Xibraz-90 Tablet Aristopharma reduces symptoms of osteoarthritis (2 blisters x 15 tablets)

visual disorders : blurred vision, lemonitis.

Patients are determined to have ischemic heart disease, peripheral artery disease, and/or cerebrovascular disease.

Precautions when using

impact on the digestive system

The above gastrointestinal disorders (such as perforation, inflammation or ulcer - pubs), several such deaths occurred when using Etoricoxib.

It is necessary to use caution when used to treat patients at high risk in gastrointestinal disorders when using NSAIDs, the elderly, the patient is simultaneously using any other NSAIDs or acetylsalicylic acid or patients with a history of previous gastrointestinal diseases such as ulcers or digestive bleeding.

When using Etoricoxib simultaneously with acetylsalicylic acid (even if the dose is low), the risk of side effects can be increased on the gastrointestinal tract (gastrointestinal ulcers or other disorders). There are no long-term clinical trials that show any significant differences in the safety of the digestive tract between combination of COX-2 and acetylsalicylic acid inhibitors compared to an NSAIDs and acetylsalicylic acid.

impact on the cardiovascular system

Clinical trials show that the selective inhibitors of COX-2 may be related to thrombosis (especially myocardial infarction (MI) and stroke), when compared to Placeboo and a few other NSAIDs. Because the cardiovascular risk of Etoricoxib increases with the dose and time of use, it should be used in the shortest possible time and with the lowest dose effectively. Patients with symptoms treated and responded to drugs should be re -evaluated most often are osteoarthritis patients.

Patients with significant risks for cardiovascular events (namely hypertension, high blood lipid, diabetes, smoking) should be carefully considered before starting treatment with Etoricoxib.

Selective inhibitors cannot replace Acetylsalicylic acid in preventing blood vessels because they have no anti-platelet effect. Therefore, anti -platelets should not be used.

impact on the kidneys

Prostaglandin in the kidneys plays a clear role in maintaining the activity of the kidney. Therefore, using Etoricoxib can reduce prostaglandin, and then reduce blood flow to the kidneys, thereby leading to renal function. Patients with the highest risk of this problem are patients with renal function in advance, loss of heart failure, or cirrhosis. Need to manage kidney function in this object.

Keeping water, edema and hypertension.

For drugs that are determined to prevent prostaglandin synthesis, water retention effects, edema and hypertension of Etoricoxib. All NSAIDs drugs, including Etoricoxib, may be related to recurrence or onset of congested heart failure muscles, need to be concerned about the information about the dose related to Etoricoxib. Be careful in patients with a history of heart failure, left ventricular dysfunction, or hypertension or edema for all causes.

If there are evidence that the patient's worsening, a number of measures should be taken, including the discontinuation of Etoricoxib.

Etoricoxib may increase the frequency as well as the severity of hypertension rather than other NSAIDs as well as COX-2 selection, especially with high doses. Therefore, it is necessary to control hypertension before Etoricoxib treatment and regular blood pressure monitor during treatment. Blood pressure control is needed for 2 weeks after the start of treatment with Etoricoxib, and periodically. If there is significant hypertension, there should be some changes in the treatment regimen.

Effects on the liver

The increase in Alt liver enzymes (Alanin Aminotransferase) and/or AST (Aspartat Aminotransferase) is about 3 times the maximum allowed amount recorded on more than 1% of the case with clinical Etoricoxib treatment for 1 year at a dose of 30, 60, 90mg per day. Any case with symptoms or signs of liver function impairment, or test results show that the abnormal activity of the liver should be strictly managed. If these signs occur, Etoricoxib is needed. Etoricoxib may obscure the symptoms of fever or other symptoms of inflammation.

The ability to drive and operate machinery

There has been no research on the influence of Etoricoxib on the ability to drive and operate machinery. However, patients with dizziness, dizziness, and drowsiness when using Etoricoxib should limit driving and operating machinery.

Pregnancy

Similar to other drugs in the selective inhibitor group Cox-2, Etoricoxib are not indicated for pregnant women to prepare for birth.

There is no clinical data on Etoricoxib exposure on pregnant mothers. Animal studies have shown toxicity. The likelihood of human risk is not clear. As other prostaglandin synthesis inhibitors, etoricoxib can cause an early uterine tone to close the fetal artery in the last 3 months of pregnancy. Contraindicated Etoricoxib on pregnant women. If women are pregnant during treatment with Etoricoxib, they must stop using this drug.

Breastfeeding period

It is unknown whether Etoricoxib will be secreted into the milk gland. Etoricoxib has the secretion of the mouse milk glands. The mother is using Etoricoxib not to breastfeed.

Drug interaction

Etoricoxib metabolism through cytochrom P450's enzyme system. When used simultaneously with this inhibitor or induction this enzyme can lead to changes in the plasma concentration of Etoricoxib. In addition, In vitro studies show that a few other enzymes can also intermediate the metabolism of Etoricoxib. Rifampicin, a liver enzyme induction can reduce the concentration of Etorieoxib in plasma. Etoricoxib increases the plasma concentration of ethinylelestradiol. Etoricoxib's interaction with other drugs such as oral salbutamol and minoxidil can also occur because these drugs are also specialized in the same enzyme with Etoricoxib.

NSAIDS drug interaction includes an increase in the impact of oral anticoagulants (namely azapropazon and phenylbutazon) and increases the plasma concentration of lithium, methotrexate, and heart glycosides. The risk of kidney toxicity can be increased if used with medications inhibitors, ciclosporin, tacrolimus, or diuretics. Impact on kidney function can lead to reducing the excretion of some other drugs. It is also possible to supplement diuretics to keep potassium. In addition, it can reduce the anti -hypertension effect of enzyme inhibitors, beta blockers and diuretics. Convulsions may occur if used with quinolones. NSAIDs can increase the effects of phenytoin and sulfonylurea diabetes. Avoid simultaneous use of 2 or more NSAIDs (including aspirin) because it is likely to increase the risk of side effects, especially bleeding or gastrointestinal ulcers.

Do not use NSAIDs because of the increased risk of drug interactions. The risk of stomach bleeding and ulcers associated with NSAID increases when used with corticosteroids, SSRIs, Snri Venlafaxin, platelet cancellation drugs Clopidogrel and Iloprost, Erlotinib, Sibutramine or possibly alcohol, bishosphate or pentoxifyllin. The risk of poisoning may be increased if zidovudin is used with NSAID drugs. Ritonavir may increase NSAID concentration in plasma. Mifepriston inhibits the synthesis of Prostaglan NSAID or Aspirin can change the effectiveness of Mifepriston.

Occasionally have an adverse effect when using the NSAID group with Misoprostol, although such a combination is sometimes used to reduce the toxicity of the stomach and intestines.