Etoricoxib
Pronunciation: ee-tor-ih-COX-ib.
- Generic name
- etoricoxib
- Brand names
- Arcoxia (United Kingdom)
- Drug class
- Selective COX-2 inhibitor (nonsteroidal anti-inflammatory drug, NSAID)
- Form
- Film-coated tablet, in multiple strengths for different indications
- Route
- Oral
- Legal status
- Not approved by the US FDA. Prescription-only medicine in the United Kingdom and over 80 other countries where it is authorised.
Availability and supply rules vary by country
Trade names by country: India
Australia: · Full directory
What etoricoxib is and how it works
Etoricoxib is a selective COX-2 inhibitor NSAID used to relieve pain and inflammation in several joint and postoperative pain conditions. It is not approved in the United States, unlike most NSAIDs commonly available there. (1)
Like other NSAIDs of this class, it carries a cardiovascular risk that increases with dose and duration, alongside gastrointestinal risks. The prescriber selects the lowest effective dose for the shortest necessary time for your specific condition.
Mechanism of action: how etoricoxib works
Etoricoxib selectively inhibits cyclo-oxygenase-2 (COX-2), reducing prostaglandin synthesis involved in pain and inflammation while relatively sparing COX-1-mediated gastric-protective prostaglandins compared with non-selective NSAIDs, though gastrointestinal and cardiovascular risks remain. (1)
What etoricoxib is used for
Osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis
Used to relieve the signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis in patients 16 years and older, per UK product information. (1)
Acute gouty arthritis
Used for the pain and inflammation of acute gouty arthritis, for a maximum of 8 days per course. (1)
Postoperative dental pain
Used for moderate pain after dental surgery, for a maximum of 3 days. (1)
Before taking etoricoxib
Do not take / not appropriate for
- Do not take etoricoxib if you have an active stomach ulcer or gastrointestinal bleeding, inflammatory bowel disease, severe liver problems, or kidney impairment with creatinine clearance under 30 mL/min. (all products) (1)
- Do not take etoricoxib if you have heart failure, established heart or blood-vessel disease (including a previous heart attack, stroke, or mini-stroke), or persistently uncontrolled high blood pressure (above about 140/90 mmHg). (all products) (1)
- Do not take etoricoxib if you are pregnant, breastfeeding, trying to become pregnant, or under 16 years of age. (all products) (1)
Tell your clinician about
- Any history of stomach ulcer, gastrointestinal bleeding, or inflammatory bowel disease.
- Heart disease, high blood pressure, stroke, or risk factors for these.
- Liver or kidney disease.
- Whether you take aspirin, warfarin, an ACE inhibitor or angiotensin receptor blocker, or rifampicin.
- Pregnancy, plans for pregnancy, or breastfeeding.
How to take etoricoxib
- Take exactly the strength and duration prescribed for your specific condition; do not use a strength or duration intended for a different indication.
- Use the lowest effective dose for the shortest time needed.
- Do not exceed the maximum course length for your indication (for example, 8 days for gout or 3 days for dental pain), and do not repeat a course without checking with your prescriber.
- Do not change your dose or stop taking etoricoxib without talking to your prescriber first.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2)
Missed dose
Follow the product instructions for missed doses, or ask your prescriber or pharmacist. Do not take a double dose to make up for a missed one.
Overdose
Contact your prescriber, pharmacist, or a poison-control/emergency service if an overdose is suspected. (1)
Side effects
Effects on the stomach, blood pressure, and fluid retention are the main concerns to watch for.
Abdominal pain, indigestion, heartburn, or nausea
What to notice: Gastrointestinal upset is very commonly reported.
What to do: Tell your prescriber if severe or persistent; seek urgent care for black stools or vomiting blood. (1)
Raised blood pressure, swelling (oedema), headache, or dizziness
What to notice: Commonly reported effects.
What to do: Blood pressure is usually checked within 2 weeks of starting and periodically after; tell your prescriber about swelling or persistent headache. (1)
Possible liver problem
What to notice: Unusual tiredness, loss of appetite, yellowing of the skin or eyes, or dark urine.
What to do: Contact your prescriber promptly for liver-function testing; a clinician will decide whether etoricoxib needs to be stopped. (1)
Serious warnings
Cardiovascular thrombotic events (heart attack or stroke) — emergency
Symptoms: Chest pain, shortness of breath, sudden weakness on one side, slurred speech, or sudden severe headache.
Action: Call emergency services immediately. Selective COX-2 inhibitors like etoricoxib carry a cardiovascular risk that can increase with dose and duration of use. (1)
Gastrointestinal bleeding, ulceration, or perforation — emergency
Symptoms: Black or bloody stools, vomiting blood or material like coffee grounds, or severe stomach pain.
Action: Get urgent medical help immediately; a clinician or emergency service will decide whether etoricoxib needs to be stopped. This risk is higher in older adults and with concurrent aspirin use. (1)
Serious allergic or skin reaction — emergency
Symptoms: Swelling of the face, lips, or throat, difficulty breathing, or a severe rash.
Action: Seek emergency medical help immediately. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Warfarin | Can increase INR by approximately 13%, raising bleeding risk. | The prescriber should monitor INR more closely. (1) |
| ACE inhibitors or angiotensin II receptor blockers | Combined use can increase the risk of reduced kidney function. | Kidney function may be monitored more closely. (1) |
| Low-dose aspirin | Combined use increases the risk of gastrointestinal ulceration. | Tell your prescriber if you take aspirin. (1) |
| Rifampicin | Can reduce etoricoxib blood levels by around 65%, potentially reducing effectiveness. | Tell your prescriber if you take rifampicin. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy and breastfeeding
Etoricoxib is contraindicated in pregnancy and breastfeeding, and is not recommended for women trying to become pregnant. (1)
Children
Not for use under 16 years of age, per the UK product information reviewed. (1)
Older adults
Gastrointestinal risks are higher in older adults; the lowest effective dose for the shortest time is especially important in this group. (1)
Monitoring
Before starting
- Confirm the diagnosis and that etoricoxib is appropriate given cardiovascular, gastrointestinal, hepatic, and renal risk factors.
- Check blood pressure and screen for contraindications listed above.
During treatment
- Monitor blood pressure within 2 weeks of starting and periodically thereafter.
- Watch for gastrointestinal, cardiovascular, and liver-related warning symptoms.
- Do not exceed the maximum course length for the indication being treated.
Storage
Store as directed on the product label, out of reach of children.
Professional information
Clinician-facing context only. Etoricoxib is not FDA-approved; use the current UK/EU product information for exact dosing.
United Kingdom
Indication: Osteoarthritis
Dose summary: 30 mg once daily; may be increased to 60 mg once daily in some patients if needed.
Renal context: Contraindicated if creatinine clearance is under 30 mL/min. (1)
United Kingdom
Indication: Acute gouty arthritis / postoperative dental pain
Dose summary: Acute gout: 120 mg once daily, maximum 8 days. Dental surgery pain: 90 mg once daily, maximum 3 days.
Renal context: As above. (1)
Hepatic guidance
Contraindicated in severe hepatic dysfunction; monitor liver function in patients with hepatic impairment.
Overdose note
Manage suspected overdose supportively per local poison-control and emergency guidance. (1)
Frequently asked questions
What is etoricoxib used for?
etoricoxib is prescribed for approved indications. Always follow your healthcare provider's guidance.
What are the side effects of etoricoxib?
Common side effects may include gastrointestinal symptoms and headache. Serious side effects require immediate medical attention.
Can I take etoricoxib with other medications?
Always inform your healthcare provider about all medications you are taking, including over-the-counter products and supplements.
What is the mechanism of action of etoricoxib?
Etoricoxib selectively inhibits cyclo-oxygenase-2 (COX-2), reducing prostaglandin synthesis involved in pain and inflammation while relatively sparing COX-1-mediated gastric-protective prostaglandins compared with non-selective NSAIDs, though gastrointestinal and cardiovascular risks remain. (1)
References
- Arcoxia 30 mg Film-coated Tablets — Summary of Product Characteristicselectronic Medicines Compendium (UK) · United Kingdom · accessed 2026-07-26 · source 1
- FDA Not Approvable letter for Arcoxia (etoricoxib), 2007, following a 20-1 Arthritis Advisory Committee vote against approvalAggregated secondary sources (Johns Hopkins Arthritis Center, PharmaTimes, Patient Care Online) corroborating a public FDA regulatory action, not used as clinical evidence · United States · accessed 2026-07-26 · source 2
- etoricoxib — RxNorm normalized drug concept (RXCUI 307296)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 3
Brand names by country
Single-ingredient etoricoxib names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
India
- Nucoxia60 mg, 90 mg, 120 mg · Zydus Healthcare Limited
- Etoshine60 mg, 90 mg · Sun Pharma
- Etozox90 mg · Cipla
- Etoford90 mg · Leeford Healthcare Ltd
- Etos90 mg · Systopic Laboratories
- Ezact90 mg · Sun Pharma
- Fitdent90 mg · Avighna Medicare Pvt Ltd
- Retoz Neo90 mg · Dr Reddy's Laboratories Ltd