Arcoxia® is not a medicine to be taken in children or adolescents or during pregnancy and lactation. Therapy with Arcoxia® can only be started at the age of 16 years. It is important that the drug is not overdosed.
For pain therapy only such a low dose should be taken that the pain is relieved. In addition, the drug should not be taken longer than necessary, as the risk of a stroke or heart attack increases with the duration of treatment. The specific dosage depends on the disease that is to be treated by taking Arcoxia®.
For the treatment of osteoarthritis, 30mg of etoricoxib are recommended once daily, which corresponds to 1/3 of Arcoxia® 90mg. For rheumatoid arthritis the dose is 90mg once daily, so one tablet of Arcoxia® 90mg can be taken. A dose of 90mg is also recommended for pain after dental surgery and ankylosing spondylitis.
However, the dose is higher for acute pain during a gout attack. In this case 120mg of the active substance etoricoxib can be taken, but only as long as the pain is acute. After a maximum of 8 days the therapy should be stopped with 120mg and switched to a normal dosage. Patients with liver damage should be dosed carefully and the dose should be adjusted to the extent of the damage.
In general, Coxibe (inhibitors of COX-2) are considered to be better tolerated compared to their relatives, COX-1 inhibitors such as ibuprofen, because they have fewer side effects. In general, the pharmacist or doctor should be consulted in case of side effects. For example, damage to the gastrointestinal tract is much less severe when COX-2 inhibitors are taken than COX-1 inhibitors.
In general, as with all other drugs, intolerance or allergic reactions can occur when taking Arcoxia®. In this case the therapy should be interrupted and a new drug should be selected in consultation with the doctor. Another relevant side effect profile of Arcoxia® are the side effects on the cardiovascular system.
The greatest risk is for patients with mild to advanced heart failure, as the effects of Arcoxia® increase the fluid available at the kidney, thus placing greater stress on the heart. In addition, inhibition of COX-2 by reducing prostaglandins increases the risk of coronary artery narrowing and the formation of blood clots (thrombi), which can lead to heart attacks or strokes. Side effects of Arcoxia® that manifest themselves on the skin can be the expression of damage to internal organs or the result of an allergic reaction.
Bleeding into the skin by Arcoxia® often occurs. Furthermore, allergic reactions manifest themselves in the form of itching or rashes on the skin. However, swelling in the face and neck area can also occur, which can lead to breathing and swallowing difficulties and should then be treated urgently.
The skin can also be swollen in other parts of the body, especially in the periphery (arms, legs, hands, feet), the swellings indicate side effects originating from the kidney. This is because not enough fluid is excreted and the body stores this fluid in the tissue (this is called oedema) in order to compensate for the increased fluid volume in a different way. Apart from side effects of the kidney, side effects of the liver can also be recognized by the skin.
In case of dramatic side effects of the liver or damage to the liver, the skin and eyes may turn yellow (jaundice). If such discoloration is observed, one should urgently consult a doctor who will check the liver. Side effects on the liver are first noticed in laboratory tests, when the laboratory parameters of the liver change.
Rather rarely, a yellowing of the skin and eyes, the so-called jaundice, occurs. Arcoxia® can aggravate or cause liver damage if it is not used in a customized way. Arcoxia® inhibits COX-2, which performs important functions at the kidney.
The metabolites of COX-2, the prostaglandins, increase blood flow and filtration rate of the kidney, as well as urination and the release of the hormone renin. The latter is important for the regulation of fluid balance and blood pressure. Therefore, there is a risk that Arcoxia® may prevent the kidney from filtering all the blood and fluid components to be excreted.
Not enough fluid is excreted and the excess fluid is distributed in the blood and as tissue deposits. As a result, fluid accumulation occurs in the legs and the heart has to cope with less blood, which can be particularly harmful for a patient with a pre-existing heart failure. In addition, the altered excretion of the kidney can cause potassium to accumulate in the body, leading to elevated potassium levels in the blood (hyperkalemia).
This hyperkalemia can lead to cardiac arrhythmia. Arcoxia® should therefore no longer be used if the kidneys are severely damaged. In general, special caution should be exercised in old age, with limited kidney function and a known diabetes mellitus.
In principle, alcohol consumption is not recommended as long as one is taking medication, because the breakdown of alcohol puts a strain on the liver, which is also needed for the breakdown of drugs such as Arcoxia®. This is why simultaneous intake often leads to liver damage in the long term. It is generally known that alcohol is not compatible with the intake of painkillers of the NSAIDs group. Their side effects can be caused or intensified. While taking Arcoxia® alcohol consumption should be stopped.