Etoricoxib + Paracetamol is a combination pain-relief medicine commonly prescribed to treat acute and chronic pain associated with conditions such as osteoarthritis, rheumatoid arthritis, musculoskeletal pain, dental pain, and post-operative pain. Etoricoxib is a COX-2 selective anti-inflammatory agent, while Paracetamol is an analgesic and antipyretic. Together, they reduce pain, inflammation and fever more effectively than either medicine alone. This combination is well-tolerated when used under medical supervision.

Etoricoxib + Paracetamol is a prescription analgesic and anti-inflammatory combination formulated to provide fast and sustained relief from pain and swelling. Etoricoxib belongs to the class of COX-2 selective non-steroidal anti-inflammatory drugs (NSAIDs). It works by inhibiting the cyclooxygenase-2 enzyme responsible for the production of prostaglandins, chemicals that cause inflammation, swelling, and pain. By selectively blocking COX-2, Etoricoxib reduces pain and inflammation while minimising stomach-related side effects compared to traditional NSAIDs.

Paracetamol (Acetaminophen) complements the effect of Etoricoxib by acting on the central nervous system to block pain signals and reduce fever. It works through inhibition of prostaglandin synthesis in the brain, helping provide effective analgesic and antipyretic action. The combination ensures enhanced pain control, quicker relief, and broader therapeutic coverage for various acute and chronic painful conditions.

This combination is frequently used for arthritis-associated pain, muscle sprains, low back pain, gout attacks, dental procedures, and painful periods (dysmenorrhoea). It is also helpful after minor surgeries where pain and inflammation need to be controlled effectively.

Patients should use this medicine strictly as prescribed to avoid potential risks such as stomach discomfort, kidney strain, or liver issues associated with excessive Paracetamol intake. It is not recommended for long-term use without medical guidance. Regular monitoring may be required in patients with hypertension, liver disease, or kidney disease. Always inform your doctor about any ongoing medications, allergies, or medical conditions to ensure safe and effective treatment.

• Relief of pain and inflammation in osteoarthritis and rheumatoid arthritis
• Management of acute musculoskeletal pain (sprains, strains, neck or back pain)
• Treatment of dental pain, including after tooth extraction or oral procedures
• Reduction of pain and inflammation during acute gout attacks
• Relief from post-operative pain
• Menstrual pain (dysmenorrhoea)
• Fever management when pain accompanies inflammatory conditions

This combination offers dual-action relief by targeting both the source of inflammation and the perception of pain. Etoricoxib reduces inflammation at the site of injury by selectively inhibiting COX-2, making it gentler on the stomach compared to traditional NSAIDs. Paracetamol enhances overall pain control and reduces fever by acting centrally in the brain. Together, they provide faster, more comprehensive relief than individual therapy, especially in arthritis, back pain, post-operative conditions, and dental procedures. The combination improves mobility, reduces swelling, and enhances daily functioning in patients experiencing moderate to severe pain.

• Stomach discomfort or indigestion
• Headache or dizziness
• Nausea or vomiting
• Swelling of legs or feet (oedema)
• Increased blood pressure
• Mild skin rash
• Drowsiness or fatigue
• Rarely: liver enzyme elevation due to Paracetamol
• Rarely: kidney function changes

Seek medical attention if severe allergic reactions, persistent stomach pain, or breathing difficulty occur.

• Take the medicine exactly as prescribed by your doctor.
• Swallow the tablet whole with water; do not crush or chew.
• It may be taken with or without food, but taking it after meals may reduce stomach discomfort.
• Do not exceed the recommended daily dose of Paracetamol from all sources.
• Continue only for the duration advised by your doctor.

Etoricoxib works by selectively inhibiting the COX-2 enzyme responsible for the formation of prostaglandins involved in pain and inflammation. Unlike non-selective NSAIDs, Etoricoxib does not significantly inhibit COX-1, which protects the stomach lining. This selectivity allows effective management of pain and inflammation with fewer gastrointestinal side effects.

Paracetamol complements this effect by acting centrally within the brain to inhibit the synthesis of prostaglandins involved in pain signalling and fever regulation. While it has minimal anti-inflammatory action, it significantly improves analgesic response and reduces fever.

Together, the combination provides balanced control of peripheral inflammation (via Etoricoxib) and central pain perception (via Paracetamol), making it suitable for moderate pain requiring rapid and sustained relief.

• Do not exceed the total daily Paracetamol limit (usually 4 g per day from all sources).
• Avoid taking other NSAIDs unless advised by your doctor.
• Report any swelling, breathlessness, or sudden weight gain.
• Stay hydrated and take the medicine after meals if you have a sensitive stomach.
• Use only for short-term relief unless prescribed for chronic pain.

• Store in a cool, dry place away from direct sunlight.
• Keep out of reach of children.
• Do not use the medicine after the expiry date printed on the pack.
• Keep the blister pack sealed until use to maintain tablet stability.

This combination can be taken with or without food. However, taking it after meals may reduce gastric discomfort associated with Etoricoxib. Avoid alcohol completely, as it significantly increases the risk of liver toxicity from Paracetamol and worsens dizziness and stomach irritation.

Avoid:

• Alcohol

• High-fat meals (may delay absorption slightly)

• Herbal supplements that affect the liver (e.g., kava, valerian)

Some medicines may interact with this combination, increasing side effects or reducing efficacy. Always inform your doctor about all medications you are taking.

Possible interactions with:

• Anticoagulants (e.g., warfarin): Increased bleeding risk
• Diuretics or antihypertensives: May reduce effectiveness due to fluid retention
• Other NSAIDs or high-dose steroids: Increased risk of stomach issues
• Anti-tuberculosis or anti-seizure drugs: May increase liver strain
• Methotrexate: Increased toxicity risk

Use cautiously in patients with pre-existing medical conditions. Etoricoxib may worsen fluid retention and increase blood pressure, while excessive Paracetamol can strain the liver. Discuss your health history with your doctor before starting this medicine.

Caution in:

• Liver disease or alcohol-related liver damage
• Kidney disease
• Heart disease, hypertension, or history of heart failure
• Gastric ulcers
• Severe dehydration

The usual recommended dose is one tablet once daily or as directed by your doctor, depending on the severity of pain, medical condition, and treatment duration. Do not exceed the prescribed daily limit, particularly due to the Paracetamol component. Never self-adjust the dose.

An overdose may lead to severe liver damage (primarily from Paracetamol), nausea, vomiting, abdominal pain, dizziness, or confusion. Immediate medical attention is required. Do not wait for symptoms to worsen, as liver damage can occur even when early symptoms appear mild.

If you miss a dose, take it as soon as you remember. If it is close to the next scheduled dose, skip the missed one and continue with your regular dosing routine. Do not double the dose to make up for a missed one, as excess Paracetamol may harm the liver. Maintain regular dosing for optimal pain control.