Arcoxia tabs 90mg #7

Arcoxia instruction

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Composition

One tablet of Arcoxia contains the active substance: etorikoksiba - 30, 60, 90 or 120 mg, depending on the dosage.
Excipients: calcium hydrogen phosphate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate.
The composition of the shell: white Opadrai II, carnauba wax.
The composition of the film shell: lactose monohydrate, hypromellose, titanium dioxide, triacetin, aluminum based on indigo carmine, iron oxide yellow dye.

Form of issue

Medication Arcoxia is a tablet covered with a turquoise shell, biconvex, globular, with the inscription "ACX 30" on one side and the inscription "101" on the other.
    Tablets with a dosage of 30 mg are available in 2, 4, 7 or 14 pieces in a blister; 2, 1 or 4 such blisters in a cardboard bundle.
    Tablets Arcoxia 60 mg are available in 7 pieces in a blister; 1 or 4 such blisters in a cardboard bundle.
    Tablets Arcoxia 90 mg are also available in 7 pieces in a blister; 1 or 4 such blisters in a cardboard bundle.
    Tablets with a dosage of 120 mg are available in 7 blister packs; 1 such a blister in a cardboard bundle.

pharmachologic effect

Non-steroidal anti-inflammatory drug. Selective blocker of cyclooxygenase-2.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Etorikoksib is an oral selective cyclooxygenase-2 blocker.
In clinical trials, the preparation Arcoxia dose-dependently blocked cyclooxygenase-2 without suppressing cyclooxygenase-1 when used at a dose of less than 150 mg per day. Etorikoksib does not inhibit the production of prostaglandins of the stomach and does not change the function of thrombocytes.
Cyclooxygenase regulates the formation of prostaglandins. There are two of its forms - Cyclociogenase-1 and Cycloclase-2. The latter is considered as the main factor responsible for the production of mediators of pain, fever and inflammation. Cycloclogenase-2 is involved in the mechanisms of ovulation, implantation and obturating the arterial duct, monitoring the functions of the nervous system and kidneys. She also participates in the processes of scarring of ulcers.

Pharmacokinetics

Etoricoxib is well adsorbed by oral use. Absolute bioavailability reaches 100%. The maximum concentration of the drug in the blood is observed one hour after taking an empty stomach. When taking the drug during meals, there was no significant effect on the level of absorption.
92% of etorikoksib binds to blood proteins. The drug is actively metabolized, less than 2% of the dose is excreted in the urine in an unchanged form. In humans, 5 metabolites of ethoricoxib have been studied. The main metabolite is 6-carboxylic acid, which is formed during the oxidation of 6-hydroxymethyl. These substances are either biologically inactive, or are weakly active blockers of COX-2. None of them suppress COX-1. 70% of the drug is excreted in the urine, about 25% - with feces. The half-life is 22 hours.
Pharmacokinetics in elderly patients (over 65 years) is identical to those in younger people and does not depend on sex.
The pharmacokinetics of the drug in children under 12 years of age has not been studied. The safety and effectiveness of the use of etorikoksib in children has not been proven.

Indications for use Arcoxia

Indications for use:
    symptomatic treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, accompanied by inflammatory symptoms and pain;
    short-term therapy of moderate acute pain after dental operations;
    acute gouty arthritis.
The decision to appoint an election blocker for COX-2 should be made taking into account all individual risks for the patient.

Contraindications

Arcoxia is contraindicated:
    with sensitization to the active substance, to any other substance in the formulation or to other non-steroidal anti-inflammatory drugs;
    with active ulcers or bleeding from the stomach or intestines;
    during lactation and pregnancy;
    with severe liver damage (blood albumin less than 25 g / l);
    Persons with renal clearance of creatinine less than 30 ml / min;
    children under the age of 16;
    Persons with inflammatory bowel disease;
    with heart failure with stagnation;
    patients with arterial hypertension, whose blood pressure is constantly greater than 140/90 mm Hg. p.
    with ischemic heart disease, pathology of peripheral arteries or other cardiovascular diseases.

Side effects

The administration of the drug may cause the following side effects:
    From the side of the central nervous system: in less than 10% of cases - dizziness, headache, weakness; in less than 1% of cases - drowsiness, sleep disorders, taste disorder, paresthesia, anxiety, concentration disorders, hyperesthesia, depression, in less than 0.01% of cases - hallucinations, confusion.
    On the part of the digestive system: in less than 10% of cases - pain in the upper abdomen, diarrhea, dyspepsia, nausea, flatulence; in less than 1% of cases - belching, bloating, constipation, increased peristalsis, gastritis, dry mouth, ulcers of the stomach or duodenum, esophagitis, ulcers of the oral mucosa, vomiting; in less than 0.01% of cases - gastric and intestinal ulcers with perforation or bleeding.
    On the part of the liver: in less than 0.01% of cases - hepatitis.
    From ENT organs: in less than 1% of cases - conjunctivitis, tinnitus, blurred vision, vertigo.
    From the side of immunity: in less than 0.01% of cases - anaphylactic reactions, including severe pressure drop and shock.
    On the part of the genitourinary system: in less than 1% of cases - proteinuria; in less than 0.01% of cases - reversible renal failure.
    On the part of the respiratory system: in less than 1% of cases - dyspnea, cough, nosebleeds; in less than 0.01% of cases - bronchospasm.
    From the side of the cardiovascular system: in less than 10% of cases - palpitation, increased blood pressure; in less than 1% of cases - cerebral circulatory disorders, hot flashes, atrial fibrillation, ECG changes; in less than 0.01% of cases - hypertensive crisis.
    Infections: in less than 1% of cases - gastroenteritis, urinary tract infection, respiratory tract.
    From the skin and subcutaneous tissue: in less than 10% of cases - ecchymoses; in less than 1% of cases - puffiness of the face, itching, rash; in less than 0.0 1% of cases - Stevens-Johnson syndrome, urticaria, Lyell's syndrome.
    Metabolic disorders: less than 10% of cases - swelling; in less than 1% of cases - changes in appetite.
    From the side of the musculoskeletal tract: in less than 1% of cases - arthralgia, cramps, myalgia.
    Other: often - influenza-like syndrome; infrequently - pain in the chest.
    Changes in clinical analyzes: in less than 10% of cases - increased transaminases; in less than 1% of cases - decreased hematocrit, increased activity of creatine phosphokinase, hyperkalemia, decreased hemoglobin, thrombocytopenia, leukopenia, increased serum creatinine, uric acid; in less than 0.01% of cases - an increase in sodium in the blood.

Instructions for use Arcoxia (Method and dosage)

Instructions for use Arcoxia prescribes to take this medicine inside, not taking into account the reception of food. After swallowing the tablets, take Arcoxia with water.
    For osteoarthritis: the recommended dose is 60 or 30 mg once a day.
    Ankylosing spondylitis and rheumatoid arthritis: Take an Arcoxia 90mg tablet once a day.
    Acute gouty arthritis: in the acute period, the dose of the drug is 120 mg once a day. The duration of use of the preparation Arcoxia in a dose of 120 mg should not exceed 8 days.
It is recommended to use the minimum effective dosage with the shortest possible course.

Overdose

During the tests, there was no report of an overdose of Arcoxia.
If the condition of an overdose does develop, there may be undesirable symptoms from the stomach and intestines, kidneys and the cardiovascular system. Treatment is symptomatic. Etorikoksib is not released during hemodialysis.

Interaction

Lithium. Nonsteroidal anti-inflammatory drugs inhibit the excretion of lithium in the urine, increasing its level in the blood.
Methotrexate. With the simultaneous use of etorikoksib and methotrexate, monitoring should be carried out in relation to the increase in toxic effects of the latter.
Oral contraceptives. Joint reception with oral contraceptives can delay their withdrawal, and as a consequence, increase the incidence of side effects (venous thromboembolism).
Digoxin. Etorikoksib increases the toxic effects of digoxin.
Rifampicin. The simultaneous use of etorikoksiba and rifampicin leads to a decrease in the content of etorikoksiba in the blood by 65%.
Antacids. Do not have a significant effect on the pharmacokinetics of etorikoksib.

Terms of sale

To buy Arcoxia you don't need a prescription.

Storage conditions

Store at temperatures below 30 degrees. Keep away from children.
Shelf life three years. Do not use after the expiration date.

special instructions

Admission Arcoxia requires constant monitoring of blood pressure. All patients with this drug should be monitored for blood pressure within the first 14 days of treatment. It is also recommended to regularly monitor the indicators of kidney and liver.
If the level of hepatic enzymes is increased three times or more relative to the normal level, the drug must be canceled.
Given the increased risk of side effects due to the increased duration of admission, it is necessary to regularly assess the need for prolonged use of Arcoxia and the possibility of dose reduction.
It is forbidden to use the drug together with other non-steroidal anti-inflammatory drugs.
The shell of the drug contains lactose in small amounts - this should be taken into account when appointing Arcoxia patients with intolerance to lactose.
During treatment, special care must be taken when driving vehicles and engaging in potentially dangerous activities that require concentration of attention and speed of psychomotor reactions. Persons who have a history of episodes of dizziness, weakness, should refrain from such activities.

Children

The drug is prohibited for use in children under 16 years.

Compatibility with alcohol

You should stop taking alcohol for the period of treatment with the drug.

In pregnancy and lactation

The use of etorikoksib and other COX-2 inhibitors is not recommended for pregnant women, women planning pregnancy and lactating.
If a woman becomes pregnant during the treatment period, the drug must be canceled.
Application in the last trimester of pregnancy can lead to suppression of uterine contractions and early closure of the arterial duct.
Women who use etorikoksib should not breast-feed.

Reviews about Arcoxia

Medical portals and forums abound with reviews of Arcoxia. In general, the reviews of doctors and patients on these tablets are the same: almost 100% effectiveness when using the drug and a fairly high number of reports of the occurrence of side effects. Also, many complain about the rather high cost of the drug.