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Etoricoxib Tablets I.P

Etoxicalm  (Etoricoxib) is a selective  COX-2 inhibitor from  Merck & Co. Currently it is approved in more than 80 countries worldwide but not in the US, where the  Food and Drug Administration (FDA) has required additional safety and efficacy data for etoricoxib before it will issue approval.

Therapeutic indications

Etoricoxib is indicated for the treatment of  rheumatoid arthritis,  psoriatic  arthritis,  osteoarthritis,  ankylosing spondylitis, chronic  low back pain, acute pain, and  gout. Approved indications differ by country.

A Cochrane systematic review assessed the benefits of single-dose etoricoxib in reduction of acute post-operative pain in adults. Single-dose oral etoricoxib provides four times more pain relief post-operatively than placebo, with equivalent levels of adverse events. Etoricoxib given at a dose of 120 mg is as effective or even better than other analgesics that are commonly used.

Mechanism of action

Like any other selective COX-2 inhibitor ("coxib"), etoricoxib selectively inhibits  isoform 2 of the enzyme cyclooxygenase (COX-2). It has approximately 106-fold selectivity for COX-2 inhibition over  COX-1. This reduces the generation of  prostaglandins (PGs) from  arachidonic acid. Among the different functions exerted by PGs, their role in the inflammation cascade should be highlighted.

Selective COX-2 inhibitors show less activity on COX-1 compared to traditional  non-steroidal anti-inflammatory drugs (NSAID). This reduced activity is the cause of reduced gastrointestinal side effects, as demonstrated in several large clinical trials performed with different coxibs.

Adverse effects

Like all other NSAIDs the COX-2 inhibitors too have their share of adverse effects. Fixed drug eruption and generalised  erythema, acute generalized exanthematous pustulosis (AGEP),  erythema multiforme like eruption and drug induced pretibial erythema are some serious side effects reported, besides the usual innocuous ones.