Elaxib 90mg Tablet

Elaxib 90mg Tablet is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to a subclass known as Selective Cyclooxygenase-2 (COX-2) Inhibitors. It is used for the relief of pain and inflammation associated with various conditions, including osteoarthritis, rheumatoid arthritis (RA), ankylosing spondylitis (AS), and acute gouty arthritis. By selectively blocking the COX-2 enzyme, Etoricoxib reduces the production of prostaglandins, which are chemicals responsible for causing pain, fever, and swelling.

Elaxib 90mg Tablet contains Etoricoxib, a potent, orally active, and highly selective inhibitor of the Cyclooxygenase-2 (COX-2) enzyme. NSAIDs work by blocking COX enzymes. There are two main types: COX-1 and COX-2.

COX-1 is responsible for producing prostaglandins that protect the stomach lining and aid in blood clotting.

COX-2 is responsible for producing prostaglandins in response to injury or inflammation, causing pain and swelling.

Traditional, non-selective NSAIDs block both COX-1 and COX-2, which is why they frequently cause gastrointestinal ulcers and bleeding. Etoricoxib, however, is designed to selectively target COX-2. This selectivity is intended to provide effective anti-inflammatory and pain relief benefits while minimising the severe gastrointestinal side effects associated with COX-1 inhibition.

Despite its GI benefits, the selective inhibition of COX-2 can upset the natural balance of substances that regulate blood vessel function, which is linked to its increased cardiovascular risk profile. Therefore, Etoricoxib is generally reserved for patients who need NSAIDs but are at high risk of GI complications.

Crucial Safety Note: Because Etoricoxib is a selective COX-2 inhibitor, it carries a potentially increased risk of serious cardiovascular (CV) events, including heart attack and stroke, especially with long-term use and high doses. It should be used at the lowest effective dose for the shortest possible duration.

Elaxib 90mg Tablet (Etoricoxib) is indicated for the symptomatic relief of pain and inflammation in adults and adolescents 16 years of age and older:

• Acute Gouty Arthritis: For the treatment of acute pain and inflammation flares.

• Osteoarthritis (OA): For symptomatic relief of joint pain and stiffness.

• Rheumatoid Arthritis (RA): For symptomatic relief of joint pain and swelling.

• Ankylosing Spondylitis (AS): For the treatment of pain and inflammation in the spine.

• Acute Pain: For the short-term treatment of moderate acute pain, such as dental pain or post-operative pain.

• Effective Pain Relief: Provides strong analgesic and anti-inflammatory action comparable to traditional NSAIDs.
• COX-2 Selectivity: Offers a reduced risk of serious gastrointestinal side effects (ulcers, bleeding) compared to non-selective NSAIDs like ibuprofen or naproxen.
• Once-Daily Dosing: The long half-life of Etoricoxib allows for convenient, once-daily administration, improving patient compliance.
• Rapid Onset: It provides relatively fast relief, especially for acute conditions like gout.

Elaxib 90mg Tablet is generally well-tolerated, but common and, more importantly, rare but severe side effects require immediate monitoring and action.

Critical Side Effects (Seek Immediate Emergency Medical Attention)

These are serious risks associated with NSAIDs, especially selective COX-2 inhibitors. Stop taking the medication and seek emergency help immediately if you experience any of the following:

• Cardiovascular Events (Heart attack or Stroke):

• Sudden chest pain, spreading to the neck, jaw, or arm.

• Sudden weakness or numbness on one side of the body.

• Sudden shortness of breath or difficulty breathing.

• Slurred speech or sudden confusion.

• Gastrointestinal (GI) Bleeding and Ulcers:

• Passing black, tarry stools or stools that look bloody.

• Vomiting material that looks like coffee grounds.

• Severe, persistent stomach pain.

• Severe Allergic Reaction (Anaphylaxis or Angioedema):

• Swelling of the face, lips, tongue, or throat.

• Severe difficulty breathing or wheezing.

• Widespread, severe skin rash, blistering, or peeling (including Stevens-Johnson syndrome).

Common Side Effects (Usually Mild and Temporary)

These effects are generally mild and may decrease as your body adjusts. Consult your doctor if they persist or worsen.

• Fluid Retention and Swelling:

• Swelling of the ankles, feet, or legs (oedema).

• Requires monitoring of weight and blood pressure.

• High Blood Pressure (Hypertension):

• Regular blood pressure checks are essential while on this medication.

• Central Nervous System (CNS) Effects:

• Headache, dizziness, or fatigue.

• Mild drowsiness or somnolence.

• Gastrointestinal Effects:

• Nausea, indigestion (dyspepsia), or abdominal pain.

• Flatulence (excess gas).

• Lowest Effective Dose: Always use the lowest dose that controls your pain and for the shortest duration necessary, especially if you have heart concerns.

• Timing: Take the tablet once daily, at the same time each day, as prescribed by your doctor.

• Food: Elaxib 90mg Tablet can be taken with or without food. Taking it with a meal may help reduce minor stomach upset.

• Swallowing: Swallow the tablet whole with a glass of water. Do not crush or chew.

• Duration of Use: For acute pain (like gout), the treatment is usually short-term. For chronic conditions (like OA/RA), your doctor will periodically re-evaluate the need for continued treatment.

• Report Cardiovascular Symptoms Immediately: Any chest pain, shortness of breath, or numbness/weakness must be reported to emergency services immediately.
• Watch for GI Bleeding Signs: Be vigilant for black, tarry stools or vomiting blood, which indicate serious stomach bleeding.
• Monitor Blood Pressure (BP): Etoricoxib can increase BP. If you have hypertension, check your blood pressure regularly while on this medication and inform your doctor of any changes.
• Hydration is Key: Ensure you drink adequate fluids, as NSAIDs can put stress on the kidneys, especially when dehydrated.
• Inform Your Providers: Always tell your doctor, surgeon, and dentist that you are taking Etoricoxib before any procedure or starting new medications.

• Store the tablets at controlled room temperature, typically between 15 degrees C to 30 degrees C (59 degrees F to 86 degrees F).
• Keep the medicine in its original blister pack, away from excessive moisture, heat, and direct light.
• Keep securely out of the reach and sight of children and pets.
• Do not use the medication past the expiry date printed on the packaging.

• Absorption: Food does not significantly affect the total amount of Etoricoxib absorbed, but it may slow down the rate of absorption. This means it might take slightly longer to feel the pain relief if taken with a large meal, but this is usually not clinically significant for long-term use.
• General Rule: Can be taken with or without food.

Etoricoxib has several important drug interactions:

• Warfarin and Other Anticoagulants: Etoricoxib increases the risk of bleeding. The combination requires frequent monitoring of blood clotting time (INR).
• Low-Dose Aspirin: Although often taken together for cardiovascular protection, the combination increases the risk of GI ulceration and other NSAID-related side effects. If taken together, Etoricoxib should be started after the morning dose of Aspirin.
• Diuretics and ACE Inhibitors/ARBs (Blood Pressure Medications): Etoricoxib can reduce the effectiveness of these BP-lowering drugs and increase the risk of kidney damage.
• Lithium and Methotrexate: Etoricoxib can increase the plasma concentrations of Lithium and Methotrexate, leading to toxicity. Dose adjustment and monitoring are essential.
• Oral Contraceptives: Etoricoxib can increase the plasma levels of certain oral contraceptives, potentially increasing side effects related to birth control pills.

Caution is required for patients with:

• Cardiovascular Disease: Including heart failure (NYHA Class II-IV), ischemic heart disease, peripheral arterial disease, or previous stroke/TIA. Etoricoxib is often contraindicated in these conditions.
• Peptic Ulcer Disease (PUD) / GI Bleeding History: Increased risk of recurrence of GI bleeding or perforation.
• Hypertension (High Blood Pressure): Etoricoxib can worsen hypertension.
• Renal Impairment (Kidney Disease): Can cause acute kidney injury or fluid retention.

The standard daily dose for Etoricoxib 90mg varies based on the condition being treated:

• Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS): The recommended dose is 90 mg once daily. This dose may be reduced to 60 mg once daily based on the physician's assessment of chronic management.
• Acute Gouty Arthritis: The recommended dose is 120 mg once daily, which should only be used for the acute symptomatic period, generally for a maximum of 8 days.
• Acute Pain/Dental Surgery: The recommended dose is 90 mg once daily, limited to the acute pain period, not exceeding 8 days of treatment.
• Maximum Dose: The maximum daily dose is 120 mg for short-term use and 90 mg for chronic conditions (RA, AS).

An overdose of Elaxib 90mg Tablet may result in severe GI toxicity (bleeding, perforation), acute kidney failure, and severe cardiovascular events. Other symptoms may include nausea, vomiting, stomach pain, drowsiness, and, in rare cases, respiratory depression.

If an overdose is suspected, seek emergency medical care immediately. Treatment is supportive, as there is no specific antidote.

If you miss a dose of Elaxib 90mg Tablet, take it as soon as you remember. However, if it is already time for your next scheduled dose, skip the missed dose and continue with your regular once-daily schedule. Do not take a double dose to make up for the missed one, as this increases the risk of side effects.