Kostarox (Etoricoxib)

Etoricoxib is a COX‑2 selective NSAID used to manage inflammatory joint and musculoskeletal conditions.

• Osteoarthritis: reduces joint pain and improves mobility.
• Rheumatoid arthritis: alleviates inflammation and joint swelling.
• Ankylosing spondylitis: decreases spinal pain and stiffness.
• Acute pain: provides rapid relief of moderate to severe pain episodes.
• Musculoskeletal pain: eases pain associated with injuries or overuse.

• Etoricoxib selectively inhibits the cyclooxygenase‑2 (COX‑2) enzyme, which is responsible for converting arachidonic acid to prostaglandins involved in inflammation, pain and fever. By blocking COX‑2 while sparing COX‑1, the drug reduces prostaglandin synthesis at sites of inflammation, leading to decreased swelling and nociceptive signaling without markedly affecting gastric protective prostaglandins. This targeted action contributes to its analgesic and anti‑inflammatory efficacy in chronic and acute conditions.

Etoricoxib may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness or vertigo.
• Elevated blood pressure.
• Peripheral edema.
• Skin rash or itching.

Serious or Rare Side Effects

• Cardiovascular events: myocardial infarction or stroke.
• Gastrointestinal ulceration or bleeding.
• Severe liver enzyme elevation or hepatitis.
• Renal impairment or failure.
• Life‑threatening skin reactions such as Stevens‑Johnson syndrome.
• Anaphylaxis or severe hypersensitivity.

Before prescribing Etoricoxib, clinicians should evaluate several safety considerations.

• Cardiovascular risk: assess history of heart disease or stroke.
• Gastrointestinal risk: avoid in patients with active ulcers or prior GI bleeding.
• Renal function: use cautiously in impaired kidney function.
• Hepatic function: monitor liver enzymes during therapy.
• Drug interactions: review concomitant medications for potential additive effects.
• Pregnancy and lactation: avoid unless benefits outweigh risks.
• Store at ambient temperature: keep in original packaging, protect from moisture.

Etoricoxib can interact with other medicines, influencing efficacy or safety.

Major Interactions (Avoid)

• Warfarin: increased risk of bleeding.
• Other NSAIDs or COX‑2 inhibitors: additive gastrointestinal toxicity.
• Lithium: elevated serum lithium levels.
• Methotrexate: enhanced toxicity and reduced clearance.
• ACE inhibitors: potential for reduced renal function.

Moderate Interactions (Monitor Closely)

• Diuretics: may worsen renal impairment.
• Antihypertensives: possible reduction in blood pressure control.
• SSRIs or SNRIs: increased bleeding tendency.
• Corticosteroids: heightened risk of gastrointestinal ulceration.
• Antiplatelet agents: additive effect on bleeding.