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 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 that protects the stomach lining. This mechanism offers a refined approach to managing chronic musculoskeletal conditions, particularly osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, with a favorable gastrointestinal safety profile compared to traditional NSAIDs. It is indicated for the symptomatic relief of pain and inflammation and should be used at the lowest effective dose for the shortest duration necessary.
Features
- Active ingredient: Etoricoxib
- Drug class: Selective COX-2 inhibitor NSAID
- Available in tablet formulations: 60 mg, 90 mg, 120 mg
- Once-daily oral dosing for consistent therapeutic coverage
- Prescription-only medication requiring medical supervision
- Not affected by food intake; can be taken with or without meals
Benefits
- Provides powerful and sustained relief from inflammatory pain and stiffness associated with chronic arthritis conditions.
- Reduces joint swelling and improves physical function, enhancing mobility and quality of life.
- Lower risk of gastrointestinal ulcers and complications compared to non-selective NSAIDs.
- Convenient once-daily dosing supports adherence and consistent symptom control.
- Effective in managing acute gouty arthritis and primary dysmenorrhea when prescribed appropriately.
- Allows for tailored dosing based on specific condition severity and patient response.
Common use
Arcoxia is commonly prescribed for the symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gouty arthritis. It is also used for the relief of acute pain associated with dental surgery and for the management of primary dysmenorrhea. Its use is generally reserved for cases where first-line analgesics or traditional NSAIDs are ineffective or not tolerated, particularly in patients with a history of GI sensitivity. Treatment should be individualized based on the patient’s condition, comorbidities, and response to therapy.
Dosage and direction
The recommended dose of Arcoxia varies depending on the indication and patient factors. For osteoarthritis, the usual dose is 60 mg once daily. For rheumatoid arthritis, 90 mg once daily is standard. Acute gouty arthritis typically requires 120 mg once daily for a limited duration (up to 8 days). For acute pain and primary dysmenorrhea, 120 mg once daily is used as needed. The tablet should be swallowed whole with water, and may be taken with or without food. Dosage should be individualized; the lowest effective dose should be used for the shortest possible time. Patients with hepatic impairment may require dose adjustment or avoidance.
Precautions
Arcoxia should be used with caution in patients with a history of cardiovascular disease, hypertension, heart failure, or edema, as NSAIDs may increase the risk of thrombotic events. Renal function should be monitored in patients with pre-existing renal impairment, dehydration, or those taking concomitant nephrotoxic drugs. Use with caution in elderly patients, who may be more susceptible to adverse reactions. Patients with a history of asthma, especially aspirin-sensitive asthma, should be closely monitored for hypersensitivity reactions. Avoid use in patients with active peptic ulcer disease or GI bleeding, although the selective mechanism reduces this risk compared to traditional NSAIDs.
Contraindications
Arcoxia is contraindicated in patients with known hypersensitivity to etoricoxib or any component 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. Contraindicated in patients with active peptic ulceration or gastrointestinal bleeding. Should not be used during the third trimester of pregnancy, in patients with severe hepatic dysfunction (Child-Pugh score ≥9), or in those with estimated creatinine clearance <30 mL/min. Not recommended for use in children and adolescents under 16 years of age.
Possible side effect
Common side effects include dizziness, headache, edema, hypertension, dyspepsia, nausea, abdominal pain, and heartburn. Less frequently, patients may experience fatigue, palpitations, flushing, pruritus, rash, or increased liver enzymes. Serious but rare adverse effects include gastrointestinal ulceration or bleeding, severe cutaneous adverse reactions (e.g., Stevens-Johnson syndrome), acute renal failure, hepatotoxicity, and an increased risk of cardiovascular thrombotic events such as myocardial infarction or stroke. Patients should seek immediate medical attention for signs of allergic reactions, chest pain, shortness of breath, weakness on one side of the body, or black tarry stools.
Drug interaction
Arcoxia may interact with several medications. Concomitant use with other NSAIDs or aspirin may increase the risk of GI adverse events. It may reduce the antihypertensive effect of ACE inhibitors, angiotensin II receptor antagonists, and diuretics. Caution is advised with warfarin and other anticoagulants due to an increased risk of bleeding. Concomitant use with lithium may increase lithium levels. Rifampicin may decrease etoricoxib concentrations. Arcoxia may increase plasma levels of methotrexate. Use with cyclosporine or tacrolimus may increase nephrotoxicity risk.
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 usual dosing schedule. Do not double the dose to make up for a missed one. Maintaining a consistent dosing time each day can help improve adherence and steady-state plasma concentrations.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, hypertension, acute renal failure, or respiratory depression. There is no specific antidote for etoricoxib overdose. Management is supportive and symptomatic, including gastric lavage or activated charcoal (if presented early), monitoring of vital signs, and maintaining adequate renal function. Hemodialysis is not likely to be effective due to high protein binding. Contact a poison control center or seek emergency medical attention immediately.
Storage
Store Arcoxia tablets at room temperature (15–30°C or 59–86°F), in a dry place, protected from light and moisture. Keep the medication in its original blister pack or container to protect from degradation. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Dispose of unused or expired medication properly according to local guidelines, preferably through a pharmacy take-back program.
Disclaimer
This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting, changing, or stopping any medication. The prescribing physician should evaluate individual patient factors, including medical history, current medications, and potential risks. Do not use Arcoxia without a valid prescription and appropriate medical supervision.
Reviews
Clinical studies and post-marketing surveillance indicate that Arcoxia is effective in reducing pain and improving function in patients with chronic inflammatory arthritis. Many patients report significant improvement in quality of life and daily mobility. However, responses can vary, and some individuals may not achieve adequate relief or may experience side effects. Long-term tolerability and cardiovascular safety continue to be monitored in real-world use. Always discuss your treatment experience and any concerns with your healthcare provider.