Exinef contains etoricoxib, a COX-2 selective anti-inflammatory. It is used for arthritis pain, acute gout attacks, and short-term pain after dental surgery. It is gentler on the stomach than older anti-inflammatories but carries a cardiovascular risk that means it is not suitable for everyone.
What is Exinef?
Exinef contains etoricoxib, dispensed in South Africa in 60 mg, 90 mg and 120 mg tablets.
Etoricoxib is a COX-2 selective NSAID, often called a coxib. Understanding what that means explains both its appeal and its limits.
Ordinary anti-inflammatories such as diclofenac and ibuprofen block two enzymes: COX-1 and COX-2. COX-2 drives inflammation and pain — blocking it is the therapeutic effect. COX-1 produces prostaglandins that protect the stomach lining, so blocking that is where the ulcer and bleeding risk comes from.
Etoricoxib blocks COX-2 while largely sparing COX-1. The result is anti-inflammatory pain relief with meaningfully less risk of stomach ulceration — genuinely useful for people who need an anti-inflammatory but have had stomach trouble.
The trade-off is cardiovascular. COX-2 inhibitors are associated with an increased risk of heart attack and stroke, particularly at higher amounts and with longer use. That is not a reason to avoid them universally, but it is why they are prescribed with attention to your heart risk rather than handed out freely.
It is a Schedule 3 medicine, taken once daily.
What is Exinef commonly used for?
Etoricoxib is prescribed for:
- Osteoarthritis, for pain and stiffness.
- Rheumatoid arthritis and ankylosing spondylitis.
- Acute gout attacks, where it is particularly effective and works quickly.
- Short-term pain after dental surgery.
- Musculoskeletal pain, where an anti-inflammatory is appropriate and stomach risk is a concern.
The once-daily dosing suits chronic conditions, and the different strengths map to different uses — the higher strengths are generally reserved for acute gout and short courses rather than ongoing use.
Two things it does not do. It is not a simple painkiller — for an ordinary headache, paracetamol such as Donapan is the more sensible choice. And it does not treat the underlying arthritis; it manages pain and inflammation while disease-modifying treatment, where relevant, does the other work.
How Exinef fits into this medicine category
Exinef sits among the anti-inflammatories, distinguished by its selectivity:
| Group | Examples | Stomach risk | Cardiovascular risk |
|---|---|---|---|
| Simple analgesics | Paracetamol | Low | Low |
| Non-selective NSAIDs | Ibuprofen, diclofenac, naproxen | Higher | Varies by drug |
| COX-2 selective | Etoricoxib (Exinef), celecoxib | Lower | Requires attention |
| Corticosteroids | Prednisone | Raised with NSAIDs | Other effects |
| Opioids | Tramadol, codeine | Low | Low, but dependence |
The choice between a non-selective NSAID and a coxib is a balance between stomach and cardiovascular risk, judged for the individual. Someone with a history of ulcers and a healthy heart may suit a coxib well; someone with cardiovascular disease may not. That is a prescriber’s judgement, and it is why these are not interchangeable. See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Exinef
Tell your prescriber or pharmacist if:
- You have heart disease, heart failure, angina, or have had a heart attack or stroke. COX-2 inhibitors are avoided or used with particular care.
- You have high blood pressure, especially if not well controlled. Etoricoxib can raise blood pressure noticeably, more so than some other anti-inflammatories.
- You have kidney disease, or are dehydrated.
- You have liver disease.
- You have a history of stomach ulcers or bleeding. The risk is lower than with older NSAIDs but not absent.
- You have inflammatory bowel disease.
- You are pregnant or breastfeeding. NSAIDs are generally avoided, particularly later in pregnancy.
- You take blood thinners, an ACE inhibitor, a diuretic, lithium or methotrexate.
- You take another anti-inflammatory. Do not combine two NSAIDs — the risks multiply without added benefit.
Do not take low-dose aspirin for heart protection and assume Exinef covers it. They are different things: coxibs do not provide the antiplatelet effect aspirin does.
Follow the dispensing label. This page does not set doses, and the strength depends on what is being treated.
Possible cautions and when to ask a pharmacist or doctor
Use the lowest effective amount for the shortest period. This guidance applies to all anti-inflammatories and matters especially here, because cardiovascular risk rises with dose and duration.
Blood pressure needs watching. Etoricoxib raises it in some people. If you have hypertension, expect your readings to be checked after starting.
Stomach risk is reduced, not eliminated. Report stomach pain, and seek urgent attention for vomiting blood or material like coffee grounds, or black tarry stools.
Kidney function. During a vomiting or diarrhoeal illness, or in very hot weather, ask whether to pause it.
Fluid retention and swelling occur in some people; report significant ankle swelling or sudden weight gain.
Skin reactions. Serious skin reactions are rare but reported with this class. Stop and seek urgent medical attention for a spreading rash, blistering, or involvement of the mouth or eyes.
Seek emergency care for chest pain, sudden breathlessness, one-sided weakness, facial droop or difficulty speaking — the cardiovascular risks this class carries are the reason to treat those symptoms as urgent rather than waiting.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What is Exinef 90 mg used for? Arthritis pain and inflammation, acute gout attacks, and short-term pain after dental surgery. It contains etoricoxib.
How is it different from ibuprofen or diclofenac? It blocks COX-2 selectively, so it is gentler on the stomach. In exchange it requires more attention to cardiovascular risk and blood pressure.
Is it safer than other anti-inflammatories? Safer for the stomach, not safer overall. The right choice depends on your own stomach and heart risk, which is a prescriber’s judgement.
Can I take it with ibuprofen? No. Do not combine two anti-inflammatories — the risks add up without extra benefit.
Does it replace my low-dose aspirin? No. Aspirin taken for heart protection works differently, and a coxib does not provide that effect. Do not stop prescribed aspirin.
Can I take it long term? Sometimes, for chronic arthritis, at the lowest effective amount and with monitoring. Cardiovascular risk rises with dose and duration, so it is reviewed rather than simply repeated.