Arcoxia and prednisolone.Consumer medicine information

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Arcoxia and prednisolone.Prednisolone & Prednisone



  Cardiovascular data. This information is not intended as medical advice for individual problems nor for making an individual assessment of the risks and benefits of taking a particular medicine. Steady-state concentrations of etoricoxib are reached within seven days of once daily administration of mg, with an accumulation ratio of approximately 2, corresponding to an accumulation half-life of approximately 22 hours. It allows continued monitoring of the benefit-risk balance of the medicinal product. If signs of hepatic insufficiency occur, or if persistently abnormal liver function tests three times the upper limit of normal are detected, Arcoxia should be discontinued. This interaction should be given consideration in patients taking Arcoxia concomitantly with these products. It's not known if etoricoxib passes into breast milk. ❿  


- Arcoxia and prednisolone



  The rates per hundred patient years of confirmed upper GI clinical events perforations, ulcers, and bleeds; PUBs were 0. Pharmacokinetics in the elderly 65 years of age and older are similar to those in the young. In each of these datasets, a higher incidence of adverse events was seen in older patients compared to younger patients; the relative differences between the etoricoxib and control groups were similar in the elderly and the young. Standard monitoring for methotrexate related toxicity should be considered when Arcoxia at doses greater than 90 mg daily and methotrexate are administered concomitantly. Mechanism of action.     ❾-50%}

 

Prednisolone & Prednisone — Arthritis Australia.Arcoxia (etoricoxib): uses, dosage and side effects



    See related product images. Signs of adrenal insufficiency include weakness, fatigue, fever, weight loss, vomiting, diarrhoea and abdominal pain. Our websites. When I first started the steroids the pain eased dramatically. However, these side effects are still possible, particularly in elderly people.

Although the risk of upper GI toxicity is not eliminated with Arcoxia, the results of the MEDAL program demonstrate that in patients treated with Arcoxia, the risk of upper GI toxicity with Arcoxia 60 mg or 90 mg once daily is significantly less than with diclofenac mg daily see Section 5. In clinical studies with ibuprofen and naproxen, the risk of endoscopically detected upper GI ulcers was lower in patients treated with Arcoxia mg once daily than in patients treated with the non-selective NSAIDs.

While the risk of endoscopically detected ulcers was low in patients treated with Arcoxia mg it was higher than in patients treated with placebo. These events can occur at any time during use and without warning symptoms. Independent of treatment, patients with a prior history of GI perforation, ulcers and bleeding PUB and patients greater than 65 years of age are known to be at a higher risk for a PUB.

The utility of periodic laboratory monitoring has not been demonstrated, nor has it been adequately assessed. These trends continue, thus increasing the likelihood of developing a serious GI event at some time during the course of therapy. However, even short-term therapy is not without risk. There is a further increase in the risk of gastrointestinal adverse effects gastrointestinal ulceration or other gastrointestinal complications when etoricoxib is taken concomitantly with acetylsalicylic acid even at low doses.

Renal effects. Renal prostaglandins may play a compensatory role in the maintenance of renal perfusion.

Therefore, under conditions of compromised renal perfusion, administration of Arcoxia may cause a reduction in prostaglandin formation and, secondarily, in renal blood flow and thereby impair renal function.

Patients at greatest risk of this response are those with pre-existing significantly impaired renal function, uncompensated heart failure or cirrhosis. Monitoring of renal function in such patients should be considered.

Caution should be used when initiating treatment with Arcoxia in patients with considerable dehydration. It is advisable to rehydrate patients prior to starting therapy with Arcoxia. Fluid retention, oedema, hypertension. As with other drugs known to inhibit prostaglandin synthesis, fluid retention, oedema and hypertension have been observed in patients taking Arcoxia. All non-steroidal anti-inflammatory drugs NSAIDs , including etoricoxib, can be associated with new onset or recurrent congestive heart failure.

For information regarding a dose related response for etoricoxib, see Section 4. Caution should be exercised in patients with a history of cardiac failure, left ventricular dysfunction or hypertension and in patients with pre-existing oedema from any other reason. If there is clinical evidence of deterioration in the condition of these patients, appropriate measures including discontinuation of etoricoxib should be taken.

Etoricoxib may be associated with more frequent and severe hypertension than some other NSAIDs and selective COX-2 inhibitors, particularly at high doses. Therefore, hypertension should be controlled before treatment with etoricoxib see Section 4. Blood pressure should be monitored within two weeks after initiation of treatment and periodically thereafter. If blood pressure rises significantly, alternative treatment should be considered. Hepatic effects. These abnormalities may progress, may remain essentially unchanged, or may resolve in patients with continued treatment of Arcoxia, with approximately half resolving while patients remained on therapy.

In controlled clinical trials of Arcoxia 30 mg daily versus ibuprofen mg daily or celecoxib mg daily, the incidence of elevations of ALT or AST was similar. In post-marketing experience jaundice has been reported rarely. Limited reports of hepatic failure have been reported, but without clear association to Arcoxia. Physicians and patients should remain alert for hepatotoxicity.

If signs of hepatic insufficiency occur, or if persistently abnormal liver function tests three times the upper limit of normal are detected, Arcoxia should be discontinued.

When using etoricoxib in the elderly and in patients with renal, hepatic, or cardiac dysfunction, medically appropriate supervision should be maintained. If these patients deteriorate during treatment, appropriate measures should be taken, including discontinuation of therapy.

Serious skin reactions. Serious skin reactions, some of them fatal, including drug reaction with eosinophilia and systemic symptoms DRESS syndrome see Drug reaction with eosinophilia with systemic symptoms DRESS , exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported very rarely in association with the use of NSAIDs and some selective COX-2 inhibitors during post-marketing surveillance see Section 4.

These serious events may occur without warning. Patients appear to be at highest risk for these reactions early in the course of therapy; the onset of the reaction occurring in the majority of cases within the first month of treatment. Serious hypersensitivity reactions such as anaphylaxis and angioedema have been reported in patients receiving etoricoxib see Section 4.

Some selective COX-2 inhibitors have been associated with an increased risk of skin reactions in patients with a history of any drug allergy. Etoricoxib should be discontinued at the first appearance of skin rash, mucosal lesions or any other sign of hypersensitivity.

Some of these events have been fatal or life-threatening. Other clinical manifestations may include hepatitis, nephritis, haematological abnormalities, myocarditis, or myositis. Eosinophilia is often present. Because this disorder is variable in its presentation, other organ systems not noted here may be involved. It is important to note that early manifestations of hypersensitivity, such as fever or lymphadenopathy, may be present even though rash is not evident. Use in patients with inflammatory bowel disease IBD.

There has only been limited study of etoricoxib in patients with IBD. Use in patients with fever and infection. Arcoxia may mask fever, which is a sign of infection. The physician should be aware of this when using Arcoxia in patients being treated for infection. Use in hepatic impairment. See Hepatic effects, above; see Section 5. Use in the elderly. Of the 17, patients who received Arcoxia in the MEDAL program, 7, were 65 years of age or older this included 2, patients who were 75 years or older.

In each of these datasets, a higher incidence of adverse events was seen in older patients compared to younger patients; the relative differences between the etoricoxib and control groups were similar in the elderly and the young. Greater sensitivity of some older individuals cannot be ruled out. Paediatric use. Safety and effectiveness in patients aged below 18 years have not been established.

Effects on laboratory tests. Please see Section 4. Etoricoxib is an inhibitor of human sulfotransferase activity, particularly SULT1E1 and has been shown to increase the serum concentrations of ethinyl oestradiol see Section 4.

This interaction should be given consideration in patients taking Arcoxia concomitantly with these products. In some patients with compromised renal function e. These effects are usually reversible. Therefore, the combination should be administered with caution, especially in the elderly. Arcoxia can be used concomitantly with low dose aspirin at doses for cardiovascular prophylaxis.

At steady state, Arcoxia mg once daily had no effect on the antiplatelet activity of low dose aspirin 81 mg once daily , as assessed by ex vivo platelet aggregation and serum TXB 2 generation in clotting blood. However, concomitant administration of low dose aspirin with Arcoxia increases the rate of GI ulceration or other complications, compared to use of Arcoxia alone. Arcoxia mg once daily for 10 days did not alter the steady-state plasma AUC hr or renal elimination of digoxin.

Therefore, digoxin and Arcoxia may be coadministered without dose adjustment. Clinical studies have shown that NSAIDs can reduce the natriuretic effect of frusemide and thiazides in some patients.

This response has been attributed to inhibition of renal prostaglandin synthesis. The clinical significance of this increase is not known.

NSAIDs have produced an elevation of plasma lithium levels and a reduction in renal lithium clearance. Thus, when Arcoxia and lithium are administered concurrently, subjects should be observed carefully for signs of lithium toxicity.

Two studies investigated the effects of Arcoxia 60, 90 or mg administered once daily for seven days in patients receiving once weekly methotrexate doses of 7. Arcoxia at 60 and 90 mg had no effect on methotrexate plasma concentrations as measured by AUC or renal clearance. In one study, Arcoxia mg had no effect on methotrexate plasma concentrations as measured by AUC or renal clearance.

Standard monitoring for methotrexate related toxicity should be considered when Arcoxia at doses greater than 90 mg daily and methotrexate are administered concomitantly. Oral contraceptives. Arcoxia 60 mg given concomitantly with an oral contraceptive containing 35 microgram ethinyl estradiol EE and 0.

This increase in EE concentration should be considered when selecting an oral contraceptive for use with Arcoxia. An increase in EE exposure can increase the incidence of adverse events associated with oral contraceptives e. Hormone replacement therapy. Administration of Arcoxia mg with hormone replacement therapy consisting of conjugated oestrogens 0. The effect of the recommended chronic doses of Arcoxia 30 and 60 mg has not been studied.

The effects of Arcoxia mg on the exposure AUC hr to these oestrogenic components of Premarin were less than half of those observed when Premarin was administered alone and the dose was increased from 0. The clinical significance of these increases is unknown, and higher doses of Premarin were not studied in combination with Arcoxia. These increases in oestrogenic concentration should be taken into consideration when selecting postmenopausal hormone replacement therapy for use with Arcoxia.

Etoricoxib did not have any clinically important effect on the pharmacokinetics of prednisolone or prednisone. This interaction should be taken into consideration when Arcoxia is coadministered with rifampicin.

Anticoagulant activity should be monitored, particularly in the first few days after initiating or changing Arcoxia therapy in patients receiving warfarin or similar agents, since these patients are at an increased risk of bleeding complications.

Effects on fertility. These changes are expected with inhibition of prostaglandin synthesis and are not the result of permanent alteration of female reproductive function see Use in pregnancy. Category C Medicines which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human foetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details. Non-steroidal anti-inflammatory drugs NSAIDs inhibit prostaglandin synthesis and, when given during the latter part of pregnancy, may cause closure of the foetal ductus arteriosis, foetal renal impairment, inhibition of platelet aggregation, and delay labour and birth.

Data from epidemiological studies suggest an increased risk of miscarriage after the use of a prostaglandin synthesis inhibitor in early pregnancy. Oligohydramnios and neonatal renal impairment. Use of NSAIDs from about 20 weeks gestation may cause foetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment.

These adverse outcomes are seen, on average, after days to weeks of treatment, although oligohydramnios has been infrequently reported as soon as 48 hours after NSAID initiation. Oligohydramnios is often, but not always, reversible with treatment discontinuation. Complications of prolonged oligohydramnios may, for example, include limb contractures and delayed lung maturation.

In some post-marketing cases of impaired neonatal renal function, invasive procedures such as exchange transfusion or dialysis were required. Cases of foetal renal dysfunction that have resulted in reduction of amniotic fluid volume oligohydramnios have been reported in pregnant women treated with non steroidal anti-inflammatory drugs NSAIDs at 20 weeks of gestation or later. In some cases, this may result in neonatal renal dysfunction.

Such effects may occur shortly after NSAID treatment initiation; oligohydramnios is often reversible after treatment discontinuation. Use of Arcoxia is not recommended in pregnancy from 20 weeks of gestation onwards.

If, after careful consideration of alternative treatment options for pain management, NSAID treatment is necessary from about 20 weeks, limit use to the lowest effective dose and shortest duration possible. Consider ultrasound monitoring of amniotic fluid if treatment extends beyond 48 hours. There are no adequate and well-controlled studies of Arcoxia in pregnant women. Arcoxia should be used during the first two trimesters of pregnancy only if potential benefit justifies the potential risk to the foetus.

High placental transfer of etoricoxib has been demonstrated in pregnant rats and rabbits. A low incidence of ventricular septal defects and other cardiovascular malformations has been observed in rabbits given etoricoxib at oral doses producing exposure levels comparable to that expected in humans. Etoricoxib is excreted in the milk of lactating rats at concentrations up to two-fold greater than the maximal maternal plasma concentration.

Because many drugs are excreted in human milk and because of the possible adverse effects of drugs that inhibit prostaglandin synthesis on nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. The effect of Arcoxia on the ability to drive or use machinery has not been studied.

However, based on its pharmacodynamic properties and overall safety profile it is unlikely to have an effect on these activities. In the 6 to 12 week placebo controlled population, discontinuations due to clinical adverse experiences for Arcoxia 30 mg, Arcoxia 60 mg, and placebo were 4.

The most common reasons for discontinuation due to adverse experiences in OA patients treated with Arcoxia 30 and 60 mg, were dyspepsia and dizziness 0. Among patients receiving placebo, 0.

In patients treated for up to one year, discontinuations due to clinical adverse experiences for Arcoxia 30 mg, Arcoxia 60 mg and naproxen were 7. The most common reasons for discontinuation due to adverse experiences in patients treated with Arcoxia 30 and 60 mg, were dyspepsia and upper abdominal pain 0. In the 6 to 12 week RA population, discontinuations due to clinical adverse experiences were 3. The most common causes of discontinuation were dyspnoea, breast malignant neoplasm and headache with each event occurring at 0.

In RA patients treated for up to one year, discontinuations due to clinical adverse experiences were 7. The most common causes of discontinuation in patients treated with Arcoxia were dyspepsia 0. In the naproxen group, 1. In two placebo controlled clinical trials of 12 weeks duration for chronic low back pain, patients were treated with Arcoxia 60 mg or 90 mg daily.

Discontinuations due to clinical adverse experiences were reported in Arcoxia 60 mg In twelve acute analgesia studies, 1, patients were treated with Arcoxia in either a single dose or multiple dose regimen. In the single dose population, 1, patients were treated with Arcoxia dosages of Six patients discontinued due to clinical adverse experiences including 0. In the multiple dose acute analgesia study population, patients received Arcoxia mg as the initial dose followed by 60 mg or mg once daily for up to 7 days.

Discontinuations due to adverse experiences were 8. The most common causes of discontinuation for those patients treated with Arcoxia were nausea and confusion. In the postdental surgery pain study of patients treated with Arcoxia 90 mg once daily for up to 3 days, the adverse experience profile was generally similar to that reported in patients treated with Arcoxia mg in all acute analgesia studies.

In two active comparator clinical trials for acute gouty arthritis, patients were treated with Arcoxia mg once daily for eight days. Discontinuations due to adverse experiences were 3. The most common cause of discontinuation was hypertension occurring at 1. Since these ten trials were of different durations, and patients in the trials may not have been exposed for the same duration of time, these percentages do not capture cumulative rates of occurrence.

The following lists additional adverse experiences, regardless of causality, occurring in patients receiving Arcoxia with a frequency of between 0. Infections and infestations. Herpes simplex, infection, pharyngitis, sinusitis, staphylococcal infection, tonsillitis. Immune system disorders. Seasonal allergy. Metabolism and nutrition disorders. Diabetes mellitus. Psychiatric disorders.

Anxiety, anxiety disorder, depression. Nervous system disorders. Carpal tunnel syndrome, paraesthesia, somnolence, vasovagal syncope, tremor. Eye disorders. Blepharitis, conjunctivitis, eye pain, vision blurred. Ear and labyrinth disorders. Cardiac disorders. Vascular disorders. Diastolic hypertension, flushing, hot flush. Respiratory, thoracic and mediastinal disorders. Cough, dyspnoea exertional, rales, sinus congestion, wheezing. Gastrointestinal disorders. Abdominal distension, aphthous stomatitis, bowel sounds abnormal, change of bowel habit, constipation, dry mouth, frequent bowel movements, gastritis, glossitis, irritable bowel syndrome, mouth ulceration, oral pain, retching, toothache.

Skin and subcutaneous tissue disorders. Blister, dermal cyst, dermatitis, eczema, hyperhidrosis, rash, rash maculopapular, rosacea, skin ulcer. Musculoskeletal and connective tissue disorders. Neck pain, osteoporosis, periarthritis, rotator cuff syndrome, tendinitis, toe deformity. Renal and urinary disorders. Nephrolithiasis, nocturia, polyuria. Reproductive system and breast disorders. Erectile dysfunction, vaginal haemorrhage. General disorders and administration site conditions.

Asthenia, face oedema, fatigue, feeling hot, oedema. Faecal occult blood positive. Just because a side effect is listed here, this does not mean that everyone who uses this medicine will experience it, or any side effect.

If you are concerned about side-effects or experience an adverse reaction from your medicine, consult your GP. These are less likely than older NSAIDs such as naproxen and diclofenac to irritate the gut and cause side effects such as stomach ulcers.

However, these side effects are still possible, particularly in elderly people. Your doctor might prescribe you a medicine to help protect your stomach if you're taking Arcoxia for long periods of time. People taking painkillers like etoricoxib have a slightly higher risk of heart problems such as fast heartbeat, chest pain, heart attack, heart failure or stroke. These are more of a risk if you're taking a high dose of etoricoxib for a long time.

If you have risk factors for heart disease or stroke, such as diabetes, high blood pressure, high cholesterol or smoking, your doctor will need to assess the overall benefits and risks before deciding if etoricoxib is suitable for you. You should read the patient information leaflet that is supplied with your medication for more information about side effects associated with Arcoxia.

You can find a copy of this here. If you think you have experienced side effects from this medicine you can report them using the yellow card scheme. You should check with your pharmacist before taking any new medicines while you're taking etoricoxib, to make sure that the combination is safe. It's fine to take paracetamol with Arcoxia. You can also take opioid-type painkillers such as codeine, co-codamol, tramadol or morphine in combination with Arcoxia. However, don't take anti-inflammatory painkillers NSAIDs like aspirin, ibuprofen or naproxen with Arcoxia, as this increases the risk of getting side effects on the gut.

Remember that many cold and flu remedies and over-the-counter painkillers contain ibuprofen or aspirin and so should be avoided while you're taking etoricoxib. Be sure to check the ingredients of other medicines before taking them with Arcoxia, or ask your pharmacist for advice. It's also best to check with your pharmacist if you want to use an anti-inflammatory gel such as diclofenac, ibuprofen, ketoprofen or piroxicam while you're taking Arcoxia, because this may not be safe for everyone.

If you're taking a medicine that affects blood clotting, such as those below, taking Arcoxia may increase the risk of bleeding, particularly in the gut:. You are more at risk of ulceration or bleeding in your gut if you take etoricoxib with steroids such as prednisolone. Etoricoxib may oppose the effect of diuretics and medicines for high blood pressure antihypertensives. There may be an increased risk of side effects on the kidneys if etoricoxib is taken with any of the following medicines.

If you're taking one of these with Arcoxia your doctor may want to monitor your kidney function:. Read more detailed information about medicines that interaction with etoricoxib here. Type keyword s to search. It is important to see your general practitioner if you have been asked to do so as they have an important role to play in monitoring your condition. Use in pregnancy and breastfeeding Prednisolone may be used safely in pregnancy and breastfeeding.

It is important to tell your doctor if you are, or intend to become pregnant or if you are breastfeeding. Use with other medicines Corticosteroids can interact with other medicines. You should tell all your doctors about all medicines you are taking or plan to take. You should also mention your treatment when you see other health professionals, even if you have stopped taking corticosteroids within the last 12 months.

Talk with your rheumatologist before receiving any vaccines. Your doctor may tell you that you need some additional prednisolone at the time of surgery. Your adrenal glands, which are just above the kidneys, normally make glucocorticoids in small amounts. These are important for many normal body functions. If prescribed glucocorticoids are taken, the body begins to make less than usual or even stops making glucocorticoids completely.

This problem is called adrenal insufficiency. Signs of adrenal insufficiency include weakness, fatigue, fever, weight loss, vomiting, diarrhoea and abdominal pain. If you experience any of these problems, seek medical help. How to store prednisolone Store prednisolone tablets at room temperature, away from heat, moisture and light e.

Keep all medicines out of reach of children. Important things to remember You must see your rheumatologist regularly to make sure the treatment is working and check for possible side effects. You should have regular blood tests as suggested by your rheumatologist. Do not increase or reduce the dose of prednisolone or prednisone unless your doctor or rheumatologist tells you to. It is important to tell your rheumatologist if you have a new serious illness such as a serious infection, cancer or heart failure.

If you are worried about any side effects, you should contact your rheumatologist as soon as possible. If you plan to become pregnant, you must discuss the timing with your rheumatologist. Last reviewed May Discover more What is accessible design? Find out about what accessible design is and about the Accessible Design Division.

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It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist. All medicines have risks and benefits. Osteoarthritis Osteoarthritis is a joint disease. It results from the gradual breakdown of the cartilage that covers the joints and cushions the ends of bones. Symptoms of osteoarthritis include pain, tenderness, stiffness of one or more joints, and physical disability.

The hips and knees are the most commonly affected joints, but other joints, such as those of the hands and spine, may also be affected. Osteoarthritis is more common in women than in men. Many factors can lead to the development of osteoarthritis, including obesity and joint injury e. Gout Gout is a disease that causes attacks of arthritis, usually in a single joint.

The affected joint is red, swollen, painful and extremely tender. A gout attack usually lasts a few days and it may recur. For more information about osteoarthritis or gout, contact the Arthritis Foundation in the capital city of your state. It works in a similar way to traditional anti-inflammatory medicines, known as Non-Steroidal Anti-Inflammatory Drugs NSAIDsby blocking the production of substances that cause pain and inflammation.

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. You may need different amounts of your medicine, or you may need to take different medicines.

If you are taking low-dose aspirin to help prevent a heart attack or stroke, do not stop taking it unless your doctor tells you to because ARCOXIA cannot replace the use of aspirin for this purpose. For osteoarthritis, the recommended dose is 30mg once a day, increased to a maximum of 60mg once a day if needed.

For the relief of gout attacks, the recommended dose is mg taken once a day, which should only be used during the painful period, to a maximum of 8 days treatment. For the relief of cramp-like pain or discomfort before or during a menstrual period, the recommended dose is mg taken once a day, which should only be used during the painful period, to a maximum of 8 days treatment.

For the relief of short term pain after dental procedures, the recommended dose is 90 mg taken once a day, which should only be used during the painful period, to a maximum of 8 days treatment. Doses greater than those recommended for each condition stated above have either not been shown to improve the effectiveness of ARCOXIA or have not been studied.

Therefore, the daily doses stated above for each condition should not be exceeded. If you have moderate liver disease, do not take more than 60 mg every second day or 30mg once a 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.

It will also help you remember when to take the dose. For the relief of gout attacks and short term pain, including menstrual pain and dental pain, ARCOXIA should only be used during the painful period, limited to a maximum of 8 days treatment.

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. Do this even if there are no signs of discomfort or poisoning. ARCOXIA may hide fever and may make you think, mistakenly, that you are better or that that your infection is less serious than it might be.

If any of the following symptoms: serious skin rash, shortness of breath, chest pains or ankle swelling, appear or worsen, stop your treatment with ARCOXIA and consult a doctor, as soon as is practical. Adverse experiences may occur at a higher incidence in older patients compared to younger patients.

If you are elderly i. No dosage adjustment is necessary for older patients. If you have kidney, liver or heart disease, your doctor will want to keep a regular check on you. Your doctor will want to discuss your treatment from time to time. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.

ARCOXIA can increase blood pressure in some people, especially in high doses, and this could increase the risk of heart attacks and strokes. Your doctor will want to check your blood pressure from time to time, to make sure that it is safe to continue treatment. The effect of ARCOXIA on the ability to drive a car or operate machinery has not been studied, although it is thought to be unlikely to have any effect on these activities.

Some self help measures suggested below may help your condition. Talk to your doctor or pharmacist about these measures and for more information. ARCOXIA helps most people with arthritis, menstrual pain, or other types of pain, but it may have unwanted side effects in a few people.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects. These may be serious side effects. You may need urgent medical attention. If any of the following happen, tell your doctor immediately or go to accident and emergency at your nearest hospital:. Other side effects not listed above may also occur in some patients. Tell your doctor if you notice any other effects.

Keep your tablets in the blister pack until it is time to take them. If you take the tablets out of the blister pack, they may not keep well. Do not store it or any other medicine in the bathroom or near a sink. Do not leave it in the car or on window sills.

Heat and dampness can destroy some medicines. Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

If your doctor tells you to stop taking ARCOXIA or the tablets have passed their expiry date, ask your pharmacist what to do with any that are left over. This CMI leaflet was current at the time of printing. Etoricoxib is a white to off-white powder. Etoricoxib is freely soluble in methanol, tetrahydrofuran, dimethyl sulfoxide, methyl ethyl ketone, dimethyl formamide, and chloroform. Etoricoxib is soluble in isopropyl acetate, ethanol and toluene, sparingly soluble in 2-propanol, and practically insoluble in water.

Each tablet of Arcoxia for oral administration contains either 30, 60, 90 or mg of etoricoxib. Excipients with known effect. Lactose monohydrate. For the full list of excipients, see Section 6. Arcoxia etoricoxib 30 mg is a blue-green, apple-shaped, biconvex film coated tablet debossed "" on one side and "ACX 30" on the other side. Arcoxia etoricoxib 60 mg is a dark green, apple-shaped, biconvex film coated tablet engraved "" on one side and "ARCOXIA 60" on the other side.

Arcoxia etoricoxib 90 mg is a white, apple-shaped, biconvex film coated tablet debossed "" on one side and "ARCOXIA 90" on the other side. Arcoxia etoricoxib mg is a pale green, apple-shaped, biconvex film coated tablet engraved "" on one side and "ARCOXIA " on the other side.

Arcoxia is indicated for: Symptomatic treatment of the signs and symptoms of osteoarthritis OA. Treatment of acute gouty arthritis. Treatment of acute pain, including that related to primary dysmenorrhoea and minor dental procedures. The decision to prescribe a selective COX-2 inhibitor should be based on an assessment of the individual patient's overall risks.

Arcoxia is administered orally. Arcoxia may be taken with or without food. As the cardiovascular risks of etoricoxib may increase with dose and duration of exposure, the shortest duration possible and the lowest effective daily dose should be used. Patients on long-term treatment should be reviewed regularly with regards to efficacy, risk factors and ongoing need for treatment.

The recommended dose is 30 mg once daily. In some patients with insufficient relief from symptoms, the dose may be increased to 60 mg once daily. In the absence of therapeutic benefit after 4 weeks of treatment with etoricoxib 60 mg, other therapeutic options should be considered. In the following acute painful conditions. Acute gouty arthritis. The recommended dose is mg once daily. Arcoxia should be used only for the acute symptomatic period, limited to a maximum of 8 days treatment.

Primary dysmenorrhoea. Dental pain. The recommended dose is 90 mg once daily. Doses greater than those recommended for each indication have either not demonstrated additional efficacy or have not been studied. Therefore: The dose for OA should not exceed 60 mg daily. The dose for acute pain, primary dysmenorrhoea, and acute gout should not exceed mg daily, limited to a maximum of 8 days treatment. The dose for dental pain should not exceed 90 mg, limited to a maximum of 8 days treatment.

Hepatic insufficiency. In patients with mild hepatic insufficiency Child-Pugh scorea dose of 60 mg once daily should not be exceeded. In patients with moderate hepatic insufficiency Child-Pugh scorethe dose should be reduced; a dose of 60 mg every other day should not be exceeded, administration with 30 mg once daily can also be considered.

This study compared the efficacy and safety of prednisolone, etoricoxib, and indomethacin in the treatment of AGA. Material/methods: This was an. I already take Arcoxia 90 and Gabapentin Yesterday I went down to prednisolone for 1 month. Feel pretty rough and just wondered if. I already take Arcoxia 90 and Gabapentin Yesterday I went down to prednisolone for 1 month. Feel pretty rough and just wondered if. Arcoxia 30 mg Film-coated Tablets - Summary of Product Characteristics (SmPC) Prednisone/prednisolone: In drug-interaction studies, etoricoxib did not. Information about taking Arcoxia tablets, an NSAID, including how to take gut if you take etoricoxib with steroids such as prednisolone. In the MEDAL program, there was no significant difference between etoricoxib and diclofenac in the rate of cardiovascular thrombotic events over a mean treatment duration of 18 months see Section 5. In the combined analysis, the magnitude of the risk reduction for the complicated events primarily a result of upper GI haemorrhages was generally consistent over the entire treatment period with results for overall upper GI clinical events relative risk 0. Use with other medicines Corticosteroids can interact with other medicines. In one study, Arcoxia mg had no effect on methotrexate plasma concentrations as measured by AUC or renal clearance.

Arcoxia is a brand name for etoricoxib. Unbranded generic etoricoxib tablets are also available. Etoricoxib is used to reduce inflammation swelling and relieve pain in arthritic conditions such as osteoarthritis , rheumatoid arthritis and ankylosing spondylitis.

It is also prescribed for short-term pain relief in attacks of gout and following dental surgery. Etoricoxib works by blocking the action of an enzyme in the body called cyclo-oxygenase COX. COX is involved in making substances in the body known as prostaglandins, in response to injury and in conditions like arthritis. The prostaglandins cause pain, swelling and inflammation. Etoricoxib reduces inflammation and pain by reducing the production of these prostaglandins.

Etoricoxib will start to relieve pain after a single dose, but its anti-inflammatory effect builds up over a few weeks of taking it regularly.

It's not suitable for children under 16 and women who are pregnant, trying for a baby or breastfeeding. If you think this medicine is not working for you, consult your doctor. Some people might need a lower dose of etoricoxib or extra monitoring.

These include:. Arcoxia tablets should be taken once a day, preferably at the same time each day. You can take your tablet either with or without food, but if you take it without food it may start to work faster. If you have arthritis you'll usually need to take a tablet every day on a regular basis to reduce inflammation and pain. For acute gout you can take one tablet a day for up to eight days.

There are four strengths of tablet available 30 mg, 60 mg, 90 mg and mg. The strength you are prescribed depends on why you are taking the medicine:. Missed dose: If you forget to take a tablet at your usual time, take it as soon as you remember that day.

If you don't remember until the following day, just leave out the forgotten dose and take your next dose as usual. Do not take a double dose to make up for a missed dose. Never take more than the dose prescribed by your doctor. If you think this medicine is not working well enough you should make an appointment with your doctor. Medicines and possible side effects can affect individual people in different ways. The following are some of the side effects which may be associated with this medicine.

Just because a side effect is listed here, this does not mean that everyone who uses this medicine will experience it, or any side effect. If you are concerned about side-effects or experience an adverse reaction from your medicine, consult your GP. These are less likely than older NSAIDs such as naproxen and diclofenac to irritate the gut and cause side effects such as stomach ulcers. However, these side effects are still possible, particularly in elderly people. Your doctor might prescribe you a medicine to help protect your stomach if you're taking Arcoxia for long periods of time.

People taking painkillers like etoricoxib have a slightly higher risk of heart problems such as fast heartbeat, chest pain, heart attack, heart failure or stroke. These are more of a risk if you're taking a high dose of etoricoxib for a long time. If you have risk factors for heart disease or stroke, such as diabetes, high blood pressure, high cholesterol or smoking, your doctor will need to assess the overall benefits and risks before deciding if etoricoxib is suitable for you.

You should read the patient information leaflet that is supplied with your medication for more information about side effects associated with Arcoxia.

You can find a copy of this here. If you think you have experienced side effects from this medicine you can report them using the yellow card scheme.

You should check with your pharmacist before taking any new medicines while you're taking etoricoxib, to make sure that the combination is safe. It's fine to take paracetamol with Arcoxia.

You can also take opioid-type painkillers such as codeine, co-codamol, tramadol or morphine in combination with Arcoxia. However, don't take anti-inflammatory painkillers NSAIDs like aspirin, ibuprofen or naproxen with Arcoxia, as this increases the risk of getting side effects on the gut. Remember that many cold and flu remedies and over-the-counter painkillers contain ibuprofen or aspirin and so should be avoided while you're taking etoricoxib.

Be sure to check the ingredients of other medicines before taking them with Arcoxia, or ask your pharmacist for advice. It's also best to check with your pharmacist if you want to use an anti-inflammatory gel such as diclofenac, ibuprofen, ketoprofen or piroxicam while you're taking Arcoxia, because this may not be safe for everyone.

If you're taking a medicine that affects blood clotting, such as those below, taking Arcoxia may increase the risk of bleeding, particularly in the gut:. You are more at risk of ulceration or bleeding in your gut if you take etoricoxib with steroids such as prednisolone. Etoricoxib may oppose the effect of diuretics and medicines for high blood pressure antihypertensives. There may be an increased risk of side effects on the kidneys if etoricoxib is taken with any of the following medicines.

If you're taking one of these with Arcoxia your doctor may want to monitor your kidney function:. Read more detailed information about medicines that interaction with etoricoxib here. Type keyword s to search. Science Photo Library Getty Images. What is Arcoxia? Arcoxia tablets contain etoricoxib, which is an anti-inflammatory medicine.

Arcoxia etoricoxib is only available on prescription. What is Arcoxia used for? How does Arcoxia etoricoxib work? Who should not take Arcoxia? Arcoxia tablets are not suitable for: Children under 16 years of age. People allergic to any ingredient of the tablets. People who have ever had an allergic reaction after taking aspirin or other NSAIDs such as ibuprofen or naproxen for example an asthma attack, itchy rash, nasal inflammation rhinitis or swelling of the lips, tongue and throat.

People with an active peptic ulcer or bleeding in the gut. People with inflammatory bowel disease such as Crohn's disease or ulcerative colitis. People with uncontrolled high blood pressure hypertension. People with heart disease, including heart failure , angina or history of heart attack. People who have ever had a stroke or mini-stroke TIA. People with poor blood circulation in the arteries of the legs or feet peripheral arterial disease. Women who are pregnant. Some evidence suggests that NSAIDs should also be avoided by women who are trying for a baby, as they may temporarily reduce female fertility during treatment and may also increase the risk of miscarriage or malformations.

Women who are breastfeeding. It's not known if etoricoxib passes into breast milk. People with severe liver or kidney problems. Related Story. Advertisement - Continue Reading Below.

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