Ebicox

Etoricoxib

Symptomatic relief of OA, RA, ankylosing spondylitis, pain & signs of inflammation associated w/ acute gouty arthritis in adults & adolescents ≥16 yr. Short term treatment of moderate pain associated w/ dental surgery.

OA 30 mg once daily. May be increased to 60 mg once daily if relief of symptoms is insufficient. Max: 60 mg daily. RA & ankylosing spondylitis 60 mg once daily. May be increased to 90 mg once daily if relief of symptoms is insufficient. Down-titration to 60 mg once daily if patient is clinically stabilized. Max: 90 mg daily. Acute gouty arthritis 120 mg once daily for 8 days. Post-op dental surgery pain 90 mg once daily, limited to max of 3 days. Mild hepatic dysfunction (Child-Pugh score 5-6) Max: 60 mg once daily. Moderate hepatic dysfunction (Child-Pugh score 7-9) Max: 30 mg once daily.

May be taken with or without food.

Hypersensitivity. Patients w/ history of stroke (CVA), heart attack (MI), CABG, uncontrolled HTN, CHF (NYHA II-IV). Active peptic ulceration or active GI bleeding. Patients who experience bronchospasm, acute rhinitis, nasal polyps, angioneurotic oedema, urticaria, or allergic-type reactions after taking ASA or NSAIDs including COX-2 inhibitors. Inflammatory bowel disease. Established ischaemic heart disease, peripheral arterial disease, &/or cerebrovascular disease. Severe hepatic dysfunction (serum albumin <25 g/L or Child-Pugh score ≥10). Estimated renal CrCl <30 mL/min. Pregnancy & lactation. Childn & adolescents <16 yr.

Hypersensitivity reactions eg, anaphylaxis & angioedema. Patients at risk of developing GI complication eg, those using any other NSAID or ASA concomitantly or those w/ prior history of GI disease eg, ulceration & GI bleeding. Patients w/ significant risk factors for CV events (eg, HTN, hyperlipidemia, DM, smoking). Not a substitute for ASA for prophylaxis of CV thromboembolic diseases. Preexisting significantly impaired renal function, uncompensated heart failure, or cirrhosis; history of cardiac failure, left ventricular dysfunction, pre-existing oedema. Fluid retention, oedema & HTN. Monitor patients w/ symptoms &/or signs suggesting liver dysfunction, or in whom an abnormal LFT has occurred. Dismiss use if signs of hepatic insufficiency occur, or if persistently abnormal LFTs (3 x ULN) are detected. Discontinue therapy when any of the organ system functions deteriorate; at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity. Patients w/ dehydration. Serious skin reactions including exfoliative dermatitis, SJS, TEN. May mask fever & other signs of inflammation. Co-administration w/ warfarin or other oral anticoagulants. Refrain from driving or operating of machinery if experiencing dizziness, vertigo or somnolence. Not recommended in women attempting to conceive. Elderly.

Abdominal pain. Alveolar osteitis; oedema/fluid retention; dizziness, headache; palpitations, arrhythmia; HTN; bronchospasm; constipation, flatulence, gastritis, heartburn/acid reflux, diarrhea, dyspepsia/epigastric discomfort, nausea, vomiting, oesophagitis, oral ulcer; increased ALT & AST; ecchymosis; asthenia/fatigue, flu-like disease.

Closely monitor prothrombin time INR when concomitantly used w/ oral anticoagulants. May reduce effect of diuretics, ACE inhibitors, AIIA & other antihypertensive drugs. Further deterioration of renal function, including possible acute renal failure w/ ACE inhibitors or AIIA in some patients w/ compromised renal function. Increased rate of GI ulceration or other complications w/ low-dose ASA. May increase the nephrotoxic effect of cyclosporin or tacrolimus. Decreased renal excretion & increased plasma levels of lithium. Adequate monitoring for toxicity when concomitantly administered w/ MTX; digoxin. Increased conc & exposure of OCs (ethinyl estradiol) or HRT (estrogen). May increase serum conc of drugs metabolized by human sulfotransferases (eg, oral salbutamol & minoxidil). Increased AUC w/ ketoconazole. Slight increase in exposure w/ oral voriconazole or topical miconazole oral gel, strong CYP3A4 inhibitors. Decreased plasma conc w/ rifampicin.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

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

Rx