Arcoxia tablets contain the active ingredient etoricoxib, which is a type of medicine known as a non-steroidal anti-inflammatory drug (NSAID).
NSAIDs work by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in producing prostaglandins, in response to injury or certain diseases. These prostaglandins cause pain, swelling and inflammation. Because NSAIDs block the production of these prostaglandins, they are effective at relieving pain and inflammation.
Cyclo-oxygenase does not only produce prostaglandins that cause inflammation. It also produces prostaglandins that have useful roles in the body. There are two different forms of cyclo-oxygenase, COX-1 and COX-2. COX-2 is the form that (among other things) produces prostaglandins that cause inflammation. COX-1 does not produce inflammatory prostaglandins, but does produce others that have useful effects, including some that are involved in maintaining a healthy stomach and intestinal lining.
Traditional NSAIDs, such as ibuprofen or diclofenac, block the action of both COX-1 and COX-2, and this is why they can sometimes cause side effects such as stomach irritation and peptic ulcers. Etoricoxib belongs to a new generation of NSAIDs that selectively block the action of COX-2. This means that it stops the production of inflammatory prostaglandins, without stopping the production of prostaglandins that protect the stomach and intestines. It therefore reduces pain and inflammation, but is less likely than traditional NSAIDs to cause side effects on the stomach and intestines (although such side effects are still possible).
This medicine can be taken with or without food, but may start to work quicker if taken without food.
What is it used for?
- Acute gout.
- Rheumatoid arthritis.
Before you take Arcoxia
Do not take Arcoxia if:
- you have an allergy to Arcoxia
- the packaging is torn or shows signs of tampering
- the expiry date on the pack has passed.
- If you take this medicine after the expiry date has passed, it may not work.
- You have had heart failure, a heart attack, bypass surgery, chest pain (angina), narrow or blocked arteries of the extremities (peripheral arterial disease), a stroke or mini stroke (TIA or transient ischaemic attack).
- You have high blood pressure that is not well controlled on blood pressure medication.
- You are having major surgery and have conditions which increase your risk of coronary artery disease or atherosclerosis such as high blood pressure, diabetes, high cholesterol or smoking.
You are having major surgery on you heart or arteries.
If you are not sure whether you should start taking Arcoxia, talk to your doctor.
Arcoxia has not been adequately studied in children. Therefore, Arcoxia should not be given to children.
Arcoxia works equally well in older and younger adult patients. Adverse experiences may occur at a higher incidence in older patients compared to younger patients. If you are elderly (ie over 65 years of age), your doctor will want to appropriately keep a check on you. No dosage adjustment is necessary for older patients.
Before you start to taking Arcoxia tell your doctor if:
- you are pregnant or intend to become pregnant. Arcoxia is not recommended for use during late pregnancy. If there is a need to consider using Arcoxia during your pregnancy, your doctor will discuss with you the benefits and risks of using it.
- you are breast-feeding or plan to breast-feed. It is not known if Arcoxia passes into breast milk. You and your doctor should discuss whether you should stop breast-feeding or not take Arcoxia.
you have or have had any medical conditions, especially the following:
- history of angina
- heart attack or a blocked artery in your heart
- narrow or blocked arteries of the extremities
- kidney disease
- liver disease
- heart failure
- high blood pressure
- you have had an allergic reaction to aspirin or other anti-inflammatory medicines (commonly known as NSAIDs) Symptoms of an allergic reaction may include asthma, pinkish itchy swellings on the skin (hives), runny or blocked nose.
- you have an infection
- If you take Arcoxia while you have an infection, it may hide fever and may make you think, mistakenly, that you are better or that your infection is less serious than it might be.
- you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.
- you have a history of stroke or mini stroke
- you have conditions which increase your risk of coronary artery disease or atherosclerosis such as high blood pressure, diabetes, high cholesterol or smoking.
If you have not told your doctor about any of the above, tell them before you take any Arcoxia.
Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from your pharmacy, supermarket or health food shop.
Some medicines and Arcoxia may interfere with each other. These include:
- warfarin, a medicine used to prevent blood clots
- rifampicin, an antibiotic used to treat tuberculosis and other infections
- water pills (diuretics)
- ACE inhibitors and angiotensin receptor blockers, medicines used to lower high blood pressure or treat heart failure
- lithium, a medicine used to treat a certain type of depression
- birth control pills
- hormone replacement therapy
- methotrexate, a medicine used to suppress the immune system
These medicines may be affected by Arcoxia or may affect how well it works. You may need different amounts of your medicine, or you may need to take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or avoid while taking Arcoxia.
Arcoxia can be taken with low dose aspirin. If you are currently taking low dose aspirin for the prevention of a heart attack or stroke, you should continue to do so unless specified by your Doctor. Arcoxia cannot replace aspirin for this purpose.
How to take Arcoxia
Take Arcoxia only when prescribed by your doctor.
For osteoarthritis, the recommended dose is 60 mg once a day.
For rheumatoid arthritis the recommended dose is 90 mg once a day.
For ankylosing spondylitis the recommended dose is 90 mg once a day.
For the relief of gout attacks the recommended dose is 120 mg once a day, which should only be used for the acute painful period.
For the relief of chronic musculoskeletal pain the recommended dose is 60 mg once a day.
Doses greater than those recommended for each condition have either not demonstrated additional efficacy or have not been studied. Therefore, the daily doses stated above for each condition should not be exceeded.
If you have mild liver disease, you should not take more than 60 mg a day. If you have moderate liver disease, you should not take more than 60 mg every other day.
Follow all directions given to you by your doctor carefully. They may differ from the information contained in this leaflet.
If you do not understand the instructions on the box, ask your doctor or pharmacist for help. Arcoxia comes as tablets.
When taking the tablets, swallow them with a glass of water. Do not halve the tablet.
Take your Arcoxia at about the same time each day.
Taking Arcoxia at the same time each day will have the best effect. It will also help you remember when to take the dose.
It does not matter if you take Arcoxia before or after food.
Do not use Arcoxia for longer than your doctor says.
Your doctor will want to discuss your treatment from time to time. It is important that you use the lowest dose that controls your pain and you should not take Arcoxia for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.
Depending on your condition, you may need to take Arcoxia for a few days or for a longer period.
For osteoarthritis and rheumatoid arthritis Arcoxia helps relieve your symptoms but it does not cure it. Continue taking Arcoxia for as long as your doctor prescribes.
For the relief of gout attacks or other types of pain, Arcoxia is usually only needed for a few days.
If you are not sure how long to take Arcoxia, talk to your doctor.
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking your tablet(s) as you would normally.
If you are not sure whether to skip the dose, talk to your doctor or pharmacist.
Do not take a double dose to make up for the dose that you missed.
If you have trouble remembering to take your tablets, ask your pharmacist for some hints.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Arcoxia.
Arcoxia helps most people with osteoarthritis, rheumatoid arthritis, menstrual pain, gout or other types of pain, but it may have unwanted adverse effects in a few people. All medicines can have adverse effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the adverse effects.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice or have any of the following and they worry you:
- feeling sick (nausea), vomiting
- heartburn, indigestion, uncomfortable feeling or pain in the stomach
- swelling of the legs, ankles or feet
- high blood pressure
Additionally, the following have been reported:
- allergic reactions including rash, itching and hives
- severe skin reactions, which may occur without warning
- taste alteration
- mouth ulcers
- severe increase in blood pressure
- platelets decreased
These are usually the mild adverse effects of Arcoxia.
If any of the following happen, stop taking Arcoxia and tell your doctor immediately or go to Accident and Emergency at your nearest hospital:
- swelling of the face, lips, tongue or throat which may cause difficulty in swallowing or breathing (hypersensitivity reactions, anaphylactic/anaphylactoid reactions including shock)
- abnormal rhythm of the heart (atrial fibrillation)
- heart failure
- serious kidney problems
- serious liver problems
- stomach pain
- stomach ulcers that may become serious and may bleed, and may occur at any time during use and without warning
Other adverse effects not listed above may also occur in some patients. Tell your doctor if you notice any other effects.
Do not be alarmed by this list of possible adverse effects. You may not experience any of them.