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What is Etoricoxib and its indications: Etoricoxib is one of a group of medicines called selective COX-2 inhibitors. These belong to a family of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). What are the uses of Etoricoxib? • Helps Etoricoxib reduce pain and swelling (inflammation) in joints and muscles of people aged 16 and above who have osteoporosis, rheumatoid arthritis, ankylosing spondylitis, and gout. • Also used for short-term treatment of moderate pain after dental surgery in people aged 16 and above. What is arthritis? • Osteoarthritis is a disease that affects the joints. It results from the gradual breakdown of cartilage that covers the ends of bones. This causes swelling (inflammation), pain, tenderness, stiffness, and disability. What is rheumatoid arthritis? • Rheumatoid arthritis is a long-term inflammatory disease that affects the joints. It causes pain, stiffness, swelling, and increased loss of movement in the affected joints. It may also cause inflammation in other parts of the body. What is gout? • Gout is a disease caused by sudden and repeated episodes of very painful inflammation and redness in the joints. It occurs due to deposits of mineral crystals in the joint. What is ankylosing spondylitis? • Ankylosing spondylitis is an inflammatory disease affecting the spine and large joints. What you need to know before using Etoricoxib: Do not use Etoricoxib: Tell your doctor if you: • Are allergic (severe allergy) to Etoricoxib or any other ingredients of this medicine • Are allergic to NSAIDs, including aspirin and COX-2 inhibitors • Have a stomach ulcer or bleeding in the stomach or intestines • Have severe liver disease • Have severe kidney disease • Are pregnant or may become pregnant or breastfeeding • Are under 16 years old • Have inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis • Have uncontrolled high blood pressure (consult your doctor or nurse if you are unsure whether your blood pressure is well controlled) • Have been diagnosed with heart problems including heart failure (moderate or severe) and angina (chest pain) • Have had a heart attack, bypass surgery, or peripheral artery disease (poor circulation in the legs or feet due to narrowed or blocked arteries) • Have had any type of stroke (including minor stroke, transient ischemic attack, or TIA). Etoricoxib may slightly increase the risk of heart attacks and strokes, and therefore should not be used in those who already have heart problems or have had a stroke. Precautions and warnings: You should inform your doctor if you: • Have a history of stomach bleeding or ulcers. • Are dehydrated, for example due to a long episode of vomiting or diarrhea. • Have swelling due to fluid retention. • Have a history of heart failure or any other form of heart disease. • Have a history of high blood pressure. Etoricoxib can increase blood pressure in some people, especially at high doses, and your doctor will want to check your blood pressure from time to time. • Have any history of liver or kidney disease. • Are being treated for an infection. Etoricoxib can hide fever or mask it, which is a sign of infection. • Have diabetes, high cholesterol, or are a smoker. These can increase the risk of heart disease. • Are a woman trying to conceive. • Are over 65 years old. Other medicines and Etoricoxib: Please inform your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including over-the-counter medicines. • Blood thinners, such as warfarin • Rifampicin (antibiotic) • Methotrexate (a drug used to suppress the immune system, often used in rheumatoid arthritis) • Cyclosporine or tacrolimus (immunosuppressive drugs) • Lithium (used to treat some types of depression) • Medicines used to help control high blood pressure and heart failure called ACE inhibitors and angiotensin receptor blockers, such as enalapril, ramipril, losartan, and valsartan • Diuretics (water pills) • Digoxin (for heart failure and irregular heartbeat) • Minoxidil (used to treat high blood pressure) • Salbutamol tablets or oral solution (for asthma) • Birth control pills (taking them together may increase side effects) • Hormone replacement therapy (may increase the risk of side effects) • Aspirin, as the risk of stomach ulcers is higher when taken with Etoricoxib. • Aspirin for prevention of heart attacks or strokes: • Etoricoxib can be taken with a low dose of aspirin. • If you are currently taking a low dose of aspirin to prevent heart attacks or strokes, do not stop taking aspirin until you have spoken with your doctor. • Aspirin and other NSAIDs: • Do not take a high dose of aspirin or other anti-inflammatory drugs while taking Etoricoxib. How to use Etoricoxib: • Always take this medicine exactly as your doctor has told you. Ask your doctor or pharmacist if you are unsure. • Do not take more than the recommended dose for your condition. Your doctor will want to review your treatment from time to time. • It is important to use the lowest dose that controls your pain and not to take Etoricoxib longer than necessary. • This is because the risk of heart attacks and strokes may increase after long-term treatment, especially at high doses. The recommended doses are: Rheumatoid arthritis • The recommended dose is 60 mg once daily, increased to 90 mg once daily if needed. Ankylosing spondylitis • The recommended dose is 60 mg once daily, increased to 90 mg once daily if needed. Acute pain conditions • Etoricoxib should only be used for the duration of acute pain. Gout • The recommended dose is 120 mg once daily, to be used only for the duration of acute pain, for a maximum of 8 days of treatment. Post-dental surgery pain • The recommended dose is 90 mg once daily, for a maximum of 3 days of treatment. People with liver problems • If you have mild liver disease, do not take more than 60 mg per day. • If you have moderate liver disease, do not take more than 30 mg per day. Use in children and adolescents • Do not give Etoricoxib tablets to children or adolescents under 16 years old. Elderly • No dose adjustment is needed for elderly patients. As with other medicines, caution should be exercised in elderly patients. Method of administration • Etoricoxib for oral use. Take the tablets once daily. It can be taken with or without food. Possible side effects: • Stop using the product and seek medical attention immediately if you notice any of the following signs • Shortness of breath, chest pain, or swelling of the ankle, or if it worsens • Yellowing of the skin and eyes (jaundice) — signs of liver problems • Severe or persistent stomach pain or dark stools • Allergic reaction — which can include skin problems such as ulcers or pustules, or swelling of the face, lips, tongue, or throat, which may cause difficulty breathing How to store Etoricoxib: • Keep this medicine out of sight and reach of children. • Do not use this medicine after the expiration date printed on the carton. • The expiration date refers to the last day of that month. • Bottles: Keep the container tightly closed to protect from moisture. • Pouches: Store in the original package to protect from moisture. • Do not dispose of medicines in wastewater or household waste. • Ask your pharmacist how to dispose of medicines you no longer use. These measures will help protect the environment.