What is Etoreal 90 mg?
Etoreal 90 mg is a brand name for the active substance etoricoxib, which belongs to a class of medications known as selective cyclooxygenase-2 (COX-2) inhibitors. This places it within the broader family of non-steroidal anti-inflammatory drugs (NSAIDs). Etoricoxib works by targeting and inhibiting the COX-2 enzyme, which is primarily responsible for producing prostaglandins—chemical messengers that signal pain and cause inflammation in the body. Unlike traditional, non-selective NSAIDs that inhibit both COX-1 and COX-2 enzymes, etoricoxib's selective action aims to reduce inflammation and pain with a lower risk of certain gastrointestinal side effects.
Medical conditions treated by Etoreal 90 mg
The 90 mg dosage of Etoreal is specifically indicated for the symptomatic relief of pain and swelling in several inflammatory joint conditions. The appropriate dosage and duration of treatment are determined by a doctor based on the specific condition being treated.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis is a long-term inflammatory disease affecting the joints, causing pain, stiffness, and swelling. Etoricoxib 90 mg is a standard dose for managing the symptoms of RA in adults and adolescents aged 16 and over. Studies have shown that etoricoxib can provide effective relief comparable to or greater than conventional NSAIDs for RA symptoms.
Ankylosing Spondylitis (AS)
Ankylosing spondylitis is an inflammatory disease primarily affecting the spine and large joints. Etoricoxib 90 mg is used to manage the pain and inflammation associated with AS, providing significant relief from spinal pain and improving function. The drug has shown superior efficacy to some traditional NSAIDs in treating AS over the long term.
Acute Pain after Dental Surgery
Etoricoxib 90 mg is also prescribed for the short-term treatment of moderate pain following dental surgery. This use is typically limited to a maximum of 3 days to manage post-operative pain and swelling.
Osteoarthritis (OA)
While the standard dose for osteoarthritis is typically lower (e.g., 30 mg or 60 mg), a doctor may increase the dose to 90 mg if a patient is not achieving sufficient relief from the lower dose. This condition involves the gradual breakdown of cartilage in the joints, leading to pain, swelling, and stiffness. The aim of treatment is to relieve pain and improve joint function.
How Etoricoxib 90 mg works in the body
The active ingredient, etoricoxib, is a highly selective COX-2 inhibitor. Its mechanism of action can be explained in three steps:
- Selective Inhibition: At the site of inflammation or injury, the body's immune response triggers the production of the COX-2 enzyme. Etoricoxib selectively binds to and inhibits this enzyme, without significantly affecting the COX-1 enzyme.
- Reduced Prostaglandin Synthesis: By blocking COX-2, the drug prevents the production of pro-inflammatory prostaglandins from arachidonic acid.
- Analgesic and Anti-inflammatory Effect: The reduction in these chemical messengers leads to a decrease in pain and swelling (inflammation), providing symptomatic relief for the patient.
This selectivity for COX-2 is the key difference from traditional NSAIDs and is intended to spare the protective functions of COX-1, such as maintaining the stomach's protective lining.
Potential side effects and precautions
Like all medications, Etoreal 90 mg can cause side effects. Some are common and mild, while others are less common but more serious.
Common Side Effects:
- Gastrointestinal Issues: Abdominal pain, indigestion (dyspepsia), nausea, or diarrhea.
- Cardiovascular: High blood pressure (hypertension) and swelling due to fluid retention (oedema). Your blood pressure should be monitored regularly.
- Nervous System: Dizziness or headache.
- Other: Fatigue or weakness.
Serious Side Effects:
- Cardiovascular Events: An increased risk of serious cardiovascular events such as heart attack and stroke has been associated with etoricoxib, particularly at high doses and with long-term use.
- Serious Gastrointestinal Complications: While less likely than with traditional NSAIDs, serious GI issues like bleeding, ulcers, or perforation can occur, especially in older patients.
- Kidney or Liver Issues: Etoricoxib can affect kidney and liver function. Patients with pre-existing conditions need close monitoring.
- Allergic Reactions: Severe allergic reactions, including anaphylaxis, are possible and require immediate medical attention.
Etoricoxib vs. Traditional NSAIDs: A comparison
| Feature | Etoricoxib (COX-2 Inhibitor) | Traditional NSAIDs (e.g., Ibuprofen, Diclofenac) |
|---|---|---|
| Mechanism | Selectively inhibits the COX-2 enzyme. | Non-selectively inhibits both COX-1 and COX-2 enzymes. |
| Efficacy | Comparable or sometimes superior efficacy for arthritic and pain conditions. | Effective for a wide range of pain and inflammatory conditions. |
| Gastrointestinal (GI) Safety | Lower risk of uncomplicated GI adverse events (e.g., ulcers, bleeding) due to minimal effect on protective COX-1. | Higher risk of GI complications compared to etoricoxib. |
| Cardiovascular (CV) Safety | Carries a risk of CV events (heart attack, stroke), especially with long-term, high-dose use. Contraindicated in patients with established CV disease. | Carries a similar CV risk profile, which is also dose and duration-dependent. |
| Key Indication Advantage | Useful for patients with a high risk of GI complications but low CV risk. | Broadly indicated, often available over-the-counter, but requires caution in those with GI risk factors. |
Conclusion
Etoricoxib, marketed as Etoreal, offers an effective therapeutic option for managing the pain and inflammation associated with rheumatoid arthritis, ankylosing spondylitis, and acute pain following dental surgery, with the 90 mg dose often used for RA and AS. As a selective COX-2 inhibitor, it provides a favorable gastrointestinal safety profile compared to many traditional NSAIDs. However, it is crucial for patients to be aware of the associated cardiovascular risks, especially with prolonged use and higher doses. Treatment should always be discussed with a doctor, who will evaluate the individual patient's risk factors and determine the lowest effective dose for the shortest duration necessary.
What is the difference between etoricoxib and other NSAIDs?
Etoricoxib selectively inhibits the COX-2 enzyme, primarily responsible for inflammation, while traditional NSAIDs inhibit both COX-1 (stomach protection) and COX-2. This selectivity gives etoricoxib a better gastrointestinal safety profile, but it is contraindicated in patients with cardiovascular or cerebrovascular disease.
