When joints hurt or injuries begin to bother you, your doctor may prescribe Ancoxia. This is an antirheumatic, non-steroidal anti-inflammatory drug that is used to treat patients with diseases of the musculoskeletal system accompanied by pain. Arcoxia is available in the form of tablets with dosages of the active substance etoricoxib 30 mg, 60 mg, 90 mg and 120 mg.
Arcoxia with different types of dosage
Contraindications
According to clinical studies, the following contraindications have been identified:
- tendency to gastrointestinal bleeding;
- cerebrovascular bleeding;
- individual intolerance to the components of the drug;
- bronchial asthma;
- polyposis of the nose or sinuses in the acute stage and frequent relapses;
- intolerance to NSAIDs;
- ulcers, erosions and perforations of the gastrointestinal tract;
- intestinal inflammation;
- kidney disease in progress;
- hyperkalemia;
- blood diseases caused by bleeding disorders (hemophilia);
- severe liver failure;
- liver diseases;
- chronic renal failure;
- pregnancy and breastfeeding;
- children under 16 years of age;
- period after surgery associated with coronary artery bypass grafting;
- peripheral arterial disease;
- blood pressure over 140/90 Hg;
- cerebrovascular diseases;
- lactase intolerance, lactase deficiency.
Doses and method of administration of the drug Arcoxia
The dosage of Arcoxia is prescribed by the doctor himself.
Arcoxia is prescribed only by the attending physician. He can correctly calculate the dosage and risks for the patient. Take the medicine one tablet once a day, regardless of meals. The course of treatment should not exceed 8 days.
- for osteoarthritis: 1 tablet 30 or 60 mg per day, depending on the severity of symptoms;
- for rheumatoid arthritis and ankylosing spondylitis: 1 tablet 90 mg per day;
- for acute gouty arthritis: one 120 mg tablet per day. The duration of therapy is no more than 8 days;
- for acute pain (including after dental surgery): 1 tablet 90 or 120 mg, depending on the severity of the pain syndrome;
- for chronic pain: 1 tablet 60 mg.
The principle of action of the drug
Arcoxia is not only a selective inhibitor of cyclooxygenase type 2, but it also exhibits a high degree of selectivity. Almost 95% is a connection with the desired isoform of the enzyme. That is why this drug is safe and can be used even in patients with compromised mucous membranes of the stomach and duodenum, that is, in patients with various forms of gastritis and even gastric ulcers, albeit during a period of remission and covered with certain drugs (Omeprazole). Etoricoxib, or Arcoxia, has the ability to inhibit cyclooxygenase in a dose-dependent manner. However, it does not have any effect on the first type of enzyme, which is affected by very “ancient” drugs, such as Diclofenac.
After taking a standard dose of Arcoxia, maximum plasma concentration occurs within an hour. The drug is processed, or metabolized, in the liver, and even its metabolites do not affect cyclooxygenase type 1.
Side effects when taking Arcoxia
Vomiting and nausea are side effects when taking Arcoxia.
Like any drug, Arcoxia has a number of side effects when taken. Well, the list is impressive.
- epigastric pain;
- nausea, vomiting;
- diarrhea;
- dyspepsia;
- flatulence;
- bloating;
- belching;
- increased peristalsis;
- constipation;
- dryness of the oral mucosa;
- gastritis;
- ulcer of the mucous membrane of the stomach or duodenum;
- irritable bowel syndrome;
- esophagitis;
- ulcers of the oral mucosa;
- gastrointestinal ulcers (with bleeding or perforation);
- headache;
- dizziness;
- weakness;
- taste disturbance;
- drowsiness;
- sleep disorders;
- sensitivity disorders, incl. paresthesia/hyperesthesia;
- anxiety;
- depression;
- hallucinations;
- confusion;
- blurred vision;
- conjunctivitis;
- noise in ears;
- renal failure, usually reversible when the drug is discontinued;
- anaphylactic/anaphylactoid reactions, including a marked decrease in blood pressure and shock;
- heartbeat;
- increased blood pressure;
- tides;
- cerebrovascular accident;
- atrial fibrillation;
- congestive heart failure;
- hypertensive crisis;
- cough;
- dyspnea;
- nose bleed;
- bronchospasm;
- swelling of the face;
- skin itching;
- rash;
- hives;
- Stevens-Johnson syndrome;
- Lyell's syndrome;
- infections of the upper respiratory tract, urinary tract;
- muscle cramps;
- arthralgia;
- myalgia;
- swelling, fluid retention;
- changes in appetite;
- weight gain;
- leukopenia, thrombocytopenia;
- flu-like syndrome;
- chest pain.
A little history
The history of the creation of effective drugs is constantly updated with new facts, since scientific and technological progress does not stand still. Nonsteroidal anti-inflammatory drugs are so named because they are not analogues of steroid hormones. It is known that steroid hormones, for example, dexamethasone or prednisolone, have the strongest anti-inflammatory effect, and this makes it possible to create potent drugs, for example, Diprospan or Kenalog for intra-articular administration. However, hormones have a large number of side effects, especially when used in tablets. Steroid diabetes mellitus, osteoporosis, and edema may develop. Immunity decreases, the patient may develop a fungal infection against the background of long-term immunosuppression caused by steroids.
Therefore, non-steroidal drugs have firmly occupied their niche for the treatment of various inflammatory diseases. The main points of application of NSAIDs are the reduction of body temperature, or antipyretic effect, pain relief, and reduction of inflammation. The leaders in the manifestation of antipyretic effect can be considered ibuprofen and paracetamol (Nurofen and Panadol), we will not dwell on them.
Ketorolac, which is well known to Russians under the name Ketanov, has very powerful analgesic activity. But well-known drugs such as Voltaren, diclofenac, indomethacin, meloxicam, and etoricoxib, the culprit of this article, have a powerful and pronounced anti-inflammatory effect. The last medicinal substance is Arcoxia, only by INN, or international nonproprietary name.
Arcoxia fights inflammation
It is known that the main symptoms of inflammation are a local increase in temperature or a local feeling of heat, swelling of soft tissues, soreness, redness of the skin, as well as dysfunction. Almost all of these symptoms occur during exacerbation of osteochondrosis, when the patient has a hernia, perhaps with the exception of redness of the skin, because inflammation occurs in the depths. But even there there is an analogue of redness - this is plethora in the area of inflammation caused by the pressure of the hernia on the soft tissue. Modern drugs from the NSAID group stop all these symptoms, affecting the mechanism of inflammation.
The key enzyme that is blocked by all these drugs turns out to be cyclooxygenase (COX). It is its activity that underlies the launch of the inflammatory cascade, and if a drug causes a decrease in its activity, or a pharmaceutical blockade, then the development of inflammation is also blocked. Therefore, all of the above symptoms are either mildly expressed or absent altogether. Accordingly, the patient experiences improvement, despite the fact that the protrusion or hernia remains in its place.
However, it's not that simple. It turns out that the enzyme cyclooxygenase comes in two types, and only the second type (COX-2) causes inflammation. ITS complex structure is shown in the photo.
The first type is associated with the normal function of the mucous membrane of the stomach and duodenum. The first, crude drugs from the NSAID group suppressed both types of this enzyme, were non-selective COX inhibitors, and therefore had a very harmful effect on the gastric mucosa. And, perhaps, the rather crude drug Diclofenac can be considered the leader in the number of complications manifested by erosive gastritis and even peptic ulcers and bleeding. Despite the fact that it is very unsafe, it is very potent, and therefore is still loved by doctors and patients.
But still, not only efficiency is important, but also safety. Therefore, drugs began to be created that inhibit only the second type of cyclooxygenase. These are modern effective drugs meloxicam, ketoprofen, nimesulide and others. Many people know such medications as Movalis, Ketonal, Nimesil. All these drugs are used for protrusions and hernias, relieve acute and chronic back pain, improve range of motion and improve quality of life. Then a whole class of NSAIDs appeared, which were called coxibs. They have been introduced into clinical practice since the nineties of the last century, and the first representative was celecoxib, or Celebrex. One of the most modern and effective drugs is Arcoxia, or etoricoxib.
Interaction with other drugs and alcohol
The use of Arcoxia does not replace the need to use other groups of medications, including antibiotics. But it's worth remembering the following:
- Before combining Arcoxia and other drugs, you should consult your doctor;
- Arcoxia enhances the effectiveness of anticoagulants and antiplatelet agents, lowering prothrombin time;
- reduces the effect of diuretics and antihypertensive drugs;
- if acetylsalicylic acid is used, then as a prevention of cardiovascular complications. But you should not get carried away, as gastric bleeding may be provoked;
- the compatibility of cyclosporines with Arcoxia enhances its nephrotoxic effect.
Arcoxia and Kagocel
Kagocel is an antiviral drug. Judging by the instructions for both Arcoxia and Kagocel, taking these drugs together is possible. Arcoxia can coexist with drugs of this pharmacological group, and Kagocel combines well with other antiviral drugs, immunomodulators, antibiotics and other drugs. But the combination of such means should be carried out by a qualified specialist. Independence in this matter and an arbitrary combination of medications can lead to negative consequences, poisoning and even death.
Arcoxia and alcohol
Due to the fact that the instructions do not directly prohibit combination with alcohol, the question of their compatibility naturally arises. The simultaneous use of non-steroidal anti-inflammatory drugs in combination with alcohol is undesirable due to the possible occurrence and intensification of side effects. Migraine, weakness, nausea and vomiting, allergic reactions, diarrhea, disorientation in space, kidney failure, increased load on the liver, etc. Not the most pleasant set, right? Arcoxia in combination with alcohol leads to deterioration of the gastrointestinal tract and poisoning and internal bleeding. The risk of myocardial infarction, increased blood pressure, and cardiovascular failure cannot be excluded. But there are still a couple of tips. You can start drinking alcohol only after the drug has been completely eliminated from the body, which means 24 hours after taking the last pill. This also works the other way around: you should not drink alcohol the day before taking Arcoxia.
Overdose and side effects, interactions with drugs
However, no one has yet managed to create a drug that would not have overdose symptoms and side effects. They are also found in various commercial varieties of etoricoxib. Quite often (from 1 to 10%) adverse reactions such as epigastric pain, nausea, loose stools, bloating and symptoms of gastric dyspepsia, that is, belching, occur. From the central nervous system, patients most often report dizziness, weakness and headache.
Sometimes there is palpitations and increased blood pressure. Frequent side effects are edema and fluid retention, as well as increased activity of ALT and AST in the blood plasma, that is, liver transaminases. With long-term treatment, patients may experience a flu-like syndrome, that is, fever with aching joints. All of the above common side effects occurred no more often than in 10% of cases. You should not think that if Arcoxia is a modern and safe drug, then you can take it and forget it. Among the side effects, increased blood pressure is quite common, so during treatment with the drug it is imperative to monitor blood pressure numbers, especially in patients with arterial hypertension.
Since there is an increase in transaminases, it is necessary to monitor the condition of the liver and kidneys, especially in patients with diseases of these organs. If transaminases, that is, ALT and AST levels, exceed the norm two times or higher, then the medicine must be discontinued.
It is prohibited to use this drug in combination with other drugs from the NSAID group, for example, Arcoxia + aspirin, or Arcoxia + Paracetamol, not to mention such very harmful combinations as Arcoxia plus Diclofenac or Movalis.
Finally, you need to remember that if the patient has such a side effect as drowsiness or dizziness, then he is recommended to refrain from driving vehicles and working with potentially dangerous machines and mechanisms.
Arcoxia is a drug that very rarely causes overdose symptoms, but if the dose is exceeded by 10 times or more, side effects may increase. There are also interactions of this medicine with other drugs, but this should be taken care of by the attending physician, having found out everything about what drugs the patient is taking. Special attention is required to such drugs as cardiac glycosides, rifampicin, oral contraceptives, cytostatics and immunosuppressants, and other drugs.
Analogs
Analogues of the drug Arcoxia
To date, the drug Arcoxia has no analogues in the literal sense of the word, so if a replacement is necessary, you should consult your doctor.
Let us recall that Arcoxia is a selective nonsteroidal anti-inflammatory drug (NSAID) that suppresses the production of prostaglandins, which are mediators of inflammation. NSAIDs reduce fever, suppress pain and relieve inflammation and are used for symptomatic therapy. Although Arcoxia and the medications described below are part of the same pharmacological group, they have different active substances (to which the patient may have hypersensitivity), release forms, price, negative effects on the body, sometimes contraindications and side effects. Let's try to figure out what the pharmacy counter offers us. Remember that only a doctor can prescribe the appropriate drug!
Arcoxia or Movalis
Movalis is a drug whose active ingredient is meloxicam. Arcoxia and Movalis have similar indications and algorithm of action, but the release forms and negative effects on the body are different. Arcoxia is available in the form of tablets, and Movalis in the form of tablets, injection solution, suspension, and rectal suppositories. Thus, Arcoxia has a negative effect on the cardiovascular system, and Movalis has a negative effect on the gastric mucosa and gastrointestinal tract as a whole, causing perforations and possible bleeding. For endocrinological disorders (diabetes) and for elderly people, Arcoxia is indicated, since these parameters are on the list of contraindications for Movalis.
Arcoxia or Nimesil
The active substance Nimesil is nimesulide. It, like Arcoxia, blocks the activity of COX 2, which makes it possible to achieve an analgesic effect and be used for the treatment of inflammatory and degenerative diseases of the musculoskeletal system. But Nimesil has an additional area of application: it is used in the treatment of infectious and inflammatory processes of the respiratory system. Reduces temperature, relieves pain and inflammation.
Release form Nimesil is medicinal granules (powder), which are diluted in a glass of warm water.
Arcoxia or Aertal
Indications for use, contraindications and algorithm of action are identical to Arcoxia. The active ingredient in Aertal is aceclofenac. Release form: tablets, cream for external use and powder, from which a suspension is first prepared before use. The main negative effects that the patient encounters when taking Aertal are: nausea, vomiting, epigastric pain, intestinal colic, dyspepsia, flatulence, anorexia, constipation.
Arcoxia or Dexalgin
The active substance in Dexalgin is dexketoprofen, which, it should be noted right away, often causes allergies. It is sold in tablets and injections (administered intramuscularly) and taken throughout the day (tablets 2-6 times, injections 2-3 times). Otherwise, this is a NSAID with similar indications, action and contraindications.
Arcoxia or Diclofenac
Diclofenac is a very effective NSAID. It is not for nothing that doctors use it when they need to quickly relieve pain in the postoperative and post-traumatic period. Also, this remedy in the form of a suppository helps well with migraines. But, alas, the effect on the human body is negative. Long-term use of the drug affects not only the gastric mucosa, but also the cardiovascular system.
Arcoxia or Costarox
Kostarox is a generic, that is, a drug with the same active ingredient as the original (etoricoxib 90), however, it has not passed all stages of clinical trials. Generic status makes the drug cheaper, often without loss of pharmacological properties. Note that Kostarox, unlike Arcoxia, is available in only one dosage - 90 mg.
Arcoxia or Celebrex
Celebrex also belongs to the group of NSAIDs. It is sold on the market in the form of capsules containing 200 mg of the active substance - celecoxib. Celebrex is indicated for the following diseases:
- osteoarthritis;
- rheumatoid arthritis;
- primary dysmenorrhea;
- ankylosing spondylitis;
- pathologies of bone and muscle structures, accompanied by pain.
Since the indications and algorithm of action are the same, the prescription of Arcoxia or Celebrex will depend on the doctor, since only he, having carried out the necessary studies and taking an anamnesis, will be able to determine the need for a particular drug.
Eat right, move more, stay positive, and your mobility will stay with you!
The effectiveness of the drug for spinal hernia
Unfortunately, neither Arcoxia nor any other tablet drug or injectable drug is capable of ridding the patient of protrusion and hernia of any part of the spine. Let's say more: not a single type of physiotherapy, massage, manual therapy, or exercise therapy can get rid of a hernia. A hernia cannot be removed by swimming, traction, or other, even exotic, techniques.
Hernia on MRI.
If a hernial protrusion has already formed and the outer layers of the intervertebral disc are destroyed, then such a hard cartilaginous defect can only be eliminated through surgery. Modern minimally invasive neurosurgical operations make it possible to quickly and painlessly eliminate the hernia itself, and, as a result, relieve the patient from excruciating pain, muscle spasms, conductive neurological symptoms, such as numbness and crawling, weakness in the limbs.
We can say that neurosurgery completely cures a person from problems associated with hernial protrusion, since it eliminates the cause of back pain. Science does not stand still, and highly effective operations are performed not only in the USA and Great Britain, but also in Eastern European countries, for example in the Czech Republic. Czech neurosurgeons have achieved high results, which do not differ from the world level in terms of long-term results of surgical interventions. All other methods that relate to therapeutic or conservative treatments directly address the cause, that is, they do not affect the hernia. Their task is to temporarily eliminate or reduce unpleasant symptoms such as pain and the chronic muscle spasm that is caused by this pain. And the most effective drugs are considered to be drugs from the NSAID group (non-steroidal anti-inflammatory drugs). Arcoxia also belongs to them. Why is this tool considered modern and new? Many will be surprised to learn that the rather expensive drug Arcoxia relieves pain even somewhat worse than the old, long-known and cheap drug Diclofenac. Let's look at this in more detail.