Common uses

Arcoxia is used for the following:
• acute and chronic treatment of the signs and symptoms of osteoarthritis (OA) and rheumatoid arthritis (RA)
• relief of chronic musculoskeletal pain
• relief of acute pain
• to treat acute gouty arthritis
Arcoxia reduces pain and inflammation by blocking COX-2, an enzyme in the body.
Arcoxia does not block COX-1, the enzyme involved in protecting the stomach from ulcers.
Arcoxia relieves pain and inflammation with less risk of stomach ulcers compared to NSAIDS.
In clinical studies, the risk of developing ulcers on Arcoxia was lower than with NSAIDs. Some people developed ulcers whether they were taking Arcoxia or placebo in these studies; however the rate was higher on Arcoxia.
Your doctor may have prescribed Arcoxia for another reason. Ask your doctor if you have any questions about why Arcoxia has been prescribed for you.
Arcoxia is not addictive.

Before using

Do not take Arcoxia if:
• you have an allergy to Arcoxia or any of the ingredients listed at the end of this leaflet
• the packaging is torn or shows signs of tampering
• The expiry date on the pack has passed.
• If you take this medicine after the expiry date has passed, it may not work.
• you are pregnant or intend to become pregnant
Arcoxia is not recommended for use during late pregnancy. If there is a need to consider using Arcoxia during your pregnancy, your doctor will discuss with you the benefits and risks of using it.
• you are breast-feeding or plan to breast-feed
It is not known if Arcoxia passes into breast milk. You and your doctor should discuss whether you should stop breast-feeding or not take Arcoxia.
• you have or have had any medical conditions, especially the following: history of angina, heart attack or a blocked artery in your heart, kidney disease, liver disease, heart failure, high blood pressure
• you have had an allergic reaction to aspirin or other anti-inflammatory medicines (commonly known as NSAIDs)
• Symptoms of an allergic reaction may include asthma, pinkish itchy swellings on the skin (hives), runny or blocked nose.
• you have an infection
• If you take Arcoxia while you have an infection, it may hide fever and may make you think, mistakenly, that you are better or that your infection is less serious than it might be.
• You have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.
• 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.


Directions

Arcoxia comes as tablets. When taking the tablets, swallow them with a glass of water.

When to take it
Take your Arcoxia at about the same time each day. Taking Arcoxia at the same time each day will have the best effect. It will also help you remember when to take the dose. It does not matter if you take Arcoxia before or after food.

How long to take it
Do not use Arcoxia for longer than your doctor says. Depending on your condition, you may need to take Arcoxia for a few days or for a longer period. For osteoarthritis and rheumatoid arthritis Arcoxia helps relieve your symptoms but it does not cure it. Continue taking Arcoxia for as long as your doctor prescribes. For the relief of gout attacks or other types of pain, Arcoxia is usually only needed for a few days. If you are not sure how long to take Arcoxia, talk to your doctor.


Cautions

This medicine can sometimes cause liver problems. Consult your doctor promptly if you develop unexplained itching, yellowing of the skin or eyes, unusually dark urine, nausea and vomiting, abdominal pains, loss of appetite or flu-like symptoms.
Stop taking this medicine and consult your doctor if you develop any of the following symptoms while taking this medicine: skin rash, skin blistering or peeling, sores inside your mouth, other signs of an allergic reaction, or signs of bleeding in the stomach or intestine, such as passing a black or blood-stained bowel movement or vomiting blood.
This medicine may hide fever, which is a sign of infection. This may make you think mistakenly that an infection is getting better when it isn't, or that an infection is less serious than it is. For this reason you should tell your doctor if you get an infection while you are taking this medicine.
People with impaired kidney, liver or heart function should have their kidney function monitored while taking this medicine. Your blood pressure should be regularly monitored while you are taking this medicine.
This medicine may cause fatigue and dizziness. You should take care when performing potentially hazardous activites, such as driving or operating machinery, until you know how this medicine affects you and are sure you can perform such activities safely.
The use of this medicine is not recommended if you have active peptic ulcer, Bleeding from the stomach or intestines, Inflammatory bowel disease such as ulcerative colitis or Crohn's disease, Uncontrolled high blood pressure (hypertension), Moderate to severe heart failure, Heart disease caused by inadequate blood flow to the heart (ischaemic heart disease), eg angina or history of heart attack, Disease of the blood vessels in and around the brain (cerebrovascular disease), eg history of stroke, Moderate to severely decreased kidney function, severely decreased liver function, pregnancy, breastfeeding, people who have developed asthma, nasal inflammation (rhinitis), nasal polyps, swelling of the face, lips and tongue (angioedema) or itchy rash (urticaria) following the use of aspirin or other NSAIDs, rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malsorption.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Possible side effects

The following are some of the side effects that are known to be associated with this medicine: headache, dizziness, disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain, weakness or loss of strength (asthenia), fatigue, cold or flu-like symptoms, rash, blurred vision, difficulty in sleeping (insomnia), muscle cramps, weight gain, excessive fluid retention in the body tissues, resulting in swelling, nosebleeds (epistaxis), difficulty in breathing (dyspnoea), high blood pressure (hypertension), chest pain, heart failure, anxiety, ulceration or bleeding of the stomach or intestine, liver or kidney disorders.

If you take too much

There have been reports of acute overdosage with etoricoxib, although adverse experiences were not reported in the majority of cases. The most frequently observed adverse experiences were consistent with the safety profile for etoricoxib.(e.g. gastrointestinal events, renovascular events).
In the event of overdose, it is reasonable to employ the usual supportive measures, e.g., remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring, and institute supportive therapy, if required.
Etoricoxib is not dialysable by haemodialysis; it is not known whether etoricoxib is dialysable by peritoneal dialysis.

Drug interactions

t is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

This medicine may be taken with low-dose (75mg daily) aspirin. However, the combination may carry an increased risk of ulceration or bleeding in the stomach or intestines compared to taking etoricoxib on its own. Etoricoxib should not be taken with higher daily doses of aspirin. For more information and advice ask your doctor or pharmacist.

This medicine should not be taken with other non-steroidal anti-inflammatory drugs (NSAIDs), eg ibuprofen, diclofenac, as using more than one NSAID together may also increase the risk of side effects on the gut.

This medicine may increase the anti-blood-clotting effect of warfarin. People taking warfarin or other anticoagulant medicines at the same time as this medicine should therefore have their blood-clotting time (INR) regularly monitored, particularly in the first few days of treatment with etoricoxib and following any dose changes.

This medicine may oppose the effect of diuretics and other medicines for high blood pressure (antihypertensives).

There may be an increased risk of side effects on the kidneys if this medicine is taken with any of the following medicines. People taking any of these medicines in combination with etoricoxib should have their kidney function monitored, particularly if elderly:
• ACE inhibitors, eg enalapril, captopril
• angiotensin II antagonists, eg losartan
• ciclosporin
• diuretics
• tacrolimus.
This medicine may increase the blood levels of the following medicines:
• lithium (your lithium blood level should be monitored if you are starting, changing dose, or stopping etoricoxib while taking lithium).
• methotrexate (people taking methotrexate should be well monitored for any side effects of methotrexate while taking etoricoxib.
• oestrogens in oral contraceptives or HRT (this may increase the risk of side effects from these medicines. Discuss this with your doctor.)
• digoxin.
Rifampicin may decrease the blood level of this medicine and therefore make it less effective at treating pain.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain etoricoxib as the active ingredient.