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 and analgesic effects by selectively inhibiting the cyclooxygenase-2 (COX-2) enzyme, which is responsible for pain and inflammation, while largely sparing the COX-1 enzyme involved in protecting the stomach lining. Clinically indicated for the symptomatic relief of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis, Arcoxia offers a targeted therapeutic approach for managing chronic inflammatory pain conditions. Its mechanism allows for effective pain control with a potentially improved gastrointestinal tolerability profile compared to traditional non-selective NSAIDs, making it a valuable option in a rheumatologist’s or pain specialist’s armamentarium for appropriate patient populations.

Features

• Active pharmaceutical ingredient: Etoricoxib
• Drug class: Selective cyclooxygenase-2 (COX-2) inhibitor
• Available in tablet formulations: 60 mg, 90 mg, and 120 mg strengths
• Prescription-only medication requiring medical supervision
• Once-daily oral dosing regimen for maintained therapeutic effect
• Not indicated for use in pediatric populations or during pregnancy
• Manufactured under strict pharmaceutical quality control standards
• Requires storage at room temperature (below 30°C) in original packaging

Benefits

• Provides potent and sustained relief from inflammatory pain associated with chronic arthritic conditions
• Demonstrates superior gastrointestinal tolerability compared to traditional NSAIDs due to COX-2 selectivity
• Offers convenient once-daily dosing that supports medication adherence and consistent pain management
• Reduces joint stiffness and improves physical function in osteoarthritis and rheumatoid arthritis patients
• Effectively manages acute pain in gouty arthritis attacks with rapid onset of action
• Maintains anti-inflammatory efficacy while minimizing the risk of gastrointestinal complications

Common use

Arcoxia is primarily prescribed for the symptomatic treatment of osteoarthritis, characterized by the degeneration of joint cartilage and underlying bone, causing pain and stiffness. It is equally effective in managing rheumatoid arthritis, an autoimmune disorder causing chronic inflammation of the joints. The medication is also indicated for ankylosing spondylitis, a type of arthritis that primarily affects the spine, and for the treatment of acute gouty arthritis, providing relief during painful gout attacks. Additionally, it may be used for managing other chronic pain conditions under specialist supervision, though such uses constitute off-label prescribing that requires careful risk-benefit assessment by treating physicians.

Dosage and direction

The recommended dosage of Arcoxia varies according to the condition being treated and should be individualized based on patient response and tolerability. For osteoarthritis, the usual dose is 60 mg once daily, while rheumatoid arthritis typically requires 90 mg once daily. Ankylosing spondylitis patients are usually prescribed 90 mg once daily, and acute gouty arthritis is managed with 120 mg once daily for a maximum of 8 days. Tablets should be swallowed whole with water, with or without food, though taking with food may minimize potential gastrointestinal discomfort. The lowest effective dose should be used for the shortest duration necessary to control symptoms, with regular physician assessment of continued treatment necessity. Dosage adjustment is necessary in elderly patients and those with hepatic impairment, while it is contraindicated in patients with severe renal impairment.

Precautions

Patients should be carefully evaluated before initiating Arcoxia therapy, particularly regarding cardiovascular risk factors, as COX-2 inhibitors may increase the risk of thrombotic events. Regular monitoring of blood pressure is recommended, especially during the initial weeks of treatment, as hypertension may develop or worsen. Hepatic function should be assessed periodically, as elevations in liver enzymes have been reported with etoricoxib use. Caution is advised in patients with a history of gastrointestinal ulceration or bleeding, despite the selective mechanism, as serious gastrointestinal events can still occur. Patients with fluid retention, hypertension, or heart failure should be closely monitored due to potential exacerbation of these conditions. Arcoxia should be used with particular caution in elderly patients, who may be more susceptible to adverse reactions.

Contraindications

Arcoxia is contraindicated in patients with known hypersensitivity to etoricoxib or any components of the formulation. It must not be used in patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs, including selective COX-2 inhibitors. Treatment is contraindicated in patients with established ischemic heart disease, peripheral arterial disease, cerebrovascular disease, or congestive heart failure (NYHA II-IV). Severe hepatic dysfunction (Child-Pugh score ≥9) represents an absolute contraindication, as does severe renal impairment (creatinine clearance <30 mL/min). Arcoxia is contraindicated during the third trimester of pregnancy and should be avoided in women attempting to conceive. Concomitant use with other NSAIDs, including COX-2 selective inhibitors, is contraindicated due to increased risk of adverse effects.

Possible side effect

The most commonly reported adverse reactions include dizziness, headache, edema, hypertension, palpitations, dyspepsia, abdominal pain, nausea, heartburn, and fatigue. Less frequently, patients may experience gastrointestinal ulceration or bleeding, although the risk is lower than with traditional NSAIDs. Cardiovascular side effects may include exacerbation of congestive heart failure and increased risk of thrombotic events such as myocardial infarction or stroke. Hepatic reactions ranging from transaminase elevations to rare cases of hepatitis have been reported. Dermatological reactions including rash, urticaria, and pruritus may occur, with rare cases of serious skin reactions such as Stevens-Johnson syndrome. Renal effects may include impaired renal function, particularly in at-risk populations.

Drug interaction

Arcoxia demonstrates several clinically significant drug interactions that require careful management. Concomitant use with warfarin or other anticoagulants may increase the risk of bleeding complications due to potential effects on platelet function. Co-administration with ACE inhibitors, angiotensin II receptor antagonists, or diuretics may reduce the antihypertensive effect of these medications and worsen renal function. Lithium levels may increase when taken with Arcoxia, necessitating close monitoring. Methotrexate toxicity may be enhanced when used concurrently. Rifampicin, a potent enzyme inducer, significantly reduces etoricoxib plasma concentrations, while fluconazole increases exposure to etoricoxib. Concomitant administration with other NSAIDs or aspirin is not recommended due to increased risk of gastrointestinal adverse effects.

Missed dose

If a dose of Arcoxia is missed, it should be taken as soon as remembered, unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one, as this may increase the risk of adverse effects. Consistency in dosing is important for maintaining stable therapeutic effects, particularly in chronic conditions like osteoarthritis and rheumatoid arthritis. If uncertainty exists regarding missed dose management, patients should consult their physician or pharmacist for specific guidance based on their individual treatment regimen.

Overdose

In cases of overdose, supportive care is the mainstay of treatment, as there is no specific antidote for etoricoxib. Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, hypertension, acute renal failure, and respiratory depression. Management should include gastric lavage and administration of activated charcoal if presentation is within one hour of ingestion. Hemodialysis is not likely to be effective due to high protein binding of etoricoxib. Symptomatic and supportive measures should be implemented, including monitoring of vital signs and management of specific complications such as gastrointestinal bleeding or renal impairment. Patients should be advised to seek immediate medical attention if overdose is suspected.

Storage

Arcoxia tablets should be stored in their original packaging at room temperature, below 30°C (86°F), protected from light and moisture. The medication should be kept out of reach of children and pets to prevent accidental ingestion. Tablets should not be removed from blister packs until immediately before administration to maintain stability and protect from environmental factors. Patients should be advised to check expiration dates before use and properly dispose of any expired medication. Unused medication should not be flushed down toilets or drains but should be disposed of through proper medication take-back programs or according to local regulations for pharmaceutical waste.

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 patient responses may vary, and treatment decisions should be based on a thorough assessment by a physician considering the patient’s complete medical history, current condition, and risk factors. The prescribing information provided here may not include all possible uses, directions, precautions, or interactions. Patients should consult their healthcare provider for personalized medical advice and should not discontinue or change their medication regimen without professional guidance.

Reviews

Clinical studies have demonstrated Arcoxia’s efficacy in managing pain and inflammation associated with various arthritic conditions. In randomized controlled trials, etoricoxib showed significant improvement in pain scores and physical function compared to placebo in osteoarthritis patients. Comparative studies have indicated similar efficacy to traditional NSAIDs like naproxen and diclofenac, with improved gastrointestinal tolerability. Rheumatoid arthritis trials have shown sustained improvement in American College of Rheumatology response criteria. Specialist reviews highlight its value in patients who require NSAID therapy but are at risk for gastrointestinal complications, though they emphasize the need for cardiovascular risk assessment before initiation. Long-term extension studies have supported its maintained efficacy and generally acceptable safety profile in appropriate patient populations when used at the lowest effective dose for the shortest necessary duration.