Etoricoxib — NZ Medication Guide

📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.

What is Etoricoxib?

Etoricoxib is a highly selective COX-2 inhibitor NSAID for arthritis and acute pain with lower GI side effects. This medication is funded by Pharmac under Special Authority for arthritis in patients with elevated GI risk.

What is Etoricoxib Used For?

Used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gouty arthritis, and acute pain where GI tolerability is a concern.

How Does Etoricoxib Work?

Highly selective COX-2 inhibition provides potent anti-inflammatory and analgesic effects by reducing prostaglandin synthesis at sites of inflammation, while largely sparing COX-1 (which protects the gastric mucosa) — resulting in lower GI side effects than non-selective NSAIDs.

How to Take Etoricoxib

30–60 mg once daily for osteoarthritis; 90 mg once daily for RA/AS; 120 mg once daily for acute gout (max 8 days). With or without food.

Common Side Effects of Etoricoxib

• Headache
• Dizziness
• Peripheral oedema
• Hypertension
• Dyspepsia (less than non-selective NSAIDs)

Serious Side Effects — Seek Medical Attention

Contact your doctor or call 111 immediately if you experience any of the following:

• Cardiovascular events — MI and stroke (MEDAL trial: similar CV risk to diclofenac)
• Hypertension (contraindicated if uncontrolled BP >140/90)
• Renal impairment
• Serious skin reactions (rare)

Drug Interactions

Etoricoxib may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:

• Antihypertensives (reduced efficacy)
• Warfarin (modest interaction — monitor INR)
• Methotrexate (increased toxicity)
• Lithium (increased levels)

New Zealand Prescribing Information

Etoricoxib (Arcoxia® 30, 60, 90, 120 mg tablets) is funded under Special Authority. It is contraindicated in patients with uncontrolled hypertension and should not be used in those with established CVD or cerebrovascular disease. Monitor BP before and during treatment.

Frequently Asked Questions

Is etoricoxib safer for the heart than other NSAIDs?

No — etoricoxib carries similar cardiovascular risk to diclofenac (per the MEDAL trial). Its primary advantage is lower GI risk. It should not be used in patients with established heart disease or stroke.

Why does etoricoxib raise blood pressure?

COX-2 inhibition in the kidney reduces prostaglandin-mediated vasodilation and sodium excretion, causing fluid retention and elevated blood pressure. Blood pressure monitoring during treatment is essential.

References & Further Information

The following New Zealand and international resources were used to inform this page:

• New Zealand Formulary — Etoricoxib
• Pharmac — Funded Medicines Schedule
• BPAC NZ — NSAIDs and Cardiovascular Risk

⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.

Reviewed by a Registered Pharmacist NZ