Introduction
The drug Arcoxia® with the active ingredient etoricoxib is a selective inhibitor of the enzyme cyclooxygenase 2, which belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). Cyclooxygenase is involved in many metabolic processes in the body. Cyclooxygenase 2 alone occurs in some tissues and organs.
Cyclooxygenase mediates an increase in fever through macrophages. Cyclooxygenase, COX-2 for short, is frequently found in tissues that are inflamed. These include developing (proliferating) blood vessels or arteriosclerotic changes.
COX-2 has also been found in a large number of tumour cells. In summary, it can be said that COX-2 is involved in inflammatory processes and fever development. Furthermore, COX-2 plays an important role in the spinal cord in pain processing.
Fields of application
The active substance etoricoxib is used for the treatment of swelling and pain in joint diseases due to its specificity to cyclooxygenase 2, i.e. it only acts on this enzyme. These are inflammatory rheumatic diseases or degenerative diseases, i.e. diseases caused by wear and tear. Arthrosis, for example, is caused by wear and tear.
Other areas of application are rheumatoid arthritis, ankylosing spondylitis or acute attacks of gout. Occasionally Arcoxia® is also used to treat pain after dental surgery. Arcoxia® alleviates the pain and helps to contain the inflammatory process and reduce the swelling.
The drug should not be taken if allergies to the active ingredient etoricoxib or other components of Arcoxia® are known. Even if allergies to other non-steroidal rheumatic drugs (NSAIDs) such as aspirin or ibuprofen are known, COX-2 inhibitors including Arcoxia® should not be taken. Other contraindications to Arcoxia® are severe diseases of the liver and kidney, damage or bleeding in the gastrointestinal tract or chronic inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis. Arcoxia® should not be used straightforwardly in patients who suffer from heart disease, have already had a heart attack or stroke, or have high blood pressure, as it increases the risk of further incidents.
Effect
The active ingredient etoricoxib, which is contained in Arcoxia®, inhibits cyclooxygenase 2, which is involved in pathological processes such as tissue injury or inflammation. COX-2 is essential for the formation of messenger substances known as prostaglandins. Special prostaglandins expressed by COX-2 are present in the kidney, stomach, brain and in the uterus.
The prostaglandins ensure that the kidney is correctly supplied with blood and maintains its function. Furthermore, the prostaglandins are physiologically essential for our memory and attention. Also in the uterus, their function is essential for the implantation of the foetus and later for the contractions.
But prostaglandins also have a pathological function caused by pollutants or diseases. These include the mediation of inflammation, fever, pain and the formation of tumours. So if COX-2 is inhibited by Arcoxia®, no prostaglandins can be formed. The effect of Arcoxia® is derived from this: Inflammation is suppressed, fever is lowered and pain is relieved. However, the desired function of prostaglandins is also suppressed, which causes side effects.