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INTRODUCTION
NUREETO contains Etoricoxib which belongs to the group of medicines called Non-Steroidal Anti-Inflammatory Drugs. It is used to reduce pain and swelling associated with inflammatory bone conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis (inflammation of the spine) and gout (joint pain caused due to excessive accumulation of uric acid in between the joints).
NUREETO can also be used to reduce pain following a dental surgery. It is suitable for use both in adults and in adolescents (aged 16 years or older).
Before taking NUREETO inform your doctor if you have any previous history of heart, liver or kidney problems. You must also inform your doctor if you have diabetes, high blood cholesterol levels, uncontrollable high blood pressure or severe dehydration.
NUREETO is strictly not recommended for use in patients with stomach problems (such as stomach ulcers, bleeding in the gut or inflammatory bowel diseases). It is also not suitable for use in patients with stroke or any severe form of heart problems, liver problems or kidney problems.
Do not take NUREETO if you are pregnant or breastfeeding without consulting your doctor. The most common side effects of taking NUREETO are stomach pain, bloating, constipation, mouth ulcers, headache and dizziness. Consult your doctor immediately if any of these side effect worsens.
USES OF NUREETO
It is used in adults and in adolescents (aged 16 years or older) to
- Treat pain and swelling caused due to inflammation of bones and joints
- Treat pain following dental surgery
HOW NUREETO WORKS
NUREETO is a pain-relieving medicine. It works by blocking the release of certain chemicals (prostaglandins) in the body that causes pain, swelling and inflammation thereby reducing pain and inflammation associated with inflammatory conditions.
DIRECTIONS FOR USE
Take NUREETO as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. NUREETO can be taken with or without food.
Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF NUREETO
COMMON
- stomach pain
- headache, dizziness
- constipation, flatulence, heartburn, indigestion, diarrhoea
- mouth ulcers
- nausea, vomiting
- feeling weak or tired
- bruising
UNCOMMON
- infections of respiratory or urinary tract
- changes in RBC, WBC and platelet count
- weight gain, changes in taste
- behavioral changes (feeling anxious or depressed, hallucination)
- tingling and numbness in the body
- high blood pressure, inflammation of blood vessels
- changes in bowel habits, dry mouth, stomach ulcers
- muscle pain or cramps
- high blood potassium levels
RARE
Stop taking NUREETO and contact your doctor immediately if you experience any of the following side effects:
- chest pain, shortness of breath and swollen ankles
- severe stomach pain with dark stools
- jaundice (yellow colouration of the skin and the eyes)
- signs of an allergic reaction (such as skin rash, itching, blistering and peeling of the skin, swelling of the face, lips, mouth, throat which may lead to breathing difficulties)
HOW TO MANAGE SIDE EFFECTS
Nausea and vomiting:
Take NUREETO with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if your nausea worsens.
Dizziness:
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.
Headache:
Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.
Constipation:
Eat plenty of fibre-rich foods such as fresh fruits, vegetables and cereals. Drink plenty of fluids. Exercise more regularly. Consult your doctor if this side effect bothers you.
Diarrhoea:
Hydrate yourself by drinking plenty of fluids, such as water or fruit juices. Consuming ORS can also be beneficial. Do not self-treat diarrhoea on your own. Consult your doctor if your diarrhoea becomes uncontrollable.
WARNING & PRECAUTIONS
PREGNANCY
NUREETO should not be used during pregnancy. Therefore, inform your doctor before taking NUREETO if you are pregnant, think you may be pregnant or planning to have a baby. If you accidentally become pregnant while undergoing therapy with NUREETO, inform your doctor immediately.
BREASTFEEDING
It is not known whether NUREETO can pass through breast milk or not. Therefore, consult your doctor before taking NUREETO if you are breastfeeding or planning to breastfeed.
DRIVING AND USING MACHINES
Do not drive or operate any heavy tools or machines if you feel dizzy or sleepy after taking NUREETO.
ALCOHOL
Avoid consumption of alcohol while taking NUREETO as it may increase the risk of stomach discomfort.
KIDNEY
NUREETO is not recommended for use in patients with serious kidney diseases. Therefore, consult your doctor before taking it. You must also inform your doctor before taking NUREETO if you have any previous history of kidney problems.
LIVER
NUREETO is not recommended for use in patients with serious liver diseases. Therefore, consult your doctor before taking it. You must also inform your doctor before taking NUREETO if you have any previous history of liver problems.
ALLERGY
Do not take NUREETO if you are allergic to etoricoxib or to any other pain reliving medicines (such as aspirin, ibuprofen, celecoxib etc.).
HEART DISEASE
NUREETO is not recommended for use in patients who have or had heart failure, angina, heart attack, bypass surgery, blocked blood vessels or poor blood circulation in the body. Therefore, consult your doctor before taking it.
OTHERS
NUREETO is not recommended for use if you:
- currently have ulcers or bleeding in your stomach or intestines
- have inflammatory bowel diseases (such as Crohn’s disease or ulcerative colitis)
- have uncontrollably high blood pressure
- have stroke (including mini-stroke, transient ischemic attack)
Before taking NUREETO, inform your doctor if you
- have a previous history of stomach ulcers
- are dehydrated, due to prolonged vomiting or diarrhea
- have a history of high blood pressure
- have edema (swelling of body parts)
- are being treated for an infection
- have diabetes
- have high cholesterol
- are a smoker
Use in Pediatrics:
NUREETO should be used in adolescents aged 16 years or above only if prescribed by the physician. It should not be used in children and adolescents (aged below 16 years). Therefore, consult your doctor for advice.
Use in Geriatrics:
NUREETO should be used with caution in elderly patients (aged above 65 years). Therefore, consult your doctor before taking it.
INTERACTIONS
A. Drug - Drug interactions:
Before taking NUREETO, inform your doctor if you are taking any of the following medicines such as:
- warfarin (a medicine used to treat blood clots)
- rifampicin (a medicine used to treat tuberculosis)
- methotrexate (a medicine used for suppressing the immune system and often used in rheumatoid arthritis)
- cyclosporin or tacrolimus (used to suppress immune system and to prevent graft rejection)
- lithium (a medicine used to treat depression)
- medicines used to treat high blood pressure and heart failure such as ACE inhibitors (Ex. enalapril, ramipril) and angiotensin receptor blockers (Ex. losartan, valsartan)
- diuretics (used to treat edema and high blood pressure) Ex. bumetanide, ethacrynic acid
- digoxin (a medicine used to treat heart failure and irregular heart rhythm)
- minoxidil (a medicine used to treat hair loss or high blood pressure)
- salbutamol (a medicine used to treat asthma)
- birth control pills (used to prevent pregnancy) Ex. mifepristone, drospirenone, ethinylestradiol
- hormone replacement therapy (used to treat hormonal imbalances) Ex. estradiol, dydrogesterone
- aspirin (used to reduce fever and pain)
Overdosage:
If you or anyone else accidentally took more NUREETO, consult your doctor immediately or visit the nearby hospital.
SYNOPSIS
| Drug | : | Etoricoxib |
| Pharmacological Category | : | Selective COX-2 Inhibitor |
| Therapeutic Indication | : | Pain relief |
| Dosage Forms | : | Tablet, Capsule, Injection |
MORE INFORMATION
- Keep NUREETO out of reach of children
- Store NUREETO at room temperature
FAQs ABOUT NUREETO
Is NUREETO safe to use in diabetic patients?
NUREETO may alter the blood sugar levels in your body. Therefore, it is necessary to inform your doctor if you have diabetes before taking NUREETO as a precaution. Your doctor will closely monitor your blood sugar levels to avoid the risk of side effects.
Is NUREETO an anti-inflammatory medicine?
Yes. NUREETO is an anti-inflammatory medicine used to reduce pain and inflammation. It acts by blocking the release of certain chemicals (Ex. prostaglandins) in the body that causes pain and inflammation.
Who should not take NUREETO?
Generally, patients who have stomach problems such as stomach ulcers or other inflammatory stomach conditions such as ulcerative colitis, Crohn’s disease or perforations or bleeding in the gut should not use NUREETO. Consult your doctor before taking NUREETO if you are pregnant or trying to become pregnant. NUREETO is also not suitable for use in patients with stroke or severe liver, kidney or heart disease and in children aged below 16 years. Therefore, consult your doctor before taking.
Is NUREETO safe to use for long term?
NUREETO should be used under medical supervision. Research shows that, prolonged use of NUREETO can increase the risk of heart attack or stroke in patients. To avoid this, take NUREETO only as advised by your physician. Your doctor will regularly monitor your health condition while taking NUREETO to avoid these side effects.
Can I take other painkillers along with NUREETO?
No, it is not advisable to take other painkillers along with NUREETO without consulting your doctor, as it may increase the risk of ulcers and bleedings in the digestive system.
Is it safe to have NUREETO with alcohol?
No. Avoid consumption of alcohol while taking NUREETO as it increases the risk of unwanted gastrointestinal side effects.
Can NUREETO cause dizziness?
Yes. NUREETO may make you feel dizzy. If you experience dizziness, try to rest and relax. Get enough sleep. Avoid driving or operating any heavy tools or machines while you are feeling dizzy. Avoid consumption of alcohol as it can aggravate your dizziness. Consult your doctor if you continue to feel dizzy for a prolonged period.
Can I take a higher dose of NUREETO?
It is not safe to take a higher dose of NUREETO without consulting your doctor. If the prescribed dose is less effective for you, kindly consult your doctor for a suitable high dose or for alternative therapy.
How long will it take for NUREETO to reduce pain?
It may take around 20-30 minutes for NUREETO to start working. The maximum benefits can achieve after 2 hours of taking NUREETO. However, this period may vary from person to person depending upon the dose of etoricoxib that is administered.
What happens if I accidentally take more NUREETO?
If you or anyone else accidentally took more NUREETO, contact your doctor immediately or visit the nearby hospital. Symptoms of overdosage might include severe stomach problems such as stomach pain, bleeding in the gut and a fast heartbeat.
Can I take NUREETO daily?
Your doctor will evaluate your health condition and suggests whether you can take NUREETO every day or not.
Can I stop taking NUREETO once my pain reduces?
Take NUREETO for the stipulated duration recommended by your doctor to achieve maximum results. Do not stop therapy with NUREETO without consulting your doctor in between the therapy.
What are the uses of NUREETO?
NUREETO is used to reduce pain and swelling associated with inflammatory bone conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and gout. It can also be used to reduce pain following dental surgery.
Can NUREETO be used in children?
NUREETO should be used in adolescents aged 16 years or above only if prescribed by the physician. It should not be used in children and adolescents (aged below 16 years). Therefore, consult your doctor for advice.
How does NUREETO work?
NUREETO is a pain-relieving medicine. It works by blocking the release of certain chemicals (prostaglandins) in the body that causes pain, swelling and inflammation thereby reducing pain and inflammation associated with inflammatory conditions.
What are the side effects of NUREETO?
The most common side effects of taking NUREETO are stomach pain, bloating, constipation, mouth ulcers, headache and dizziness. Consult your doctor immediately if any of these side effects worsen.
What is the best time to take NUREETO?
NUREETO can be taken with or without meals. Your doctor will decide the best time for you to take NUREETO based on your age, body weight and disease condition.
What to do if I forgot to take a dose of NUREETO?
If you forgot to take a dose of NUREETO, take it as soon as you remember. However, if it is time for the next dose of NUREETO, skip the missed dose and take the next one regularly. Do not take a double dose of NUREETO to compensate for the missed ones.
Will NUREETO alter the effects of birth control pills?
NUREETO may reduce the effects of birth control pills. Therefore, try to avoid taking birth control pills along with NUREETO. Consult your doctor for advice.
REFERENCES
1. KD. Tripathi. Nonsteroidal Anti-inflammatory Drugs and Antipyretic-Analgesics. Essentials of medical pharmacology. Seventh edition. 2013. Page – 206.
2. Wen-Nan Huang and Tim K. Tso. Etoricoxib improves osteoarthritis pain relief, joint function and quality of life in the extreme elderly. NIH National Library of medicine, National Center for Biotechnology Information. PMC PubMed Central. [Revised in February 2018] [Accessed on 8th October 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826680/
3. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed on 8th October 2022] https://www.medicines.org.uk/emc/files/pil.11761.pdf
4. Teva UK Limited. Etoricoxib. [Revised in August 2022] [Accessed on 8th October 2022]. https://products.tevauk.com/mediafile/id/52513.pdf
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