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Etoricoxib is a medicine called a non-steroidal anti-inflammatory drug. It is also known as an ‘NSAID’. T

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Description

Arcoxia (Etoricoxib)

Commercial name: Arcoxia
Active component: Etoricoxib
Production form: Pills
Uses: Treats the arthrosis, gout, and rheumatism
Dose: 60 mg
Category: Arthritis

What is Arcoxia (Etoricoxib)?

Arcoxia is used for the following:

  • acute and chronic treatment of the signs and symptoms of osteoarthritis and rheumatoid arthritis
  • management of ankylosing spondylitis
  • relief of chronic musculoskeletal pain
  • relief of acute pain
  • to treat acute gouty arthritis

Your doctor will prescribe Arcoxia for you only after you have used other medicines for your condition and they have not been suitable for you.

Your doctor will want discuss your treatment with Arcoxia from time to time. It is important that you use the lowest dose that controls your pain and you should not take Arcoxia for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.

Osteoarthritis

Osteoarthritis is a joint disease. It results from the gradual breakdown of the cartilage that covers the joints and cushions the ends of bones.

Symptoms of osteoarthritis include pain, tenderness, stiffness of one or more joints, and physical disability. The hips and knees are the most commonly affected joints, but other joints such as those of the hands and spine may also be affected.

Osteoarthritis is more common in women than in men. Many factors can lead to the development of osteoarthritis including obesity and joint injury (eg. from sport).

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling and loss of function in the joints and inflammation in other body organs.

Ankylosing Spondylitis

Ankylosing spondylitis is an inflammatory disease of the spine and large joints.

Gout

Gout is a disorder characterised by sudden, recurring attacks of pain and inflammation in one or more joints.

How does Arcoxia work?

Note: Arcoxia has not been approved by the FDA for the U.S. market.

Arcoxia belongs to a group of medicines called cyclooxygenase-2 (COX-2) specific inhibitors (also known as coxibs).

The body produces two similar enzymes called COX-1 and COX-2. COX-1, among other functions, is involved with protecting the stomach, while COX-2 plays a role in joint inflammation and pain.

Arcoxia reduces pain and inflammation by blocking COX-2, an enzyme in the body.

Arcoxia does not block COX-1, the enzyme involved in protecting the stomach from ulcers.

Other anti-inflammatory medicines (NSAIDS) block both COX-1 and COX-2.

Arcoxia relieves pain and inflammation with less risk of stomach ulcers compared to NSAIDS.

However taking aspirin with Arcoxia may reverse this benefit (see Before you take Arcoxia, Taking Other Medicines).

In clinical studies, the risk of developing ulcers on Arcoxia was lower than with NSAIDs. Some people developed ulcers whether they were taking Arcoxia or placebo in these studies; however the rate was higher on Arcoxia.

If any of the following symptoms: shortness of breath, chest pains or ankle swelling appear or worsen, stop your treatment with Arcoxia and consult a doctor, as soon as is practical.

If you have kidney, liver or heart disease, your doctor will want to appropriately keep a check on you.

If you develop any symptoms that could indicate a severe allergic reaction such as an inability to breathe or a serious skin reaction you must consult a doctor on an urgent basis.

Your doctor will want to discuss your treatment from time to time. It is important that you use the lowest dose that controls your pain and you should not take Arcoxia for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.

Arcoxia can increase blood pressure in some people, especially in high doses, and this could increase the risk of heart attacks and strokes. Your doctor will want to check your blood pressure from time to time, to make sure that it is safe to continue treatment.

Your doctor may have prescribed Arcoxia for another reason. Ask your doctor if you have any questions about why Arcoxia has been prescribed for you.

Arcoxia is not addictive.

Before you take Arcoxia

Note: Arcoxia has not been approved by the FDA for the U.S. market.

Do not take Arcoxia if:

  • you have an allergy to Arcoxia or any of the ingredients listed at the end of this leaflet
  • the packaging is torn or shows signs of tampering
  • the expiry date on the pack has passed.
  • If you take this medicine after the expiry date has passed, it may not work.
  • You have had heart failure, a heart attack, bypass surgery, chest pain (angina), narrow or blocked arteries of the extremities (peripheral arterial disease), a stroke or mini stroke (TIA or transient ischaemic attack).
  • You have high blood pressure that is not well controlled on blood pressure medication.
  • You are having major surgery and have conditions which increase your risk of coronary artery disease or atherosclerosis such as high blood pressure, diabetes, high cholesterol or smoking.
  • You are having major surgery on you heart or arteries.

If you are not sure whether you should start taking Arcoxia, talk to your doctor.

Arcoxia has not been adequately studied in children. Therefore, Arcoxia should not be given to children.

Arcoxia works equally well in older and younger adult patients. Adverse experiences may occur at a higher incidence in older patients compared to younger patients. If you are elderly (ie over 65 years of age), your doctor will want to appropriately keep a check on you. No dosage adjustment is necessary for older patients.

Before you start to taking Arcoxia tell your doctor if:

  • you are pregnant or intend to become pregnant. Arcoxia is not recommended for use during late pregnancy. If there is a need to consider using Arcoxia during your pregnancy, your doctor will discuss with you the benefits and risks of using it.
  • you are breast-feeding or plan to breast-feed. It is not known if Arcoxia passes into breast milk. You and your doctor should discuss whether you should stop breast-feeding or not take Arcoxia.
  • you have or have had any medical conditions, especially the following:
    • history of angina
    • heart attack or a blocked artery in your heart
    • narrow or blocked arteries of the extremities
    • kidney disease
    • liver disease
    • heart failure
    • high blood pressure
  • you have had an allergic reaction to aspirin or other anti-inflammatory medicines (commonly known as NSAIDs)
    Symptoms of an allergic reaction may include asthma, pinkish itchy swellings on the skin (hives), runny or blocked nose.
  • you have an infection
    If you take Arcoxia while you have an infection, it may hide fever and may make you think, mistakenly, that you are better or that your infection is less serious than it might be.
  • you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.
  • you have a history of stroke or mini stroke
  • you have conditions which increase your risk of coronary artery disease or atherosclerosis such as high blood pressure, diabetes, high cholesterol or smoking.

If you have not told your doctor about any of the above, tell them before you take any Arcoxia.

Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and Arcoxia may interfere with each other. These include:

  • warfarin, a medicine used to prevent blood clots
  • rifampicin, an antibiotic used to treat tuberculosis and other infections
  • water pills (diuretics)
  • ACE inhibitors and angiotensin receptor blockers, medicines used to lower high blood pressure or treat heart failure
  • lithium, a medicine used to treat a certain type of depression
  • birth control pills
  • hormone replacement therapy
  • methotrexate, a medicine used to suppress the immune system

These medicines may be affected by Arcoxia or may affect how well it works. You may need different amounts of your medicine, or you may need to take different medicines.

Your doctor or pharmacist has more information on medicines to be careful with or avoid while taking Arcoxia.

Arcoxia can be taken with low dose aspirin. If you are currently taking low dose aspirin for the prevention of a heart attack or stroke, you should continue to do so unless specified by your Doctor. Arcoxia cannot replace aspirin for this purpose.

How to take Arcoxia

Note: Arcoxia has not been approved by the FDA for the U.S. market.

Take Arcoxia only when prescribed by your doctor.

For osteoarthritis, the recommended dose is 60 mg once a day.

For rheumatoid arthritis the recommended dose is 90 mg once a day.

For ankylosing spondylitis the recommended dose is 90 mg once a day.

For the relief of gout attacks the recommended dose is 120 mg once a day, which should only be used for the acute painful period.

For the relief of chronic musculoskeletal pain the recommended dose is 60 mg once a day.

Doses greater than those recommended for each condition have either not demonstrated additional efficacy or have not been studied. Therefore, the daily doses stated above for each condition should not be exceeded.

If you have mild liver disease, you should not take more than 60 mg a day. If you have moderate liver disease, you should not take more than 60 mg every other day.

Follow all directions given to you by your doctor carefully. They may differ from the information contained in this leaflet.

If you do not understand the instructions on the box, ask your doctor or pharmacist for help. Arcoxia comes as tablets.

When taking the tablets, swallow them with a glass of water. Do not halve the tablet.

Take your Arcoxia at about the same time each day.

Taking Arcoxia at the same time each day will have the best effect. It will also help you remember when to take the dose.

It does not matter if you take Arcoxia before or after food.

Do not use Arcoxia for longer than your doctor says.

Your doctor will want to discuss your treatment from time to time. It is important that you use the lowest dose that controls your pain and you should not take Arcoxia for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.

Depending on your condition, you may need to take Arcoxia for a few days or for a longer period.

For osteoarthritis and rheumatoid arthritis Arcoxia helps relieve your symptoms but it does not cure it. Continue taking Arcoxia for as long as your doctor prescribes.

For the relief of gout attacks or other types of pain, Arcoxia is usually only needed for a few days.

If you are not sure how long to take Arcoxia, talk to your doctor.

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking your tablet(s) as you would normally.

If you are not sure whether to skip the dose, talk to your doctor or pharmacist.

Do not take a double dose to make up for the dose that you missed.

If you have trouble remembering to take your tablets, ask your pharmacist for some hints.

If you take too much Arcoxia (overdose) immediately telephone your doctor or Poison Control Center or go to the emergency department at your nearest hospital, if you think that you or anyone else may have taken too much Arcoxia. Do this even if there are no signs of discomfort or poisoning.

While you are using Arcoxia

Note: Arcoxia has not been approved by the FDA for the U.S. market.

If you become pregnant while taking Arcoxia, tell your doctor immediately.

If you get an infection while taking Arcoxia, tell your doctor. Arcoxia may hide fever and may make you think, mistakenly, that you are better or that your infection is less serious than it might be.

If you are about to be started on any new medicine, tell your doctor and pharmacist that you are taking Arcoxia.

Do not give Arcoxia to anyone else, even if they have the same condition as you.

Some self help measures suggested below may help your condition. Talk to your doctor or pharmacist about these measures and for more information.

  • Exercise – regular exercise can help reduce pain and disability from osteoarthritis by increasing muscle strength and reducing the load on joints, but it is important not to overdo it. Walking is good exercise, however, before starting any exercise, ask your doctor about the best kind of programme for you.
  • Weight – your doctor may suggest losing some weight to help reduce the strain on your joints. Some people may need a dietician’s help to lose weight.
  • Hot and cold treatments.
  • Using support devices.

Adverse Effects

Note: Arcoxia has not been approved by the FDA for the U.S. market.

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Arcoxia.

Arcoxia helps most people with osteoarthritis, rheumatoid arthritis, menstrual pain, gout or other types of pain, but it may have unwanted adverse effects in a few people. All medicines can have adverse effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the adverse effects.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor if you notice or have any of the following and they worry you:

  • feeling sick (nausea), vomiting
  • heartburn, indigestion, uncomfortable feeling or pain in the stomach
  • diarrhoea
  • swelling of the legs, ankles or feet
  • high blood pressure
  • dizziness
  • headache

Additionally, the following have been reported:

  • allergic reactions including rash, itching and hives
  • severe skin reactions, which may occur without warning
  • taste alteration
  • wheezing
  • insomnia
  • anxiety
  • drowsiness
  • mouth ulcers
  • diarrhoea
  • severe increase in blood pressure
  • confusion
  • hallucinations
  • platelets decreased

These are usually the mild adverse effects of Arcoxia.

If any of the following happen, stop taking Arcoxia and tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

  • swelling of the face, lips, tongue or throat which may cause difficulty in swallowing or breathing (hypersensitivity reactions, anaphylactic/anaphylactoid reactions including shock)
  • abnormal rhythm of the heart (atrial fibrillation)
  • heart failure
  • palpitations
  • serious kidney problems
  • serious liver problems
  • stomach pain
  • stomach ulcers that may become serious and may bleed, and may occur at any time during use and without warning

Other adverse effects not listed above may also occur in some patients. Tell your doctor if you notice any other effects.

Do not be alarmed by this list of possible adverse effects. You may not experience any of them.

After using Arcoxia

Note: Arcoxia has not been approved by the FDA for the U.S. market.

Keep your tablets in the blister pack until it is time to take them. If you take the tablets out of the blister pack they may not keep well.

Keep Arcoxia in a cool dry place where the temperature stays below 30 degrees C (86 degrees F). Do not store it or any other medicine in the bathroom or near a sink. Do not leave it in the car or on window sills. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it. A locked cupboard at least 1.5 meters (5 feet) above the ground is a good place to store medicines.

If your doctor tells you to stop taking Arcoxia, or the tablets have passed their expiration date, ask your pharmacist what to do with any that are left over.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Etoricoxib, sold under the trade name Arcoxia, is a selective COX-2 inhibitor from McOLSON Research Laboratories. Currently it is approved in more than 80 countries worldwide but not in the US, where the Food and Drug Administration (FDA) has required additional safety and efficacy data for etoricoxib before it will issue approval.

It was patented in 1996 and approved for medical use in 2002.[1]

Medical uses[edit]

Etoricoxib is indicated for the treatment of rheumatoid arthritispsoriatic arthritisosteoarthritisankylosing spondylitis, chronic low back pain, acute pain, and gout. Approved indications differ by country. In the U.K., it is also “used for the short term treatment of moderate pain after dental surgery” of adults.[2]

Cochrane review assessed the benefits of single-dose etoricoxib in reduction of acute post-operative pain in adults.[3] Single-dose oral etoricoxib provides four times more pain relief post-operatively than placebo, with equivalent levels of adverse events.[3] Etoricoxib given at a dose of 120 mg is as effective or even better than other analgesics that are commonly used.[3]

Description
Arcoxia
        Modern rheumatology has achieved great success in the treatment of the most common, socially significant diseases of the musculoskeletal system, primarily of an inflammatory nature.
        Arcoxia medicine belongs to the group of highly selective inhibitors of cyclooxygenase-2, has an analgesic and anti-inflammatory effect. Also, it can be used as a febrifuge. It has the most favourable security profile. It is popular in the treatment of musculoskeletal diseases and helps with the restoration of dental nature after surgical interventions. The therapeutic potential of the drug in the most common chronic rheumatic diseases has been proven by a series of well-organized, large-scale and long-term studies. The medication provides a persistent reduction in the severity of pain, inflammatory activity and improvement of the patient’s well-being.
        The action of the drug is the ability to inhibit the activity of the enzyme cyclooxygenase-2.
        As a consequence, arachidonic acid metabolism is disturbed and the level of prostaglandins in the affected tissues and tissues of the nervous system decreases.
        This medication blocks the generation and inhibits the conduction of pain impulse.
        In case of a disease of the musculoskeletal system, the drug reduces morning stiffness, improves joint mobility, reduces the intensity of the inflammatory process and relieves pain.
        The therapeutic effect of the drug begins after 24 minutes from the time of use and lasts for 24 hours.
In what cases to use?
        The Arcoxia pill is used to treat diseases of the musculoskeletal system, which are accompanied by acute pain syndromes. Such diseases include the following types of arthritis:
• rheumatoid arthritis is an autoimmune disease of unknown aetiology characterized by asymmetrical lesion of cartilage and bone tissue.
• osteoarthritis (damage to the structure of the joint, changes in the tissues)
• acute gouty arthritis is a disease that occurs as a result of a violation of protein metabolism in the body. When gout increases the content of uric acid in the blood.
• ankylosing spondylitis is a chronic progressive disease that manifests itself as inflammation of the joints of the spine.
• chronic or acute myalgia is a pathology characterized by the presence of severe muscle pain. Also, it can often be accompanied by weakness and swelling.
        The drug is taken orally. With regard to food intake, then in order to achieve the maximum effect of the drug, a patient should take the drug on an empty stomach. This contributes to the acceleration of the action of the drug and the exclusion of symptoms of the first degree of importance. Due to the increased risk of problems with the cardiovascular system, it is necessary to periodically review the treatment program, as well as to give preference to short courses of taking the drug, especially when using large doses and in the presence of osteoarthritis.
• with osteoarthritis: the daily intake of the drug is 30 mg. With insufficient drug effect, this dose can be increased to 60 mg per day. If there is no effect, you should consult with the doctor and change the treatment program.
• for rheumatoid arthritis: The daily Arcoxia dosage is 60 mg 1 time per day. In case of insufficiency or lack of a drug effect, an increase of up to 90 mg per day is allowed. When clinical stabilization is achieved, the dose should be reduced to 60 mg once a day.
• with ankylosing spondylitis: The daily dose should be 60 mg. With the insufficient weakening of the symptoms, the rate can be increased up to 90 mg to obtain the maximum drug effect. At the achievement of clinical stabilization of the patient, it is required to reduce to 60 mg 1 time per day.
• in case of acute pain, the symptomatic period is used only during the exacerbation.
• in acute gouty arthritis: The daily dose is 120 mg for eight days. One of the most striking evidence of the high therapeutic potential of this drug is the experience of its use for the treatment of gout. Since the elimination of microcrystalline arthritis, first of all, is associated not with analgesic, but with anti-inflammatory action
• with postoperative pain (after complex dental interventions): The maximum course of treatment is three days, 90 mg per day.
• in old age: The dose for patients of this age is not adjusted. However, during the course of this category you need to be under constant medical supervision and in case of any side effects, consult your doctor.
• liver dysfunction:
• do not exceed a daily dose of 30 mg with a light severity of the disease (5-6).
• with moderate severity (7-9), do not exceed the dose of the drug 30 mg 1 time per day.
• severe form eliminates the use of the drug.
When applying significantly overestimated doses, an overdose may occur in patients.
Overdose symptoms are:
• increased side effects of the drug,
• disorders of the cardiovascular system,
• increased swelling,
• arrhythmias
• hypertension.
There is no specific antidote for the drug, therefore, in this case, symptomatic treatment is recommended.
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