Lower recommended dose for etoricoxib

By Tulsi Pindolia on the 18 October 2016

The recommended dose of Arcoxia (etoricoxib) has been reduced to 60mg daily for patients with rheumatoid arthritis or ankylosing spondylitis.

Gastrointestinal complications (perforations, ulcers or bleeding), some fatal, have occurred in patients treated with etoricoxib. | SCIENCE PHOTO LIBRARY

Two randomised, double-blind, phase III trials have shown that a 60mg daily dose of etoricoxib is effective for the treatment of rheumatoid arthritis and ankylosing spondylitis, although some patients required an increased dose of 90mg daily.

Further information

View etoricoxib drug record Letter to healthcare professionals MHRA Drug Safety Update

As it is not possible to predict which patients may benefit from the higher dose, healthcare professionals should initiate treatment with a dose of 60mg once daily, with the option to increase to a maximum dose of 90mg once daily in patients with insufficient relief from symptoms.

As a selective COX-2 inhibitor, etoricoxib may be associated with an increased risk of cardiovascular and gastrointestinal events. These risks may increase with the dose and duration of exposure. The lowest effective daily dose should therefore be used and the need for treatment regularly reassessed.