Indication

Rheumatoid arthritis, Osteoarthritis, Gout

Administration

May be taken with or without food.

Adult Dose

Oral Osteoarthritis Adult: 30 mg once daily, increased to 60 mg once daily if needed. Ankylosing spondylitis; Rheumatoid arthritis Adult: 90 mg once daily. Acute gout Adult: 120 mg once daily. Max duration: 8 days. Hepatic impairment: Mild (Child-Pugh score of 5-6): 60 mg once daily. Moderate (Child-Pugh 7-9): Max 60 mg every other day or 30 mg once daily. Severe (Child-Pugh >10): Avoid.

Child Dose

Child: <16 yr Contraindicated.

Contraindication

Inflammatory bowel disease, severe congestive heart failure, active peptic ulceration, cerebrovascular disease, CrCL <30 ml/min; lactation. Children and adolescent < 16 yr.

Mode of Action

Etoricoxib is a selective cyclooxygenase-2 (COX-2) inhibitor primarily responsible to reduce mediators of pain and inflammation. Its action is due to inhibition of prostaglandin synthesis via inhibition of COX-2.

Precaution

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.

Side Effect

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.

Interaction

May increase INR w/ oral anticoagulants. May decrease effects of ACE inhibitors, angiotensin II antagonist and diuretics. May increase lithium plasma concentrations. May reduce plasma levels w/ rifampicin. Increased serum concentrations of ethinylestradiol.