Etoday (Etoricoxib 60/90/120mg)

Class: NSAIDs, selective COX-2 inhibitors

Manufacturer: Sun Pharamceutical Industries Limited, Village Ganguwala, Paonta Sahib – 173 025, District-Sirmour, Himachal Pradesh, India

Dosage Form: Tablet

Similar Brands: Etorix Tablets

Uses:

Etoday helps reduce the pain and swelling (inflammation) in the joints and muscles of people 16 years of age and older with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and gout.

Etoday is also used for short term treatment of moderate pain after dental surgery in people 16 years of age and older.

Dosage:

The recommended dose is:

Osteoarthritis

The recommended dose is 30mg once a day, increase to a maximum of 60mg once a day if needed.

Rheumatoid arthritis

The recommended dose is 60mg once a day, increased to a maximum of 90mg once a day if needed.

Ankylosing spondylitis

The recommended dose is 60mg once a day, increased to a maximum of 90mg once a day if needed.

Acute pain conditions

Etoricoxib should be used only for the acute painful period.

Gout

The recommended dose is 120mg once a day which should be used for the acute painful period, limited to a maximum of 8 days treatment.

Postoperative dental surgery pain

The recommended dose is 90mg once daily, limited to a maximum of 3 days treatment.

Side Effects:

If any of the following happen, stop taking etoday and tell your doctor immediately or go to the casualty department at your nearest hospital.

• An allergic reaction which can include skin problems such as ulcers or blistering, or swelling of the face, lips, tongue, or throat which may cause difficulty in breathing or swallowing, which may be serious enough to require immediate medical attention/anaphylactic/anaphylactoid reactions including shock (a serious allergic reaction that requires immediate medical attention)
• Skin conditions with severe blisters and bleeding in the lips, eyes, mouth, nose and genitals
• Shortness of breath, chest pains, or ankle swelling appear or if they get worse
• Severe or continual stomach pain or your stools become black
• Serious kidney problems
• Yellowing of the skin and/or eyes (jaundice) – these are signs of liver problems, liver failure

These may be serious side effects. You may need urgent medical attention or hospitalization

Other side effects

The following side effects can occur during treatment with etoday;

Very common (may affect more than 1 in 10 people).

1. Stomach pain

Common (may affect up to 1 in 10 people).

1. Dry socket (inflammation and pain after a took extraction).
2. Swelling of the legs and/or feet due to fluid retention(oedema).
3. Dizziness, headache.
4. Irregular heart rhythm (arrhythmia)
5. Palpitations (fast or irregular heartbeat)
6. Increased blood pressure (hypertension)
7. Wheezing or shortness of breath (bronchospasm)
8. Constipation, wind (excessive gas), gastritis (inflammation of the lining of the stomach), heartburn, diarrhea, indigestion(dyspepsia)/stomach discomfort, feeling sick, being sick, inflammation of the oesophagus, mouth ulcers (oral ulcer)
9. Changes in blood tests related to your liver
10. Bruising
11. Weakness and fatigue, flu-like illness.

Uncommon (may affect up to 1 in 100 people)

1. Gastroenteritis (inflammation of the gastrointestinal tract that involes both the stomach and small intestine/stomach flu), upper respiratory infection, urinary tract infection (painful burning while passing urine)
2. Changes in laboratory values(decreased number of red blood cells, platelets decreased)
3. Appetite increases or decreases, weight gain
4. Anxiety, depression, decrease in mental sharpness; seeing, feeling or hearing things that are not there (hallucinations)
5. Taste alteration, inability to sleep, numbness or tingling, sleepiness.
6. Blurred vision, eye irritation and redness.
7. Ringing ears, vertigo (sensation of spinning while remaining still)
8. Abnormal heart rhythm (atrial fibrillation), fast heart rate (tachycardia), heart failure, feeling of tightness, pressure or heaviness in the chest (angina pectoris), heart attack.
9. Flushing, stroke, mini-stroke (transient ischaemic attack), severe increase in blood pressure, inflammation of blood vessels (vasculitis)
10. Cough, breathlessness, nose bleed.
11. Stomach or bowel bloating, changes in your bowel habits, dry mouth, stomach ulcer, inflammation of the stomach lining that can become and may lead to bleeding, irritable bowel syndrome (can include stomach ache, diarrhea, indigestion, wind), inflammation of the pancreas (symptoms may include, nausea, stomach pain and vomiting)
12. Swelling of the face, skin rash or itchy skin, redness of the skin
13. Muscle cramp/spasm, muscle pain/stiffness
14. High levels of potassium in your blood, changes in blood or urine tests relating to your kidney(increase in blood urea nitrogen, creatine phosphokinase, uric acid etc)
15. Chest pain

Rare (may affect up to 1 in 1000 people):

1. Confusion, restlessness
2. Low blood levels of sodium

Warnings & Precautions:

Talk to your doctor or pharmacist before taking Etoday if.

• You have a history of stomach bleeding or ulcers
• You have history of heart failure, or any other form of heart disease.
• You have a history of high blood pressure. Etoday can increase blood pressure in some people, especially in high doses, and your doctor will want to check your high blood pressure from time to time.
• You have diabetes, high cholesterol, or are a smoker. These can increase your risk of heart disease.
• You have any history of liver or kidney disease.
• You have swelling due to fluid retention.
• You are dehydrated, for example by a prolonged bout of vomiting or diarrhea.
• You are being treated for an infection, Etoday can mask or hide fever, which is a sign of infection.
• You are a woman trying to become pregnant.
• You are elderly (over 65 years of age).

If you are not sure if any of the above apply to you, talk to your doctor before taking Etoday to see if the medicine is suitable for you.

Etoday works equally well in older and younger adult patients. If you are over 65 years of age, your doctor will want to appropriately keep a check on you. No dosage adjustment is necessary for elderly patients.

Do not give this medicine to children and adolescents under 16 years of age

Driving and using machines

• Do not drive if you experience dizziness or sleepiness.
• Do not use any tools or machines if you experience dizziness or sleepiness.

Pregnancy & Lactation:

If you are pregnant or breast-feeding, think you may be pregnant or planning to have a baby, ask your doctor or pharmacist to advice before taking this medicine.

Etoday tablets must not be taken during pregnancy. If you are pregnant or think you could be pregnant, or if you are planning to become pregnant, do not take these tablets. If you become pregnant, stop taking the tablets and consult your doctor. Consult your doctor if you are unsure or need more advice.

Etoday is not recommended in women attempting to become pregnant.

Breast-feeding

It is not known if etoricoxib is exreted in human milk. If you are breast-feeding, or planning to breast-feed, consult your doctor befor taking etoday. If you are using etoday, you must not breast feed.

Ask your doctor, healthcare provider or pharmacist for advice before taking any medicine

Drug Interactions:

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without prescription.

In particular if you are taking any of the following medicines, your doctor may want to monitor you to check that your medicines are working properly, once you start taking Etoday.

• Medicines that thin your blood (anticoagulants), such as warfarin.
• Diuretics (water tablets)
• Medicine used to help control high blood pressure and heart failure called ACE inhibitors (examples include enalapril and ramipril) and angiotensin receptor blockers (examples include losartan and valsartan)
• Aspirin, the risk of stomach ulcers is greator if you take etoday with aspirin.
• Aspirin for prevention of heart attacks or stroke.

Etoday can be taken with low dose aspirin. If you are currently taking low-dose aspirin to prevent heart attacks or stroke, you should not stop taking aspirin until you talk to your doctor.

• Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs)
• Cyclosporine or tacrolimus (drugs used for suppressing the immune system)
• Lithium (medicine used to treat some types of depression)
• Methotrexate (a drug used for suppressing the immune system, and often used in rheumatoid arthritis)
• Birth control pills (the combination may increase your risk of side effects)
• Hormone replacement therapy (the combination my increase your risk of side effects)
• Digoxin (a medicine for heart failure and irregular heart rhythm)
• Salbutamol tablets or oral solution (a medicine for asthma)
• Minoxidil (a drug used to treat high blood pressure)
• Rifampicin (medicines used to treat infections)

Contraindications:

• If you are allergic (hypersensitive) to etoricoxib or any of the other ingredients of Etoday.
• If you have current stomach ulcer or bleeding in your stomach or intestines.
• If you are allergic to non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and COX-2 inhibitors.
• If you are or could be pregnant or are breast-feeding.
• If you have serious liver disease.
• If you have serious kidney disease.
• If you are under 16 years of age.
• If you have inflammatory bowel disease, such as crohn’s disease, ulcerative colitis or colitis.
• If your doctors has diagnosed heart problems including heart failure (moderate or severe types), angina (chest pain).
• If you have high blood pressure that has not been controlled by treatment (check with your doctor or nurse if you are not sure whether your blood pressure is adequately controlled).
• If you have had a heart attack, bypass surgery, peripheral arterial disease (poor circulation in legs or feet due to narrow or blocked arteries).
• If you have had any kind of stroke (including mini-stroke, transient ischaemic attack or TIA). Etoricoxib may slightly increase your risk of heart attack and stroke and this is why it should not be used in those who have already had heart problems or stroke.

Price: Ksh

Notes:

Marketing authorization holder

Sun Pharmaceutical Industries Limited, Sun House, Plot No 201 B/1 western

Express Highway, Goregaon (East), Mumbai, – 400063 India