Etoricoxib

May be taken with or without food.

Hypersensitivity; history of allergic type reactions (e.g. bronchospasm, acute rhinitis, nasal polysps, angioneurotic oedema, or urticaria) after taking aspirin, NSAIDs, or other cyclooxygenase-2 (COX-2) inhibitors; active peptic ulceration or gastrointestinal haermorhage, inflammatory bowel disease; New York Heart Association (NYHA) class II-IV congestive heart failure, uncontrolled hypertension or with persistently high blood pressure (>140/90 mmHg), established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease (including patients who have recently undergone coronary artery bypass graft surgery or angioplasty. Children and adolescent <16 years. Renal (CrCl <30 mL/min) and severe hepatic (Child-Pugh ≥10) impairment. Pregnancy and lactation.

Patient with a history of gastrointestinal disease (e.g. ulceration, gastrointestinal bleeding), with a predispostion for CV events (e.g. hyperlipidaemia, hypertension, diabetes mellitus, smoking), uncompensated heart failure, cirrhosis, history of cardiac failure, left ventricular dysfunction, pre-existing oedema, dehydration. Use may mask the signs and symptoms of infection. Mild to moderate hepatic impairment. Elderly. Patient Counselling This drug may cause dizziness, vertigo, or somnolence; if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure during treatment, within 2 weeks after initiation of treatment, and periodically thereafter; renal function, hepatic function, basic metabolic panel. Asses for weight gain, oedema, and signs and symptoms of haemorrhage.

Significant: Fluid retention; new-onset or exacerbation of oedema, hypertension, new-onset or recurrent CHF; increased ALT or AST, hypersensitivity reactions (e.g. anaphylaxis, angioedema). Cardiac disorders: Palpitations, arrhythmia. Gastrointestinal disorders: Abdominal pain, constipation, flatulence, gastritis, acid reflux, diarrhoea, dyspepsia, epigastric discomfort, nausea, vomiting, oesophagitis, oral ulcer. General disorders and administration site conditions: Asthenia, fatigue, flu-like disease. Infections and infestations: Alveolar osteitis. Nervous system disorders: Headache, dizziness. Respiratory, thoracic and mediastinal disorders: Bronchospasm. Skin and subcutaneous tissue disorders: Ecchymosis.
Potentially Fatal: Gastrointestinal perforations, ulcers, or haemorrhage, CV thrombotic events (e.g. MI, stroke). Rarely, exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis.

Increased INR with anticoagulants (e.g. warfarin). May diminish the therapeutic effect of diuretics and antihypertensive agents. May increase the risk of gastrointestinal ulceration with aspirin (even at low doses). Increased plasma concentrations of ethinylestradiol, lithium, methotrexate, and other drugs metabolised by human sulfotransferases (e.g. oral salbutamol, minoxidil). Decreased plasma concentrations with rifampicin.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

M01AH05 - etoricoxib ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, coxibs.