Special Precautions. Clinical trials suggest that the selective COX-2 inhibitor class of drugs may be associated with an increased risk of thrombotic events especially MI and stroke , relative to placebo and some NSAIDs naproxen. The patient's need for symptomatic relief and response to therapy should be re-evaluated periodically. Patients with significant risk factors for cardiovascular events e. Selective COX-2 inhibitors are not a substitute for aspirin for cardiovascular prophylaxis because of their lack of effect on platelets.
Because etoricoxib, a member of this class, does not inhibit platelet aggregation, antiplatelet therapies should not be discontinued. There is a further increase in the risk of gastrointestinal adverse effects gastrointestinal ulceration or other gastrointestinal complications for etoricoxib, other selective COX-2 inhibitors and NSAIDs, when taken concomitantly with acetylsalicylic acid even at low doses.
Renal prostaglandins may play a compensatory role in the maintenance of renal perfusion. Therefore, under conditions of compromised renal perfusion, administration of ARCOXIA may cause a reduction in prostaglandin formation and, secondarily, in renal blood flow, and thereby impair renal function.
Patients at greatest risk of this response are those with pre-existing significantly impaired renal function, uncompensated heart failure, or cirrhosis. Monitoring of renal function in such patients should be considered. As with other drugs known to inhibit prostaglandin synthesis, fluid retention, edema and hypertension have been observed in some patients taking ARCOXIA.
The possibility of fluid retention, edema or hypertension should be taken into consideration when ARCOXIA is used in patients with pre-existing edema, hypertension, or heart failure. Etoricoxib may be associated with more frequent and severe hypertension than some other NSAIDs and selective COX-2 inhibitors, particularly at high doses.
Therefore, special attention should be paid to blood pressure monitoring during treatment with etoricoxib. If blood pressure rises significantly, alternative treatment should be considered. While the risk of endoscopically detected ulcers was low in patients treated with ARCOXIA mg it was higher than in patients treated with placebo.
These events can occur at any time during use and without warning symptoms. Independent of treatment, patients with a prior history of GI perforation, ulcers and bleeding PUB and patients greater than 65 years of age are known to be at a higher risk for a PUB. ARCOXIA should be used with caution in patients who have previously experienced acute asthmatic attacks, urticaria, or rhinitis, which were precipitated by salicylates or non-selective cyclooxygenase inhibitors.
Since the pathophysiology of these reactions is unknown, physicians should weigh the potential benefits of prescribing ARCOXIA versus the potential risks. When using etoricoxib in the elderly and in patients with renal, hepatic, or cardiac dysfunction, medically appropriate supervision should be maintained.
If these patients deteriorate during treatment, appropriate measures should be taken, including discontinuation of therapy. These serious events may occur without warning. Patients appear to be at highest risk for these reactions early in the course of therapy: the onset of the reaction occurring in the majority of cases within the first month of treatment. Some selective COX-2 inhibitors have been associated with an increased risk of skin reactions in patients with a history of any drug allergy.
Etoricoxib should be discontinued at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity. Use in Children: Safety and effectiveness of etoricoxib in pediatric patients have not been established. Use in the Elderly: Pharmacokinetics in the elderly 65 years of age and older are similar to those in the young.
In clinical studies, a higher incidence of adverse experiences was seen in older patients compared to younger patients; the relative differences between etoricoxib and control groups were similar in the elderly and the young.
Greater sensitivity of some older individuals cannot be ruled out. Pregnancy: The use of etoricoxib, as with any drug substance known to inhibit COX-2, is not recommended in women attempting to conceive. No clinical data on exposed pregnancies are available for etoricoxib. Studies in animals have shown reproductive toxicity. The potential for human risk in pregnancy is unknown. Etoricoxib, as with other medicinal products inhibiting prostaglandin synthesis, may cause uterine inertia and premature closure of the ductus arteriosus during the last trimester.
Etoricoxib is contraindicated in pregnancy. If a woman becomes pregnant during treatment, etoricoxib should be discontinued.
Nursing Mothers: Etoricoxib is excreted in the milk of lactating rats. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the possible adverse effects of drugs that inhibit prostaglandin synthesis on nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Side Effects. The following drug-related adverse experiences were reported in clinical studies in patients with OA, RA, or chronic low back pain treated for up to 12 weeks.
In this large trial, only serious adverse events and discontinuations due to any adverse events were recorded. It no longer hurt and I was able to do some things but not what I had been doing.
Doctor suggested stem cells and prp. Had it a month ago and am I constant pain and it Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
For details see our conditions. Take etoricoxib once daily. In this article About etoricoxib tablets Before taking etoricoxib How to take etoricoxib Getting the most from your treatment Can etoricoxib cause problems? How to store etoricoxib Important information about all medicines. Etoricoxib for pain and inflammation Arcoxia In this article About etoricoxib tablets Before taking etoricoxib How to take etoricoxib Getting the most from your treatment Can etoricoxib cause problems?
Common etoricoxib side-effects What can I do if I experience this? Indigestion, stomach upset, tummy abdominal pain Stick to simple meals - avoid fatty or spicy foods.
If the discomfort continues, speak with your doctor Feeling dizzy or tired Do not drive and do not use tools or machines while affected Constipation or diarrhoea Drink plenty of water Swollen ankles, fluid retention, being aware of your heart beating palpitations , feeling short of breath, bruising, headache and flu-like symptoms If any of these become troublesome, speak with your doctor High blood pressure, changes to some blood tests Your doctor will check for these.
If you have any questions about this medicine ask your pharmacist. Are you protected against flu? These are less likely than older NSAIDs such as naproxen and diclofenac to irritate the gut and cause side effects such as stomach ulcers. However, these side effects are still possible, particularly in elderly people. Your doctor might prescribe you a medicine to help protect your stomach if you're taking Arcoxia for long periods of time.
People taking painkillers like etoricoxib have a slightly higher risk of heart problems such as fast heartbeat, chest pain, heart attack, heart failure or stroke. These are more of a risk if you're taking a high dose of etoricoxib for a long time.
If you have risk factors for heart disease or stroke, such as diabetes, high blood pressure, high cholesterol or smoking, your doctor will need to assess the overall benefits and risks before deciding if etoricoxib is suitable for you. You should read the patient information leaflet that is supplied with your medication for more information about side effects associated with Arcoxia.
You can find a copy of this here. If you think you have experienced side effects from this medicine you can report them using the yellow card scheme. You should check with your pharmacist before taking any new medicines while you're taking etoricoxib, to make sure that the combination is safe. It's fine to take paracetamol with Arcoxia. You can also take opioid-type painkillers such as codeine, co-codamol, tramadol or morphine in combination with Arcoxia.
However, don't take anti-inflammatory painkillers NSAIDs like aspirin, ibuprofen or naproxen with Arcoxia, as this increases the risk of getting side effects on the gut. Remember that many cold and flu remedies and over-the-counter painkillers contain ibuprofen or aspirin and so should be avoided while you're taking etoricoxib. Be sure to check the ingredients of other medicines before taking them with Arcoxia, or ask your pharmacist for advice. It's also best to check with your pharmacist if you want to use an anti-inflammatory gel such as diclofenac, ibuprofen, ketoprofen or piroxicam while you're taking Arcoxia, because this may not be safe for everyone.
If you're taking a medicine that affects blood clotting, such as those below, taking Arcoxia may increase the risk of bleeding, particularly in the gut:.
You are more at risk of ulceration or bleeding in your gut if you take etoricoxib with steroids such as prednisolone. Etoricoxib may oppose the effect of diuretics and medicines for high blood pressure antihypertensives. There may be an increased risk of side effects on the kidneys if etoricoxib is taken with any of the following medicines. If you're taking one of these with Arcoxia your doctor may want to monitor your kidney function:. Read more detailed information about medicines that interaction with etoricoxib here.
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