Arcoxia: Targeted Relief for Osteoarthritis and Chronic Pain
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Synonyms | |||
Arcoxia (etoricoxib) is a prescription medication belonging to the class of drugs known as selective COX-2 inhibitors, a type of nonsteroidal anti-inflammatory drug (NSAID). It is specifically designed to provide potent anti-inflammatory, analgesic, and antipyretic effects by selectively inhibiting the cyclooxygenase-2 (COX-2) enzyme, which is primarily responsible for pain and inflammation. This targeted mechanism allows for effective management of conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis, while offering a potentially improved gastrointestinal tolerability profile compared to traditional non-selective NSAIDs. It is indicated for use in adults and should be prescribed at the lowest effective dose for the shortest duration necessary to control symptoms.
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
- Half-life: Approximately 22 hours, allowing for once-daily dosing
Benefits
- Provides potent and sustained relief from inflammatory pain and stiffness associated with chronic arthritic conditions
- Offers targeted anti-inflammatory action with reduced impact on COX-1 enzymes, potentially decreasing the risk of gastrointestinal complications compared to traditional NSAIDs
- Convenient once-daily dosing regimen improves medication adherence and consistent symptom control
- Effective management of acute pain conditions such as gouty arthritis attacks
- Improves physical function and quality of life in patients with chronic musculoskeletal disorders
- Rapid onset of action with significant pain relief often experienced within hours of the first dose
Common use
Arcoxia is primarily prescribed for the symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis. It is also used for the management of chronic musculoskeletal pain and postoperative dental pain. The medication works by reducing the production of prostaglandins, which are chemicals in the body that cause pain, inflammation, and fever. Healthcare providers determine the appropriate indication based on the patient’s specific condition, medical history, and risk factors, with treatment duration tailored to individual response and clinical need.
Dosage and direction
The recommended dosage of Arcoxia varies depending on 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)
The tablet should be swallowed whole with water, with or without food. The lowest effective dose should be used for the shortest duration possible. Dosage adjustment may be necessary for elderly patients or those with hepatic impairment. Patients with moderate hepatic impairment should not exceed 60 mg daily, while those with severe hepatic impairment should not use Arcoxia. The medication is not recommended for patients with severe renal impairment.
Precautions
Patients should be carefully evaluated before prescribing Arcoxia, particularly regarding cardiovascular, gastrointestinal, and renal risk factors. Caution is advised in patients with a history of ischemic heart disease, cerebrovascular disease, peripheral arterial disease, heart failure, hypertension, or fluid retention. Regular monitoring of blood pressure is recommended during treatment. Patients should be advised to report any signs of gastrointestinal bleeding, skin reactions, or edema. Arcoxia may mask fever, which is an important sign of infection. Use with caution in elderly patients who may be more susceptible to adverse reactions. Patients should avoid alcohol consumption during treatment as it may increase the risk of gastrointestinal complications.
Contraindications
Arcoxia is contraindicated in patients with:
- Known hypersensitivity to etoricoxib or any component of the formulation
- Active peptic ulceration or gastrointestinal bleeding
- Severe hepatic impairment (Child-Pugh score ≥9)
- Estimated creatinine clearance <30 mL/min
- Inflammatory bowel disease
- Congestive heart failure (NYHA Class II-IV)
- Established ischemic heart disease, peripheral arterial disease, or cerebrovascular disease
- Hypertension uncontrolled by medication
- Third trimester of pregnancy and during breastfeeding
- Under 16 years of age
Possible side effect
Common side effects may include:
- Headache, dizziness
- Gastrointestinal disturbances (dyspepsia, abdominal pain, nausea)
- Edema, hypertension
- Increased liver enzymes
- Fatigue, flu-like symptoms
Serious but less common side effects require immediate medical attention:
- Gastrointestinal ulceration, bleeding, or perforation
- Cardiovascular thrombotic events (myocardial infarction, stroke)
- Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- Hepatotoxicity, including hepatitis and liver failure
- Renal impairment or failure
- Fluid retention exacerbating heart failure or hypertension
- Anaphylactic reactions
Drug interaction
Arcoxia may interact with several medications, including:
- Anticoagulants (warfarin): Increased risk of bleeding
- ACE inhibitors, angiotensin II antagonists: Reduced antihypertensive effect
- Diuretics: Reduced diuretic efficacy and potential renal impairment
- Lithium: Increased lithium levels and toxicity risk
- Methotrexate: Increased methotrexate concentrations
- Cyclosporine, tacrolimus: Increased nephrotoxicity risk
- Other NSAIDs: Increased risk of adverse effects without therapeutic benefit
- SSRIs, corticosteroids: Increased risk of gastrointestinal bleeding
- Rifampicin: Reduced etoricoxib concentrations
Patients should inform their healthcare provider of all medications, including over-the-counter drugs and supplements, before starting Arcoxia.
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 is important for optimal therapeutic effect, but occasional missed doses are unlikely to significantly impact overall treatment efficacy due to the drug’s long half-life.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, hypertension, acute renal failure, and respiratory depression. In case of suspected overdose, seek immediate medical attention. Management is supportive and may include gastric lavage if presented early, activated charcoal administration, and symptomatic treatment. There is no specific antidote for etoricoxib overdose. Hemodialysis is not likely to be effective due to high protein binding.
Storage
Store Arcoxia tablets at room temperature (15-30°C or 59-86°F) in their original packaging to protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly dispose of any unused or expired medication according to local regulations, preferably through medication take-back programs.
Disclaimer
This information is provided 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. Individual response to treatment may vary, and patients should follow their physician’s instructions regarding dosage, duration, and monitoring. The benefits and risks of treatment should be carefully considered for each patient based on their medical history, current medications, and overall health status. Report any adverse effects to your healthcare provider promptly.
Reviews
Clinical studies and patient experiences generally report favorable outcomes with Arcoxia for managing inflammatory pain conditions. Many patients note significant improvement in pain scores, stiffness reduction, and enhanced mobility compared to previous treatments. Healthcare providers appreciate the once-daily dosing convenience and the potentially improved gastrointestinal safety profile compared to traditional NSAIDs. However, some patients report inadequate pain relief or experience side effects requiring discontinuation. The cardiovascular risk profile remains a consideration in treatment decisions. Overall satisfaction rates are generally high among appropriate candidates who respond well to therapy and tolerate the medication without significant adverse effects.