Etoricoxib

Etoricoxib is a nonsteroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2). It is used to treat acute and chronic pain, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gout. Unlike traditional NSAIDs, etoricoxib selectively inhibits the COX-2 enzyme, which is responsible for the synthesis of pro-inflammatory prostaglandins. This selectivity minimizes gastrointestinal side effects associated with non-selective NSAIDs, which inhibit both COX-1 and COX-2 enzymes.

Pharmacology

Etoricoxib works by selectively inhibiting the enzyme cyclooxygenase-2 (COX-2). COX-2 is involved in the production of prostaglandins, which are substances that mediate inflammation and pain. By inhibiting COX-2, etoricoxib reduces the production of prostaglandins, thereby reducing inflammation and pain. Unlike traditional NSAIDs, etoricoxib does not significantly inhibit COX-1, an enzyme involved in the protection of the stomach lining, thus it has a lower risk of causing gastrointestinal side effects.

Indications

Etoricoxib is indicated for the treatment of:

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Acute pain
• Gout

Contraindications

Etoricoxib is contraindicated in patients with:

• Known hypersensitivity to etoricoxib or any of its components
• Active gastrointestinal bleeding or ulceration
• Severe heart failure
• Severe liver dysfunction
• Severe renal impairment
• Pregnancy and lactation

Side Effects

Common side effects of etoricoxib include:

• Hypertension
• Dyspepsia
• Nausea
• Headache
• Dizziness

Serious side effects may include:

• Cardiovascular events such as heart attack and stroke
• Gastrointestinal bleeding, ulceration, and perforation
• Severe skin reactions
• Liver and kidney impairment

Drug Interactions

Etoricoxib may interact with other medications, including:

• Warfarin and other anticoagulants
• Diuretics
• ACE inhibitors and angiotensin receptor blockers
• Lithium
• Methotrexate

Patients should inform their healthcare provider of all medications they are taking to avoid potential drug interactions.

Dosage and Administration

The dosage of etoricoxib varies depending on the condition being treated. It is available in tablet form and should be taken as prescribed by a healthcare provider. It is important not to exceed the recommended dose to avoid the risk of adverse effects.

Pharmacokinetics

Etoricoxib is well absorbed orally with peak plasma concentrations occurring approximately 1 hour after dosing. It has a plasma half-life of approximately 22 hours, allowing for once-daily dosing. Etoricoxib is metabolized in the liver and excreted primarily in the urine.

Regulatory Status

The availability and approval of etoricoxib vary by country. In some countries, it is available by prescription for the treatment of arthritis and pain. In others, its use may be limited or not approved due to concerns about cardiovascular and gastrointestinal risks.