Agetoxib 90 Agimexpharm medicine for osteoarthritis treatment (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Etoricoxib
Ingredient Gout, dysmenorrhea, back pain, joint inflammation, arthritis, rheumatoid arthritis, bone inflammation

Ingredient

Composition information	Content
Etoricoxib	90mg

Uses

indications

Agetoxib 90 drug is indicated in the following cases:

Treatment of osteoarthritis symptoms.

Treatment of rheumatoid arthritis symptoms. A steroid anti -inflammatory drug (NSAID) with anti -inflammatory, analgesic, fever and is a strong Cycloxygenase - 2 (COX - 2) inhibitor, very selective, very active when taken.

NSAID works by inhibiting the activity of a substance in the body called cyclo - oxygenase. Cyclo - Oxygenase is an enzyme involved in the production of prostaglandin, responding to trauma or certain diseases. The prostaglandin causes pain, swelling and inflammation. Because NSAID prevents the production of prostaglandin, the drug is effective for pain and inflammation.

Selective inhibition of COX - 2 due to using Etoricoxib has reduced these clinical signs and symptoms along with reducing toxicity in the gastrointestinal tract without having the effect of platelet function. In all clinical studies, Etoricoxib has the effect of inhibiting COX - 2 depending on the dose of use without inhibiting COX - 1 when using the dose up to 150 mg daily.

Pharmacokinetics

absorption

Etoricoxib is well absorbed by oral. The average oral bioavailability reaches nearly 100% and the time of reaching the peak of plasma is 1 hour.

Distribution

About 90% of the drug is attached to protein without causing significant changes in the level and absorption rate when used with food.

Metabolism

Etoricoxib is metabolized mainly in the liver by Cytochrottle P450 (CYP) 3A4 and is excreted in urine, mainly metabolic forms in which no metabolites have a significant Cox - 2 or COX - 1 inhibitor.

Elimination

Etoricoxib's waste sale time is 22 hours.

Before taking Agetoxib 90 Agimexpharm medicine for osteoarthritis treatment (3 blisters x 10 tablets)

How to use

oral medication, can be taken or not with food.

Due to the increased risk of the risk of the heart of Etoricoxib, the lowest daily daily dose should be used in the shortest time. Need to re -evaluate the effectiveness of treatment, especially in osteoarthritis patients.

Dosage

adults

osteoarthritis

60 mg/day/day when the dose is 30 mg/time/day is not enough to meet. If treated without improving, other medications need to be selected.

Acute phosphorus arthritis (acute gout attack)

120 mg/time/day in the period with acute symptoms, with a maximum treatment time of 8 days.

rheumatoid arthritis

The recommended dose is 60 mg/time/day. In some patients who do not decrease symptoms, increasing the dose of 90 mg/time/day may increase the effectiveness. When the patient is clinically stable, maintenance of a dose of 60 mg/time/day may be appropriate. If treated without improvement, other medications need to be selected instead.

Age vertebral arthritis

Acute pain due to tooth surgery

90 mg/day/day, a maximum limit of 3 days.

Chronic musculoskeletal pain

60 mg/time/day. The dose of 120 mg is only used in the level. Do not exceed the dose in each treatment specified.

Some special subjects

Hepatic failure

For patients with hepatic failure in all indications, the dose is as follows:

Light liver failure (Child - Pugh: 5 - 6): Dosage not exceeding 60 mg/time/day.

Average liver failure (Child - Pugh: 7 - 9): Dosage not exceeding 30 mg/time/day.

Severe liver failure (Child - Pugh:> 10): Contraindications to use drugs.

kidney failure

Patients have creatinine clearance> 30 ml/min: no dose adjustment.

Patients have creatinine clearance

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? Etoricoxib cannot be removed by blood part, it is still unknown whether it is possible to use peritoneal fertilizer to remove Etoricoxib or not.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Agietoxib 90 you can experience unwanted effects (ADR).

Very common, ADR> 1/10

Gastrointestinal disorders: abdominal pain.

Common, 1/100

Infection and parasitic infection: alveolar bone.

Metabolic and nutrition disorders: Water keeping edema.

Nervous system disorders: dizziness, headache.

Arrhythmic disorders: Brushing the chest, arrhythmia.

Vascular disorders: High blood pressure.

Respiratory disorders, chest and mediastinum: bronchospasm.

Digestive disorders: Constipation, flatulence, gastritis, acid reflux heartburn, diarrhea, indigestion/discomfort in the epigastric area, nausea, vomiting, esophagitis, mouth ulcers.

Liver disorder: Alt increases, AST increases.

Skin and subcutaneous tissue disorders: Hematoma.

General disorders: weakness/fatigue, influenza disease.

Uncommon, 1/1000

Infections and parasitic infections: gastritis, upper respiratory infections, urinary tract infections.

Blood and lymphatic disorders: Anemia (mainly related to gastrointestinal hemorrhage), leukopenia, thrombocytopenia.

Immune system disorders: Hypersensitivity reaction.

Disorders of metabolism and nutrition: Increase or decrease appetite, weight gain.

Mental disorders: Anxiety, depression, impaired awakening, hallucinations.

Nervous disorders: Disorders, insomnia, paresthesia/sensory decrease, drowsiness.

eye disorders: blurred vision, conjunctivitis.

Disorders at and maze: Tinnitus, dizziness.

Arrhythmic disorders: Atrial fibrillation, tachycardia, congestive heart failure, Non -specific ECG changes, angina, myocardial infarction.

Bloody disorders: flushing, stroke, mild stroke, hypertension, vascular inflammation.

Respiratory disorders, chest and mediastinum: cough, shortness of breath, nosebleeds.

Gastrointestinal disorders: bloating, changes in bowel movements, dry mouth, stomach ulcer, peptic ulcer, including gastric - intestinal perforation and bleeding, irritable bowel syndrome, pancreatitis.

Skin and subcutaneous tissue disorders: Facial edema, itching, rash, erythema, urticaria.

Muscle and connective muscle disorders: muscle spastic/spasms, musculoskeletal pain/muscle stiffness.

Magic and urinary disorders: proteinuria, increased serum creatinine, kidney failure.

General disorders: chest pain.

Testing: Hypertoinemia, increased creatin phosphokinase, hyperkalemia, hyperuric uric acid.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Agetoxib 90 contraindicated drug in the following cases:

Too hypersensitivity to Etoricoxib or any ingredient of the drug.

Stomach ulcers or gastrointestinal bleeding.

Severe liver failure (Child - Pugh> 10).

Inflammation.

Cerebral vascular disease.

CLCR kidney failure cystitis.

SECRETING HEART (NYHA II - IV).

Patients with hypertension with regular blood pressure above 140/90 mmHg and not fully controlled.

Ischemic heart disease, peripheral artery disease and brain -brain disease.

History of asthma, acute rhinitis, nasal polyps, neurotransmitters, urticaria or allergic reactions after taking aspirin or nonsteroidal anti -inflammatory drugs including COX -2 inhibitors.

Pregnant or lactating women.

Children under 16 years old.

Caution when using

influence on the gastrointestinal tract (gastric esophagus)

complications on the gastrointestinal tract (perforation, ulcers or hemorrhage), some deaths, occurred in patients treated with Etoricoxib. Be careful when treating patients at risk of gastrointestinal complications with NSAID.

Effects on the heart and the risk of cardiovascular thrombosis

Non -steroid anti -inflammatory drugs (NSAIDs), non -aspirin, using systemic sugar, may increase the risk of cardiovascular thrombosis. To minimize the risk of adverse incidents, Agetoxib is needed in the lowest daily daily doses in the shortest possible time.

Caution for patients with coagulation disorders, patients with a history of heart failure, anemia heart disease, left ventricular dysfunction; Patients with heart failure, high blood pressure.

Effects on the kidneys

In people with chronic renal failure, heart failure, liver failure or disorders of plasma volume, inhibiting the synthesis of prostaglandin in the kidneys of Etoricoxib affects the blood flow through the kidney thus reduces the kidney function.

Keeping water, edema and high blood pressure

Be cautious for people with edema due to many causes, water retention (such as heart failure, kidney), hypertension due to drugs that cause stasis, worse illness.

influence on the liver

If there are signs of liver failure or if detected abnormal liver function tests should stop using Etoricoxib.

Be cautious for people with foreign cell loss (due to strong diuretics).

Be cautious in older adults due to kidney, liver or news of age.

Etoricoxib can hide the loss of symptoms of inflammation such as fever, pain, ...

The excipients of this drug have lactose: Patients with rare genetic problems in tolerance Galactose, Lapp lactase or glucose - Galactose should not be used by this drug.

The ability to drive and operate machinery

The drug can cause dizziness, headache or drowsiness, so it affects the ability to drive and operate machinery.

Pregnancy

To ensure the safety of the fetus, avoiding this medication during pregnancy. Women are likely to be pregnant or using contraception or pregnancy should consult a doctor carefully before treatment with this drug.

The period of breastfeeding

It is not known whether Etoricoxib will be excreted in breast milk or not so should not use this medication for mothers who are breastfeeding.

Interactive drug

anticoagulants

Etoricoxib increases 13% of prothrombin time. Therefore, patients taking anticoagulants such as warfarin must be monitored with blood clotting tests such as prothrombin time, especially in the first few days after the beginning of treatment or when changing therapy.

rifampin

Simultaneous use of Etoricoxib and Rifanpine, strong metabolic induction in the liver, reducing 65% of the area under the curve (AUC) of Etoricoxib in plasma.

methotrexate

Methotrexate toxicity monitoring should be considered when Etoricoxib is greater than 90 mg used at the same time as methotrexate.

Diuretics, Angiotensin (ACE) and Angiotensin II (Allas) antagonistic inhibitors (Allas)

The report shows that Etoricoxib may reduce the hypotension effect of diuretics, ACE and AIIAS enzyme inhibitors.

lithium

Etoricoxib reduces lithium kidney clearance and can therefore increase lithium concentration in plasma.

aspirin

There is no evidence that simultaneous use with aspirin reduces the risk of cardiovascular side effects associated with COX -2 inhibitors, including Etoricoxib.

Oral contraceptives

Etoricoxib may increase the incidence of side effects related to birth control pills (for example, venous thromboembolism events in risky women).

Hormone replacement therapy

estrogen in birth control pills or hormone replacement therapy may increase the risk of secondary effects when used at the same time as Etoricoxib.

Storage

To stay at a temperature of less than 30 ° C, avoid moisture and light.

Other drugs

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