With coumarins, anticoagulant effect possibly enhanced .
Plasma concentrations of erthinyloestradiol increased when given concomitantly
Plasma concentration of etoricoxib reduced when given with rifampicin.
Patients receiving digoxin concomittantly with etoricoxib should be monitored closely because the
 risk of digoxin toxicity
May increase concentration of methotrexate.
May also have the general drug interactions of NSAIDs

Headache, diarrheoa, nausea
Upper respiratory tract infection
Increasedcrisk of thrombotic events.
Dizziness, fatigue, insomnia.
Occasional fecal blood loss.small increases in blood pressure.

Previous hypersentivity to the drug, acute peptic ulcer disease or GI bleeding.
Severe renal or hepatic dysfunction.
Patients with a history of hypersentivity to aspirin or other non-steroidal anti-infammatory drugs

Special precautions-
History of allergy, conditions predisposing to gastrointestinal events.
Patients with hypertension,angina, myocardial infarction, other cardiovascular diseases.
mild to moderate liver disease ,mild to moderate renal impairment.
Pregnancy and lactation.

Rhematoid arthiritis
Osteoarthiritis

Dosages-
Osteoarthiritis, musculoskeletal pain- 60mg/day
Primary dysmennorrheoa- 60 to 120mg/day
Rheumatoid arthiritis- 90mg/day
Gouty arthiritis, acute pain associated with dental surgery- 120mg/day

Pharmacology-

Etorcoxib is a selective inhibitor of COX-2. The COX-1 isoenzyme is constitutely expressed in most tissues and is
particularly invloved prostaglandin snthesis in the kidneys, platelets and gastric mucosa, products of of COX-1
appear cytoprotective and inhibition of this isoform has been associated with antiplatelet activity and gastrointestinal
toxicity. On the other hand the inhibition of of COX-2y etoricoxib is responsible for its analgesic and anti-inflammatory
and its low incidence of adverse effects.

Pharmacokinetics-

Etoricoxib is rapidly absorbed with a mean bioavailability of approximately 100%. Food does not significantly affect
absorption. Etoricoxib undergoes extensive metabolism by the hepatic cytochrome enzymes, mostly by the
 CYP 450 3A4
It has an elimnation half-life of aproximately 22 hours and a plasma clearance of 3 litres/hour. Most of the drug is
eliminated by the kidneys and a part is eliminated through the faeces.

Food does not significantly affect absorption.

Preganancy and lactation- caution to be excercised