Etoricoxib

A selective COX-2 inhibitor designed for strong pain relief with reduced gastric irritation.

What is Etoricoxib?

Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) belonging to the selective COX-2 inhibitor class. It is mainly used for pain and inflammation associated with arthritis, gout, back pain, and post-operative conditions.

Unlike traditional NSAIDs, etoricoxib was developed to reduce gastric side effects by sparing COX-1 enzymes.

History & Development

Etoricoxib was developed in the early 2000s as part of the COX-2 selective drug class, following celecoxib. The aim was to maintain strong anti-inflammatory effects while reducing gastrointestinal toxicity.

Chemical Structure & Properties

• IUPAC name: 5-chloro-6′-methyl-3-[4-(methylsulfonyl)phenyl]-2,3′-bipyridine
• Molecular formula: C₁₈H₁₅ClN₂O₂S
• Molar mass: 358.84 g/mol
• Functional groups: Sulfone, aromatic rings, heterocyclic nitrogen

The methylsulfonyl group is critical for selective COX-2 binding, minimizing gastric COX-1 inhibition.

Mechanism of Action

Etoricoxib selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, which is mainly responsible for producing prostaglandins during inflammation.

• ↓ Prostaglandins → reduced pain
• ↓ Inflammation → reduced swelling
• Minimal effect on gastric mucosa

Pharmacokinetics

• Absorption: Rapid oral absorption
• Peak plasma time: ~1 hour
• Bioavailability: ~100%
• Protein binding: ~92%
• Half-life: ~22 hours
• Metabolism: Liver
• Excretion: Urine and feces

Medical Uses

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Acute gout attacks
• Chronic back pain
• Post-operative pain

Dosage Guidelines

Osteoarthritis: 60 mg once daily

Rheumatoid arthritis: 90 mg once daily

Acute pain / gout: 120 mg once daily (short term)

⚠️ Use the lowest effective dose for the shortest duration.

Side Effects

• Headache
• Dizziness
• Edema (fluid retention)
• Indigestion (less common)

Serious Risks & Warnings

• Increased cardiovascular risk (heart attack, stroke)
• Hypertension
• Kidney impairment

Drug Interactions

• Blood pressure medicines
• Blood thinners
• Diuretics
• Other NSAIDs

Etoricoxib vs Diclofenac

Etoricoxib offers better gastric safety, while diclofenac may be preferred for short-term acute pain.

Frequently Asked Questions

Is etoricoxib safer for the stomach? – Yes, compared to traditional NSAIDs.

Can it be used long-term? – Only with medical supervision.

Is it safe for heart patients? – Caution required.

Is etoricoxib an antibiotic? – No.

⚠️ Educational content only. Not a substitute for professional medical advice.