additional safety and efficacy data for etoricoxib before it will issue approval. Current therapeutic indications are: treatment of rheumatoid arthritis, psoriatic arthritis, osteoarthritis, ankylosing spondylitis, chronic low back pain, acute pain and gout. Note that approved indications differ by country.
Like any other COX-2 selective inhibitor, Etoricoxib selectively inhibits isoform 2 of cyclo-oxigenase enzyme (COX-2). This reduces the generation of prostaglandins (PGs) from arachidonic acid. Among the different functions exerted by PGs, their role in the inflammation cascade should be highlighted. COX-2 selective inhibitor (aka "COXIB") showed less marked activity on type 1 cycloxigenase compared to traditional non-steroidal anti-inflammatory drugs (NSAID). This reduced activity is the cause of reduced gastrointestinal toxicity, as demonstrated in several large clinical trials performed with different COXIB.
Pharmacodynamics
Pharmacokinetics
Etoricoxib selectively inhibits cyclooxygenase 2 (COX-2).
Etoricoxib Indications / Etoricoxib Uses
Information Not Available
Etoricoxib Adverse Reactions / Etoricoxib Side Effects
GI disorders; ischemic cardiac events; hypersensitivity reactions, headache, dizziness, nervousness, depression, drowsiness, insomnia, vertigo, tinnitus, photosensitivity; blood disorders, fluid retention, hypertension; dry mouth, taste disturbance, mouth ulcers; appetite and wt changes; chest pain, fatigue, paraesthesia, influenza-like syndrome, myalgia. Renal toxicity.
Precautions
Information Not Available
Special Precautions
Allergic disorders, coagulation defects; history of cardiac failure, left ventricular dysfunction, hypertension, or in patients with oedema due to other reasons; elderly, renal, cardiac or hepatic impairment. Withdraw treatment if GI lesions develop; caution when admin to dehydrated patients. Regular BP monitoring is advisable. May mask fever and other signs of infection. Pregnancy.
Other Drug Interactions
CYP3A4 inhibitors or inducers; rifampicin, ethinyloestradiol; oral salbutamol and minoxidil. Antidepressant SSRIs and venlafaxine may increase risk of bleeding. Risk of side effects increased with concomitant use of aspirin, ciclosporin, ketorolac or other NSAIDs. Lithium and methotrexate, coumarins, phenindione, phenytoin and sulphonylureas.
Other Interactions
Information Not Available
Dosage
Oral
Osteoarthritis
Adult: 60 mg once daily.
Hepatic impairment: Mild impairment (Child-Pugh score of 5 or 6): 60 mg once daily; moderate impairment (Child-Pugh 7-9): 60 mg every other day. Avoid in severe hepatic impairment (Child-Pugh ≥10).
Oral
Rheumatoid arthritis
Adult: 90 mg once daily.
Hepatic impairment: Mild impairment (Child-Pugh score of 5 or 6): 60 mg once daily; moderate impairment (Child-Pugh 7-9): 60 mg every other day. Avoid in severe hepatic impairment (Child-Pugh ≥10).
Oral
Acute gout
Adult: 120 mg once daily. Max duration: 8 days.
Hepatic impairment: Mild impairment (Child-Pugh score of 5 or 6): 60 mg once daily; moderate impairment (Child-Pugh 7-9): 60 mg every other day. Avoid in severe hepatic impairment (Child-Pugh ≥10).
Food(before/after)
May be taken with or without food
List of Contraindications
Etoricoxib and Pregnancy
Caution when used during pregnancy
Etoricoxib and Lactation
Contraindicated in lactation
Etoricoxib and Children
Information Not Available
Etoricoxib and Geriatic
Information Not Available
Etoricoxib and Other Contraindications
Inflammatory bowel disease, severe congestive heart failure, active peptic ulceration, cerebrovascular disease, CrCL <30 ml/min; lactation. Children and adolescent < 16 years.
Storage
Information Not Available
Lab interference
Information Not Available
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