Arcoxia

Arcoxia (etoricoxib) is a prescription-only selective COX-2 inhibitor, a class of nonsteroidal anti-inflammatory drug (NSAID) designed to provide effective management of pain and inflammation associated with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis. It functions by specifically inhibiting the cyclooxygenase-2 (COX-2) enzyme, which plays a key role in mediating pain, inflammation, and fever, while largely sparing the COX-1 enzyme involved in gastric mucosal protection and platelet aggregation. This targeted mechanism offers a favorable efficacy profile for appropriate patient populations under careful medical supervision. It is indicated for adult use only, following a comprehensive cardiovascular and gastrointestinal risk assessment by a qualified healthcare professional.

Features

• Active Ingredient: Etoricoxib
• Drug Class: Selective COX-2 inhibitor NSAID
• Available Strengths: 60 mg, 90 mg, 120 mg film-coated tablets
• Administration: Oral, once daily
• Prescription Status: Prescription-only medication
• Mechanism: Selective inhibition of cyclooxygenase-2 (COX-2) enzyme

Benefits

• Provides potent and sustained relief from chronic inflammatory pain associated with osteoarthritis and rheumatoid arthritis
• Once-daily dosing regimen supports treatment adherence and consistent therapeutic coverage
• Lower incidence of upper gastrointestinal ulceration compared to traditional non-selective NSAIDs
• Effective reduction in joint stiffness and improvement in physical function
• Targeted anti-inflammatory action helps minimize damage from persistent inflammation
• Suitable for long-term management of chronic arthritic conditions under medical supervision

Common use

Arcoxia is primarily indicated for the symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis in adults. It is also approved for the relief of acute dental pain and primary dysmenorrhea in certain markets. The medication is specifically designed for patients who require continuous anti-inflammatory and analgesic therapy and who are at low cardiovascular risk but may benefit from reduced gastrointestinal complications compared to traditional NSAIDs. Treatment should be initiated at the lowest effective dose for the shortest duration consistent with individual treatment goals.

Dosage and direction

The recommended dose varies according to the condition being treated:

• Osteoarthritis: 60 mg once daily
• Rheumatoid arthritis: 90 mg once daily
• Ankylosing spondylitis: 90 mg once daily
• Acute gouty arthritis: 120 mg once daily (for maximum 8 days)

Tablets should be swallowed whole with water, with or without food. The dosage should be individualized based on the patient’s medical condition, response to therapy, and risk factors. For elderly patients and those with mild hepatic impairment, dosage adjustment may be necessary. Not recommended for patients with moderate to severe hepatic impairment.

Precautions

Patients should be carefully evaluated before initiating Arcoxia therapy, particularly regarding cardiovascular risk factors. Blood pressure should be monitored regularly during treatment. Use with caution in patients with a history of hypertension, heart failure, left ventricular dysfunction, or edema. Gastrointestinal risks, though lower than with traditional NSAIDs, still exist—particularly in elderly patients and those with a history of ulcer disease. Renal function should be monitored in patients with pre-existing renal impairment, heart failure, hepatic dysfunction, or those taking diuretics or ACE inhibitors. Arcoxia may mask fever, which is an important sign of infection.

Contraindications

Arcoxia is contraindicated in patients with:

• Known hypersensitivity to etoricoxib or any component of the formulation
• Established ischemic heart disease, peripheral arterial disease, or cerebrovascular disease
• Moderate or severe heart failure (NYHA Class II-IV)
• Inflammatory bowel disease
• Active peptic ulceration or gastrointestinal bleeding
• Severe hepatic dysfunction (Child-Pugh score ≥9)
• Estimated creatinine clearance <30 mL/min
• Third trimester of pregnancy and during lactation
• Under 16 years of age

Possible side effect

Common side effects (≥1/100 to <1/10) include:

• Headache, dizziness
• Hypertension, edema
• Dyspepsia, abdominal pain, nausea, heartburn
• Fatigue
• Increased liver enzymes

Less common but serious side effects requiring immediate medical attention include:

• Signs of gastrointestinal bleeding (melena, hematemesis)
• Symptoms of cardiac ischemia (chest pain, shortness of breath)
• Signs of hepatic injury (jaundice, dark urine, right upper quadrant pain)
• Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
• Signs of anaphylaxis (swelling, difficulty breathing, rash)

Drug interaction

Arcoxia may interact with several medications:

• Warfarin and other anticoagulants: Increased risk of bleeding
• ACE inhibitors, angiotensin II antagonists, diuretics: Reduced antihypertensive effect, increased risk of renal impairment
• Lithium: Increased lithium plasma concentrations
• Methotrexate: Increased methotrexate plasma concentrations
• Rifampicin and other CYP3A4 inducers: Reduced etoricoxib plasma concentrations
• Cyclosporine, tacrolimus: Increased risk of nephrotoxicity
• Other NSAIDs including aspirin: Increased risk of gastrointestinal adverse effects

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Maintaining consistent dosing intervals helps ensure stable therapeutic levels.

Overdose

Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, hypertension, acute renal failure, and respiratory depression. There is no specific antidote for etoricoxib overdose. Management should be supportive and symptomatic, including gastric lavage or activated charcoal if presented within 4 hours of ingestion. Hemodialysis is not effective due to high protein binding. Monitor and support vital functions as necessary.

Storage

Store at room temperature (15-30°C or 59-86°F) in the original container to protect from moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly dispose of any unused medication according to local regulations, preferably through a medicine take-back program.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Arcoxia is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Patients should not initiate, adjust, or discontinue treatment without consulting their physician. The prescribing information provided here may not be comprehensive or current—always refer to the latest official prescribing information and consult with a healthcare provider for personalized medical advice.

Reviews

Clinical studies demonstrate that etoricoxib 60 mg and 90 mg provided significantly better pain relief and functional improvement in osteoarthritis and rheumatoid arthritis compared to placebo, with efficacy comparable to traditional NSAIDs but with improved upper gastrointestinal tolerability. In a meta-analysis of randomized controlled trials, etoricoxib showed consistent effectiveness across various inflammatory conditions with a predictable safety profile when used in appropriate patient populations. Long-term extension studies have confirmed maintained efficacy over 12 months of continuous treatment with stable safety parameters. Patient-reported outcomes consistently show improvements in quality of life measures, particularly in physical function and pain-related interference with daily activities.