Azcura 90 is etoricoxib 90 mg, a COX-2 selective anti-inflammatory. The 90 mg strength is the one used for rheumatoid arthritis and ankylosing spondylitis — the inflammatory arthritides — taken once daily as ongoing treatment.
What is Azcura 90?
Azcura 90 is a Schedule 3 film-coated tablet containing etoricoxib 90 mg, listed in the South African Medicine Price Registry.
Etoricoxib is a COX-2 selective inhibitor, and the selectivity is the point. Ordinary anti-inflammatories block two enzymes:
COX-1 is present constantly in normal tissue, and its prostaglandins protect the stomach lining, support kidney blood flow and help platelets clot.
COX-2 is produced mainly at sites of inflammation and drives pain and swelling.
Ibuprofen and diclofenac block both — relieving pain through COX-2, damaging the stomach through COX-1. Etoricoxib blocks COX-2 while largely sparing COX-1, which means significantly fewer stomach ulcers and less gastrointestinal bleeding, and no effect on platelets or bleeding time.
The strength determines the indication with this medicine, which is unusual and worth knowing:
| Strength | Typical use |
|---|---|
| 30 mg | Osteoarthritis |
| 60 mg | Osteoarthritis, ankylosing spondylitis |
| 90 mg | Rheumatoid arthritis, ankylosing spondylitis |
| 120 mg | Acute gout — short-term only |
So Azcura 90 is not simply “a stronger Azcura 60”. The strengths map to conditions, and moving between them is a prescribing decision.
What is Azcura 90 commonly used for?
- Rheumatoid arthritis — relieving pain, stiffness and inflammation.
- Ankylosing spondylitis — inflammatory arthritis of the spine and sacroiliac joints, where NSAIDs are a mainstay of treatment rather than just symptom relief.
- Psoriatic arthritis, in some prescribing.
- Chronic musculoskeletal pain with an inflammatory component, where a traditional NSAID is unsuitable.
It is taken once daily, which is a practical advantage in conditions requiring long-term treatment.
Two points about the context it sits in:
In inflammatory arthritis, an NSAID is not the treatment. Rheumatoid and psoriatic arthritis are driven by an immune process that damages joints permanently if uncontrolled, and what prevents that damage is disease-modifying treatment — methotrexate, sulfasalazine, or a biologic. Etoricoxib makes you comfortable while those do the real work. If you are managing inflammatory arthritis on an anti-inflammatory alone, that is worth raising with a doctor, because joint damage accumulates silently.
In ankylosing spondylitis, NSAIDs matter more. Regular NSAID use is a genuine part of treatment there, alongside exercise and physiotherapy, and there is evidence it may slow structural progression. Exercise is not an optional extra in AS — it is central.
Use the lowest effective dose for the shortest time consistent with the condition.
How Azcura 90 fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| COX-2 selective | Etoricoxib (Azcura 90), celecoxib | Fewer stomach problems; cardiovascular and blood pressure cautions |
| Traditional NSAIDs | Ibuprofen, diclofenac, naproxen | Effective; stomach, kidney and heart cautions |
| Simple analgesics | Paracetamol (Donapan) | Gentlest; little effect in inflammatory arthritis |
| Corticosteroids | Prednisone | Powerful; used in flares and as a bridge |
| Disease-modifying drugs | Methotrexate, sulfasalazine, biologics | Control the disease and prevent joint damage |
| Physiotherapy and exercise | — | Central in ankylosing spondylitis |
The bottom two rows are what change the long-term outcome. See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Azcura 90
Blood pressure is the specific concern with etoricoxib. It raises blood pressure more than most NSAIDs — enough that uncontrolled hypertension is a contraindication, and blood pressure should be checked before starting and monitored during treatment. This is a real and frequently overlooked point.
Tell your doctor or pharmacist if you:
- Have high blood pressure, particularly if it is not well controlled.
- Have heart disease, heart failure, or a history of heart attack or stroke. COX-2 inhibitors as a class carry cardiovascular risk, and etoricoxib is avoided in established cardiovascular disease.
- Have kidney or liver disease.
- Have had a stomach ulcer or bleeding, or take aspirin — low-dose aspirin removes much of the stomach advantage.
- Have asthma, especially if aspirin or NSAIDs have triggered symptoms.
- Have inflammatory bowel disease.
- Take warfarin, ACE inhibitors or ARBs, diuretics, lithium, methotrexate, or rifampicin.
- Are pregnant. NSAIDs are avoided, particularly from 20 weeks, and etoricoxib is contraindicated in pregnancy. Tell your doctor if trying to conceive — NSAIDs can interfere with ovulation.
- Are breastfeeding, or over 65.
Practical points: take it once daily, with or without food, though food slows the onset; keep your blood pressure checks; stay well hydrated; and do not combine it with another NSAID.
Possible cautions and when to ask a pharmacist or doctor
Common effects are raised blood pressure, swollen ankles, indigestion, nausea, headache, dizziness and tiredness. Fluid retention and hypertension are the class effects that matter most here.
Get emergency help for:
- Chest pain, breathlessness, or pain spreading to the arm or jaw — possible heart attack.
- Sudden weakness on one side, facial droop, slurred speech, or a severe unusual headache — possible stroke.
- Vomiting blood, or material like coffee grounds.
- Black, tarry stools, or severe stomach pain.
- Sudden worsening of asthma or wheezing.
- A rash with blistering or peeling, or sores in the mouth or eyes.
- Swelling of the face, lips or tongue, or difficulty breathing.
Contact your doctor if:
- Your blood pressure rises, or you develop swollen ankles, weight gain or breathlessness.
- You notice reduced urine output or unusual tiredness.
- Joint symptoms are not controlled, or joints are becoming stiffer, more swollen or deformed — that points to disease activity needing disease-modifying treatment, not more painkiller.
- You develop yellowing of the skin or eyes.
- You are taking it long-term without review, or without disease-modifying treatment in inflammatory arthritis.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What is Azcura 90 used for? Rheumatoid arthritis and ankylosing spondylitis, and other inflammatory joint conditions. It contains etoricoxib 90 mg.
Is 90 mg just a stronger version of 60 mg? Not exactly. Etoricoxib strengths map to conditions — 30 and 60 mg for osteoarthritis, 90 mg for rheumatoid arthritis and ankylosing spondylitis, 120 mg for acute gout.
How is it different from ibuprofen? It blocks COX-2 selectively, causing significantly fewer stomach ulcers and less bleeding. It does not reduce cardiovascular risk, and it raises blood pressure more than most NSAIDs.
Can I take it with high blood pressure? Only if it is well controlled, and with monitoring. Uncontrolled hypertension is a contraindication.
How often do I take it? Once daily.
Can I take aspirin with it? Only if your doctor says so. Low-dose aspirin removes much of the stomach advantage.
Does it treat the arthritis itself? No. It relieves pain and inflammation. In rheumatoid and psoriatic arthritis, disease-modifying treatment is what prevents joint damage.
Can I take it with another anti-inflammatory? No. Combining NSAIDs raises the risks without adding benefit.