Etovex 60/Etovex 90/Etovex 120

Etoricoxib

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

OA 30 mg once daily, may increase to 60 mg once daily if relief from symptoms is insufficient. Max: 60 mg daily. RA & ankylosing spondylitis 60 mg once daily, may increase to 90 mg once daily if relief from symptoms is insufficient. May down-titrate to 60 mg once daily once 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 to a 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. 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. CHF (NYHA II-IV). Patients w/ HTN whose BP is persistently elevated >140/90 mmHg & has not been adequately controlled. Established ischaemic heart disease, peripheral arterial disease, &/or cerebrovascular disease. Severe hepatic dysfunction (serum albumin <25 g/L or Child-Pugh score ≥10). Renal CrCl <30 mL/min. Pregnancy & lactation. Childn & adolescents <16 yr.

Discontinue use at the 1st appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity. Rehydrate patients prior to starting therapy. May mask fever & other signs of inflammation. Upper GI complications [perforations, ulcers or bleedings (PUBs)]. Risk of thrombotic events (especially MI & stroke). Patients w/ risk factors for CV events (eg, HTN, hyperlipidaemia, DM, smoking). Not a substitute for ASA for prophylaxis of CV thromboembolic diseases. Fluid retention, oedema & HTN have been observed; can be associated w/ new onset or recurrent CHF. Discontinue if signs of hepatic insufficiency occur, or if persistently abnormal LFTs are detected. Periodically re-evaluate need for symptomatic relief & response to therapy, especially in patients w/ OA. Monitor renal function in patients w/ preexisting impaired renal function, uncompensated heart failure, or cirrhosis. Monitor BP w/in 2 wk after initiation of treatment & periodically thereafter. Concomitant use w/ warfarin or other oral anticoagulants; any other NSAIDs & ASA (even at low doses). Galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. Renal, hepatic, or cardiac dysfunction. Discontinue use if a woman becomes pregnant during treatment. Not recommended in women attempting to conceive. Discontinue use during pregnancy & lactation. Elderly.

Abdominal pain. Alveolar infections; oedema/fluid retention; dizziness, headache; palpitations; HTN; bronchospasm; constipation, flatulence, heartburn, diarrhoea, dyspepsia/epigastric discomfort, nausea, vomiting, oesophagitis, oral ulcer; increased ALT/AST; ecchymosis; asthenia/fatigue, flu-like disease. Nephrotoxicity including interstitial nephritis & nephrotic syndrome; hepatotoxicity including hepatic failure.

Increased prothrombin time INR w/ warfarin & other oral anticoagulants. May reduce effects of diuretics & other antihypertensives. Further deterioration of renal function including possible acute renal failure w/ ACE inhibitors & AIIA. Increased rate of GI ulceration or other complications w/ low-dose ASA. May increase nephrotoxic effects of cyclosporin & tacrolimus. Decreased renal excretion of lithium therefore increase lithium plasma levels. MTX-related toxicity. Increased steady state AUC_0-24hr of ethinyl estradiol. Increased mean steady state AUC_0-24hr of unconjugated estrone, equilin, & 17-β-estradiol. Increased digoxin C_max. Decreased plasma conc w/ rifampicin (potent CYP enzymes inducer) which may result in recurrence of symptoms. Drugs primarily metabolized by human sulfotransferases (eg, oral salbutamol & minoxidil).

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

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

Rx