Arcoxia drug. Instructions for use of the joint disease. Reviews, analogues, the price of tablets, where to buy

Arcoxia effectively eliminates pain and inflammation in diseases of the joints. Despite the relatively gentle effect of medication on the gastric mucosa, instruction manual contains a significant number of contraindications and limitations.

Dosage Form and Packaging

The drug is available in the form of tablets film coated. Sheath color may be white or turquoise - it depends on the dose of the active substance.

Data on the release forms are presented in the table below:

Dosage	Number of tablets in a blister	The number of blisters in a cardboard box
30 mg	2, 4, 7 or 14.	1, 2 or 4.
60 mg	7	1 or 4
90 mg	7	1 or 4
120 mg	7	1

In terms of tablet may be white, yellow or beige color.

Structure

Each tablet contains 30, 60, 90 or 120 mg of active substance - etoricoxib. When administered etoricoxib selectively blocks the activity of enzymes (COX-2) is involved in the synthesis of prostaglandins responsible for the development of inflammation, pain and fever. Means does not inhibit the enzymes that protect the stomach lining (COX-1).

The composition of the tablets includes the components necessary to create and maintain the structure, and providing the content of solubility in the expiration date. Film cover made of a synthetic analog of gelatin and palm wax.

Therapeutic

The drug belongs to a class of selective NSAID - nonsteroidal anti-inflammatory drugs, drugs with selective subclass suppression enzymes. They are also called coxibs. In contrast, non-selective NSAIDs they act less aggressively on the mucosa of the digestive tract.

Efficiency

Arcoxia - preparation, instructions for use which marks its 100% bioavailability.

Therapeutic effect develops over a 24 min. after administration, and is expressed in the spectrum of the following positive effects:

• reduced pain - active component blocks nucleation and conductivity of the pain impulse;
• increase the mobility of joints and the spine - this applies to the elimination of morning stiffness of movement;
• combating inflammation - includes reducing external signs (swelling and redness) and febrile events (high temperature).

Thus the preparation (compared with other means FarmGruppa NSAIDS):

• less likely to cause negative effects on the part of the stomach and intestines (ulcer and bleeding), particularly in elderly patients;
• slightly more likely to contribute to increasing the risk of blood clots or pressure.

Indications

The main scope of use of the drug - a comprehensive treatment of diseases of the musculoskeletal system.

In rheumatology and orthopedics etoricoxib prescribed to relieve symptoms (not to restore the damaged tissues) at:

• rheumatoid arthritis - systemic disorders with primary destruction of small joints;
• osteoarthritis - thinning of the cartilage tissue, causing an inflammatory reaction of the joints;
• ankylosing spondylitis (Ankylosing spondylitis) - a primary lesion of the sacral joints, intervertebral discs, accompanied by low back pain of a chronic nature;
• acute attacks of gouty arthritis Nature - are expressed by pain, swelling and redness;
• injuries of the musculoskeletal system (Or surgical interventions), pain with a herniated disc (in the official manual that information available, but this experience is at practitioners).

The preparation is allowed to apply for short-term elimination of acute pain (moderate to severe intensity) after surgical procedures in dentistry and to alleviate the condition for painful menstrual bleeding.

Use in adults

Arcoxia - a drug user whose use involves leave with a prescription. This is due to the necessity of selecting the minimum dose for the result and the least duration of therapy. Do it in a state of a doctor, if there is information about recent and related diseases.

Among the features of therapy:

• absorption processes, exchange and removal of the drug decay products do not depend on gender and race;
• the drug should be used inside, without being tied to food intake;
• receiving combination with fatty food increases the period of maximum density and somewhat reduces its - but the basic value, these figures are not in therapy;
• tablet should drink a moderate amount of water;
• prostaglandin inhibition effect on the course of ovulation, therefore, on the female body ready for conception - do not use medication, planning a pregnancy.

Regardless of the drug dose taken once a day 1 - therapeutic effect is maintained for 24 hours.

The use in children

Mechanisms of absorption of the drug in children under 12 years of age have not been assessed, studies were carried out only in groups from 12 to 17 years. Official instruction prohibits the medicament to 16 years.

Use in elderly patients

Pharmacokinetic parameters (rate of absorption, distribution and elimination) in the elderly almost identical to younger patients, dosage adjustment of the age considerations are required. However, use of the drug for people over 65 years of age requires care and control of the general condition.

Based on the investigations safety of the drug, you can make the following conclusions:

• in people older than 75 years, the drug less often (compared to other NSAIDs) cause gastric ulceration and bleeding;
• aged 60-85 years Arcoxia increasingly leads to malfunction of the kidneys and renal manifestations of hypertension (in comparison with people of other age groups).

Use during pregnancy and lactation

The active agent is capable of overcoming the placental barrier. Use of the drug during gestation is prohibited, due to increased risk of miscarriage or premature birth.

If conception has occurred during therapy drug, Arcoxia requires cancellation. If necessary, means to take during breastfeeding, the child should be transferred to artificial feeding.

Application for liver and kidney

Arcoxia - preparation instructions for use which indicates decay etorikoksiba active in the liver and 70% of kidney excretion of metabolic products.

For patients with impaired liver function the following recommendations:

• mild (5-6 Child-Pugh classification) involve administration of no more than 60 mg per day:
• the average degree of (7-9 points) - no more than 30 mg per day;
• severe degree (over 10 points) - The drug is contraindicated.

Allowed reception medicament with impaired renal function with a creatinine clearance less than 30 mL / min.

Application of inflammatory diseases

The drug is prescribed for an active joint diseases (arthritis, spondylitis), a key role in the development of which inflammation plays.

Efficacy data are:

• rheumatoid arthritis - receiving 90 mg per day has helped reduce the pain and signs of inflammation (swelling, limitation of movement). Positive effects were observed within 3 months of therapy - reduced efficiency did not occur;
• acute attack of gouty arthritis - reception for 8 days eliminates the pain (from strong to moderate). Effect after 4 hours after the first dose;
• ankylosing spondylitis - there is a decrease pain and inflammation manifestations, increased mobility of the spine. The result is visible with 2 days of treatment and lasts for 13 months.

In these diseases Arcoxia has only a symptomatic effect, and must be combined with basic drugs, physical therapy and diet (gout).

Application of degenerative diseases

The basis of a group of diseases, grouped under the term osteoarthritis, degenerative changes are primary (destruction of cartilage) leading to the secondary inflammation. Reception Arcoxia can achieve pain relief and improve the overall condition of the patient on the second day after the start of therapy.

Wherein:

• receiving 60 mg per day provided invariability effect within 13 months of treatment;
• receiving 30 mg per day provides the stability results over 3 months.

Despite the research supporting the effectiveness of chondroitin / glucosamine in the treatment of osteoarthritis, doctors still prefer NSAIDs.

When pain syndrome

Instruction allows the use of the drug to treat acute pain after dental procedures. Arcoxia analgesic effect comparable to ibuprofen. A marked decrease in pain occurs in 30 minutes.

Contraindications

The key difference from each other NSAIDs are safety performance constraints and the number of reception.

Reception Arcoxia is contraindicated in the following diseases and conditions:

• age under 16 years;
• pregnancy;
• lactation;
• hypersensitivity to main or additional components;
• lack of lactase, lactose intolerance, malabsorption of glucose and galactose (malabsorption);
• Increased content of potassium in the blood with laboratory confirmation;
• acute occurrence of gastric ulcers and 12 duodenal ulcer, gastrointestinal bleeding;
• inflammation of the intestines;
• combination (possibly partly), bronchial asthma, nasal polyps, paranasal sinus and intolerant of aspirin or other NSAIDs;
• violation of myocardial function (failure) in the chronic form;
• pressurizing not amenable to stabilization using medicaments with sustained excess numbers 140/90;
• ischemic manifestations (myocardial infarction, angina pectoris);
• malfunction peripheral or intracerebral vessels;
• severe cirrhosis (class C, more than 10 of the Child-Pugh classification);
• severe renal failure (creatinine clearance less than 30 mL / min);
• impairment of renal function with a pronounced negative dynamics.

Use of the drug requires more attention at:

• old age or transferred ulcerative diseases of the digestive tract;
• dehydration;
• increased likelihood of the presence of cardiovascular disease - smoking, diabetes, disorders of lipid metabolism, high pressure, atherosclerosis;
• impaired renal functioning with creatinine clearance less than 60 mL / min;
• weakening renal function or a mild cirrhosis.

Use and Administration

Arcoxia - preparation instructions for use which involves typical doses for different diseases or conditions.

Dosage and recommendations for duration of the course are presented in the table below:

Diagnosis	Dose (always 1 time per day)	admission course	The maximum daily dose
osteoarthritis	30 mg or 60 mg	determined individually	60 mg
Rheumatoid arthritis and ankylosing spondylitis	60 or 90 mg	90 mg
An acute attack of gout arthritis	120 mg	No more than 8 days	120 mg
Pain following surgical procedures in the dental practice	90 mg	No more than 3 days	90 mg

Sometimes analgesia dose may be 60 or 120 mg - prescribed by a doctor. Doses exceeding the maximum or not tested clinically, or do not give a growth rate in efficiency.

Side effects

Despite the gentle overall impact of etoricoxib on the mucosa of the gastrointestinal tract, reception may be accompanied by adverse reactions:

• abdominal pain;
• constipation or diarrhea, excessive flatulence;
• nausea, vomiting and belching;
• ulcerations of the oral mucosa, stomach less;
• irritation of the esophagus and intestines;
• inflammation of the pancreas.

In addition, the technique can cause negative side symptoms:

• hematopoietic system - anemia, decrease of leukocytes or platelets;
• heart and blood vessels - irregular heartbeat, high blood pressure, palpitations, insufficiency in chronic form, "hot flashes" failure in the blood supply of the myocardium and brain, chest pain, crises, inflammation of blood vessels;
• immunity - hypersensitivity, angioneurotic edema, anaphylaxis (shock);
• Metabolism - swelling, impaired appetite, weight gain;
• urinary system - urinary protein excretion, renal failure;
• nervous system - dizziness, headache, change in taste or sensitivity, insomnia or drowsiness;
• psyche - nervousness, anxiety, concentration impairment, hallucinations;
• visual system - blurred vision, inflammation of the conjunctiva;
• hearing - ringing in the ears;
• skin - facial swelling, rash (including itching), urticaria, hemorrhages in the skin (bruises), redness, skin inflammation, Stevens-Johnson syndrome;
• respiratory system - bronchial spasm, cough, shortness of breath, bleeding from the nose;
• liver - inflammation of the liver dysfunctions, jaundice;
• muscular and skeletal system - cramps and muscle pain, cramps, stiffness or muscle weakness.

Of the common violations noted flu-like state. While taking may develop infectious inflammation of the bones, upper respiratory and urinary tract infections. The risk of adverse events is dose-dependent and increases with the duration of the course.

During the reception, also record changes in laboratory parameters:

• increase of urea nitrogen and blood creatine kinase;
• increasing uric acid;
• abnormal growth of potassium concentration in blood;
• drop in blood sodium levels.

It is impossible to exclude the characteristic for all NSAIDs likely toxic effects of etoricoxib on the kidneys.

Interactions with other drugs

Reception Arcoxia requires caution if the patient is already undergoing therapy with the help of:

• drugs that reduce blood clotting (warfarin) - necessary to monitor clotting, especially at the beginning of treatment;
• antiplatelet drugs that prevent blood clots (aspirin, clopidogrel, ticlopidine) - co-administration helps prevent heart and vascular disease, but excess doses increases the risk of gastrointestinal ulcers tract;
• Pharmaceuticals, which the decay products are sulfotransferase (Salbutamol and minoxidil);
• diuretics, ACE inhibitors, drugs for lowering pressure (AT-receptor blockers). The combination can provoke acute renal failure, especially in patients age;
• medications that suppress the immune system (Cyclosporine and Tacrolimus) - coupling requires monitoring of renal function.

Have the following data on the interaction of Arcoxia with a number of medicines:

• co-administration with lithium increases the concentration of this element in the blood - may require a dosage adjustment lithiated means;
• combination with methotrexate require control of toxic manifestations of the latter;
• combination with oral contraceptives increases the risk of adverse events in the form of acute venous congestion (in women);
• simultaneous hormone replacement therapy leads to an increase in estrogen levels and the risk of adverse gormonalnozavisimyh symptoms;
• joint digoxin therapy requires monitoring of patients at risk of digoxin poisoning;
• combination with rifampicin leads to decrease in the blood concentration etoricoxib 65%.

Compatible with alcohol

To avoid excessive load on the liver from alcohol during treatment is better to abstain. Drinking alcohol can distort the results of the monitoring pressure during therapy Arcoxia, so it is necessary to warn the doctor.

Overdose

In clinical studies overdoses (daily administration of 500 mg, or three weeks of taking 150 mg per day) did not provoke poisoning.

However, among the adverse reactions were noted:

• disruptions in the functioning of the digestive system;
• disorders of the heart on the background of kidney damage.

If the reception of an overdose has occurred, you should:

1. Remove drug from the digestive tract (by receiving sorbents gastric lavage).
2. Rate objective health indicators.
3. Choose symptomatic treatment (if necessary).

Etoricoxib defies removal by hemodialysis.

special instructions

The drug should not be used in conjunction with other NSAIDs.

In the process of treatment needed:

• tracking changes in blood pressure - in the first 2 weeks of the course daily, etc. - periodic;
• monitoring of renal and liver - by passing urine and blood;
• periodic assessment of the possibility of reducing the dose or discontinuation of therapy (if the treatment effect achieved and / or in need of support);
• attention to emerging skin reactions - with the appearance of rash or swelling of the mucous membrane the drug required immediate removal of the drug.

Patients observed as side effects headache or weakness, should the period of treatment to give up activities that require fast reactions and concentration.

Where to buy and how much it costs

Depending on the dosage and volume of the packaging cost of the drug may be about:

• 350 rubles. 4 tablets 30 mg;
• 650 rubles. 7 for 120 mg tablets;
• from 300 to 1000 rubles. 60 mg per tablet;
• from 400 to 1400 rubles. for tablets of 90 mg.

Medication can be purchased at major pharmacy chains or ordered through the Internet.

Recommendations for the storage and shelf life

Preparation can be stored at temperatures up to 30 degrees, away from children. Shelf life - 36 months.

analogs

There are analogues of Arcoxia with identical active ingredient - Eksinef, Orotiks, Kostaroks and many drugs having similar therapeutic effect, but fundamentally different composition:

• Dilaksa, Celebrex, Celecoxib - based on celecoxib;
• Dinastat (injection) - based parecoxib;
• Don rumalon - means on the basis of chondroitin / glucosamine;
• Diclofenac, Indometatsie, Tsefekon, Nimesan - inexpensive non-selective NSAID type.

List of limitations and contraindications, as well as the unique efficacy can vary - the selection should be discussed with your doctor rheumatologist or orthopedist.

Reviews

Both professionals and patients is considered one of the disadvantages of the preparation of its high cost.

Among the advantages noted Arcoxia:

• the presence of different dosages, how to quickly treat acute pain as well as for long-term therapy;
• fast analgesic and anti-inflammatory effect (the majority of patients);
• adverse effects of the drug on the digestive tract is minimal - but doctors still prescribe proton pump inhibitors at the same time to protect the gastric mucosa;
• successfully eliminating pain after removal or dental implants;
• pressure increase during the reception is usually negligible and can be corrected.

Based on the comments, among the major disadvantages of the drug:

• receiving unsafe in the presence of the transferred gastrointestinal diseases (gastritis, ulcers);
• Long-term therapy is undesirable Arcoxia at elevated pressure;
• sometimes occurs during treatment limb numbness, vanishes only some time after the withdrawal;
• individual expression of anesthetic effect (may occur in a day and sometimes requires 7 days of admission), and depends on the type of inflammation (running or recent);
• receiving performance may decrease with time (perhaps addictive);
• it is possible development of adverse effects, requiring the cancellation and subsequent symptomatic treatment (usually at the age of patients);
• There are cases of complete lack of results - despite the fact that the medication prescribed by the doctor.

According to the instructions for use, drug Arcoxia combines powerful anti-inflammatory effect and gentle effect on the gastrointestinal tract. Most doctors consider a mandatory co-administration of drugs to protect the stomach lining.

Helpful videos about the drug Arcoxia and its effectiveness

Manual preparation:

Treatment of osteoarthritis: