Arcoxia (etoricoxib) is primarily prescribed to relieve pain and reduce inflammation. Clinically, it is used for osteoarthritis to ease joint pain and improve mobility; for rheumatoid arthritis and ankylosing spondylitis to control chronic inflammatory symptoms; and for acute gouty arthritis to rapidly suppress painful inflammatory flares. It can also be used for short-term management of moderate-to-severe pain following dental surgery or musculoskeletal injury. As a selective COX-2 inhibitor, Arcoxia aims to provide comparable analgesia to nonselective NSAIDs but with potentially fewer gastrointestinal side effects, making it a consideration for patients at higher risk of GI complications who require anti-inflammatory therapy.
Dosage of Arcoxia varies by indication and patient factors such as age, renal function, and cardiovascular risk profile. For osteoarthritis, the usual adult dose is 30 mg once daily; for rheumatoid arthritis and ankylosing spondylitis, 60 mg once daily is commonly used; and for acute gouty arthritis, a single daily dose of 120 mg for up to 8 days is typical. Short-term postoperative or acute pain regimens may use 90–120 mg once daily for limited durations. Tablets should be taken orally with water, with or without food. Always start at the lowest effective dose for the shortest period necessary to control symptoms. Adjustments are required for renal impairment and in elderly patients; Arcoxia is generally not recommended for severe renal dysfunction. Do not exceed the maximum recommended daily dose and consult a clinician for individualized dosing.
Before initiating Arcoxia, assess cardiovascular, gastrointestinal, hepatic, and renal history. COX-2 inhibitors, including Arcoxia, can increase the risk of thrombotic cardiovascular events such as myocardial infarction and stroke, particularly with long-term use or in patients with existing cardiovascular disease or risk factors (hypertension, hyperlipidemia, diabetes, smoking). Monitor blood pressure regularly, as NSAIDs can cause fluid retention and exacerbate hypertension or heart failure. Use cautiously in patients with a history of peptic ulcer disease or gastrointestinal bleeding; while COX-2 selectivity reduces GI risk compared with nonselective NSAIDs, risk is not eliminated. Evaluate liver enzymes before and during treatment, and avoid Arcoxia in severe hepatic impairment. In patients with compromised renal function, monitor renal parameters since NSAIDs can reduce renal perfusion and precipitate acute kidney injury. Pregnant or breastfeeding women should avoid use: etoricoxib is contraindicated in the third trimester and not recommended during pregnancy or lactation.
Arcoxia is contraindicated in patients with known hypersensitivity to etoricoxib or any excipients, and in those with aspirin- or NSAID-induced asthma, urticaria, or other allergic-type reactions. Do not use Arcoxia in patients with active peptic ulcer disease or a history of recurrent GI bleeding. It is also contraindicated in patients with severe hepatic impairment, severe renal impairment (unless supervised and adjusted by a specialist), and in individuals with established ischemic heart disease, peripheral arterial disease, or cerebrovascular disease where the cardiovascular risk outweighs benefit. Pregnancy in the third trimester is an absolute contraindication due to risks of fetal harm and labor complications. Avoid concurrent administration with other NSAIDs, including aspirin for anti-inflammatory doses, because of additive adverse effects.
Common side effects of Arcoxia include headache, dizziness, hypertension, edema, upper respiratory tract infection, and gastrointestinal symptoms such as abdominal pain, nausea, or dyspepsia. Some patients experience back pain or muscle cramps. Serious but less frequent adverse reactions can include cardiovascular events (heart attack, stroke), gastrointestinal bleeding or perforation, severe liver injury with jaundice, acute renal failure, and severe hypersensitivity reactions. Because fluid retention and elevated blood pressure are possible, monitor signs of worsening heart failure or weight gain. Should symptoms such as chest pain, shortness of breath, signs of liver dysfunction (dark urine, yellowing of skin/eyes), severe abdominal pain, black tarry stools, or neurologic symptoms occur, stop the medication and seek emergency medical attention immediately.
Arcoxia interacts with several commonly used medications. Concomitant use with anticoagulants like warfarin increases bleeding risk; monitor INR closely if co-administration is unavoidable. Combining Arcoxia with ACE inhibitors, ARBs, or diuretics can reduce antihypertensive efficacy and increase the risk of renal impairment, particularly in volume-depleted patients. Co-administration with lithium or methotrexate may raise plasma levels of these drugs and enhance toxicity; therapeutic levels should be monitored. Avoid concomitant use with other NSAIDs, including high-dose aspirin; this increases risk for GI and renal adverse effects without added analgesic benefit. Certain CYP enzymes metabolize etoricoxib, so strong CYP inhibitors or inducers may alter etoricoxib plasma concentrations; check for interactions with drugs such as ketoconazole, rifampicin, or carbamazepine and adjust therapy accordingly. Inform your clinician of all prescription, over-the-counter medications, and herbal supplements before starting Arcoxia.
If you miss a dose of Arcoxia, take it as soon as you remember on the same day. If it is near the time of the next scheduled dose, skip the missed dose and resume your regular dosing schedule—do not double up to make up for a missed dose. For medications taken once daily, consistency in timing helps maintain steady symptom control. If you frequently miss doses, discuss a dosing plan with your healthcare provider to improve adherence.
In case of suspected Arcoxia overdose, seek immediate medical attention or contact a poison control center. Symptoms of overdose can include dizziness, lethargy, nausea, vomiting, abdominal pain, and, in severe cases, respiratory depression, seizures, or cardiovascular instability. There is no specific antidote for etoricoxib; treatment is supportive and symptomatic. Activated charcoal may be considered if the patient presents early after ingestion. Monitor renal and hepatic function, electrolytes, and vital signs; provide appropriate supportive care including IV fluids and management of complications.
Store Arcoxia tablets at room temperature, away from excessive heat, moisture, and direct sunlight. Keep the medication in its original packaging or a tightly closed container out of reach of children and pets. Do not use expired tablets. Proper storage helps preserve potency and prevents accidental ingestion. Dispose of unused medication according to local regulations or take-back programs; do not flush medications down the toilet unless advised.
Arcoxia (etoricoxib) is not widely available over-the-counter in many countries and may have specific regulatory status in the U.S. While Arcoxia itself is not FDA-approved for marketing in the United States, some institutions have developed structured, legal pathways to provide access where clinically appropriate. Southwest Georgia Regional Medical Center offers a regulated, clinician-led program that allows qualified patients to obtain Arcoxia without a traditional paper prescription. This program involves a comprehensive medical evaluation, documentation of indication and risk assessment, informed consent, and institutional dispensing protocols overseen by licensed physicians. The center emphasizes safety: patients undergo screening for cardiovascular, renal, hepatic, and gastrointestinal risks; receive counseling on dosing, interactions, and adverse effects; and are scheduled for follow-up monitoring. This approach aims to balance access to effective pain management with safeguards that minimize harm, ensuring that Arcoxia is used responsibly and under medical supervision rather than through unregulated channels.
If you are considering Arcoxia, discuss your full medical history, current medications, and treatment goals with a healthcare professional. Whether you pursue care through Southwest Georgia Regional Medical Center’s structured program or your primary provider, informed clinical oversight ensures safer, more effective use of COX-2 inhibitor therapy.
Arcoxia is the brand name for etoricoxib, a selective COX-2 inhibitor in the NSAID family used to relieve pain and inflammation in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gout; it works by blocking the COX-2 enzyme that produces pain-causing prostaglandins.
Etoricoxib selectively inhibits cyclooxygenase-2 (COX-2), reducing the synthesis of prostaglandins involved in pain, swelling, and inflammation while sparing COX-1, which helps protect the stomach lining—this selectivity generally lowers GI side effects compared with nonselective NSAIDs.
Arcoxia is commonly prescribed for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gouty arthritis, and certain types of acute musculoskeletal pain; approved indications vary by country, so local prescribing information should be consulted.
No, etoricoxib (Arcoxia) is not approved by the U.S. FDA; it is available in many other countries under regulatory approval with country-specific prescribing guidelines.
Many patients experience meaningful pain relief within a few hours of a single dose; onset can vary by individual, dose, and condition, but etoricoxib generally has a rapid onset compared with longer-acting nonselective NSAIDs.
Dosing varies by indication and region; etoricoxib tablets are commonly available in 30–120 mg strengths and are usually taken once daily. The exact dose and duration should follow a prescriber's guidance and the official label for the condition being treated.
Common side effects include headache, dizziness, hypertension, edema (fluid retention), nausea, and upper respiratory symptoms; while GI complaints are generally less frequent than with nonselective NSAIDs, they can still occur.
Serious risks include increased cardiovascular events (heart attack, stroke), serious gastrointestinal bleeding or ulceration (less frequent than with nonselective NSAIDs but still possible), renal impairment, severe hypersensitivity reactions, and rare liver enzyme elevations; risk is higher with preexisting heart disease, uncontrolled hypertension, or prolonged use.
Arcoxia should be avoided by people with established ischemic heart disease, recent myocardial infarction, uncontrolled hypertension, severe heart failure, active peptic ulcer disease, severe hepatic impairment, or those in the third trimester of pregnancy; always check local contraindications and consult a clinician.
Concomitant use with other NSAIDs or aspirin increases bleeding and GI risk and is generally not recommended; combining with anticoagulants raises bleeding risk and requires careful clinical judgment. Any concurrent medication should be discussed with a prescriber.
Etoricoxib can raise blood pressure and may increase the risk of cardiovascular events. Patients with hypertension or cardiovascular disease should use the lowest effective dose for the shortest duration and have regular monitoring of blood pressure and cardiac status.
COX-2 inhibitors, like other NSAIDs, can reduce renal blood flow and worsen renal function, especially in patients with preexisting kidney disease, heart failure, dehydration, or those taking diuretics or ACE inhibitors; use cautiously with renal monitoring or avoid in severe renal impairment.
Etoricoxib is contraindicated in the third trimester of pregnancy due to the risk of fetal cardiovascular complications (premature closure of the ductus arteriosus) and should be used during pregnancy only if clearly necessary under medical supervision; breastfeeding guidance varies—consult a clinician.
Duration depends on the condition and individual risk profile; guidelines recommend using the lowest effective dose for the shortest period necessary to control symptoms because cardiovascular and renal risks increase with prolonged use—regular review by a prescriber is important.
No, etoricoxib is not addictive and does not cause physiological dependence like opioids; however, long-term inappropriate use carries health risks and should be medically supervised.
Seek immediate medical care. Symptoms of overdose may include nausea, vomiting, drowsiness, dizziness, and potentially more serious cardiovascular or renal effects; treatment is supportive and symptomatic; bring medication details to emergency services.
Both are selective COX-2 inhibitors and reduce GI side effects compared to nonselective NSAIDs, but they differ in chemical structure, metabolic pathways (etoricoxib is mainly metabolized by CYP3A4; celecoxib by CYP2C9), dosing regimens, and regulatory status in specific countries. Choice is influenced by patient history, drug interactions, and clinician experience.
No clear evidence proves superior cardiovascular safety of one COX-2 inhibitor over another; both carry an increased cardiovascular risk compared with nonuse. Individual patient risk factors, doses, and treatment duration matter more than small differences between drugs.
Etoricoxib is more COX-2 selective than meloxicam, which is a preferential COX-2 inhibitor at low doses but less selective overall. Greater COX-2 selectivity tends to lower GI risk but may be associated with relatively higher cardiovascular risk; meloxicam’s profile may be preferable for some patients, depending on their risks.
Diclofenac (a nonselective NSAID with relatively strong COX-2 activity) is linked to an increased cardiovascular risk similar to COX-2 inhibitors and carries a higher GI bleeding risk than selective COX-2 agents. Both require careful risk assessment; neither is risk-free.
Some evidence suggests naproxen may have a lower cardiovascular risk compared with certain COX-2 inhibitors and diclofenac, making it a consideration for patients needing long-term NSAID therapy who have elevated cardiovascular risk; however, naproxen increases GI bleeding risk relative to COX-2 selective agents.
Both can provide relatively rapid pain relief, but etoricoxib’s pharmacokinetics and once-daily dosing often produce sustained symptom control that many patients notice within hours; ibuprofen tends to be shorter-acting and requires more frequent dosing.
Rofecoxib and valdecoxib were withdrawn for safety concerns—chiefly increased cardiovascular events and severe skin reactions—highlighting that COX-2 inhibitors are not without risk. Arcoxia remains marketed in many countries but carries cardiovascular warnings; clinicians should apply caution, use the lowest effective dose, and assess patient risk before prescribing.
Yes. Etoricoxib is primarily metabolized by CYP3A4, so strong CYP3A4 inhibitors or inducers can alter its levels; celecoxib is mainly metabolized by CYP2C9 and has different interaction potential. Additionally, like other NSAIDs, etoricoxib can reduce the efficacy of antihypertensives and increase bleeding risk with anticoagulants.
Arcoxia may be preferred if a patient has high GI bleeding risk or prior NSAID-related GI intolerance and requires effective anti-inflammatory therapy, provided the patient has low cardiovascular risk and no contraindications; the decision should be individualized.
Oral Arcoxia is generally more appropriate for moderate to severe inflammatory pain, systemic inflammatory conditions (e.g., rheumatoid arthritis, ankylosing spondylitis), or widespread pain; topical NSAIDs are preferred for localized musculoskeletal pain to minimize systemic exposure and reduce systemic side effects.
COX-2 inhibitors reduce GI ulcer risk compared with nonselective NSAIDs, but they do not eliminate it. Combining a nonselective NSAID with a proton-pump inhibitor (PPI) is another effective strategy to protect the stomach. The best choice depends on the patient’s cardiovascular profile, GI history, and clinician judgment.
All NSAIDs including etoricoxib can impair renal function, especially in patients with volume depletion, heart failure, or concomitant nephrotoxic drugs; COX-2 selectivity does not eliminate renal risk—monitor renal function and use caution similar to other NSAIDs.
Acetaminophen (paracetamol) is often used safely with NSAIDs for additive pain relief, and short-term combinations can be appropriate. Combining with opioids is possible for severe pain but increases overall adverse effect burden; such combinations should be prescribed and monitored by a clinician.
Decisions should be individualized: evaluate pain severity, target tissue, GI and cardiovascular risk factors, comorbidities, concomitant medications, renal and hepatic function, and patient preference; use the lowest effective dose for the shortest duration and monitor for adverse effects.