Azcura 120 is etoricoxib 120 mg, the highest strength. It is used for acute gout attacks and short-term acute pain — and it is specifically not intended for long-term daily use. Courses are usually a maximum of eight days.
What is Azcura 120?
Azcura 120 is a Schedule 3 film-coated tablet containing etoricoxib 120 mg, listed in the South African Medicine Price Registry.
Etoricoxib is a COX-2 selective inhibitor. Ordinary anti-inflammatories block two enzymes: COX-1, which is present constantly and protects the stomach lining and kidney blood flow, and COX-2, which is produced at sites of inflammation and drives pain and swelling. Etoricoxib blocks COX-2 while largely sparing COX-1 — so it causes significantly fewer stomach ulcers and less gastrointestinal bleeding than ibuprofen or diclofenac, and it does not affect platelets or bleeding time.
With etoricoxib, the strength determines the indication, which is unusual and central to understanding this particular tablet:
| Strength | Typical use | Duration |
|---|---|---|
| 30 mg | Osteoarthritis | Long-term |
| 60 mg | Osteoarthritis, ankylosing spondylitis | Long-term |
| 90 mg | Rheumatoid arthritis, ankylosing spondylitis | Long-term |
| 120 mg | Acute gout, acute pain | Short-term — usually up to 8 days |
Azcura 120 is not a stronger everyday dose. It is a short-course strength for acute conditions, and the eight-day limit is part of the indication rather than a general caution. At 120 mg the cardiovascular and blood pressure effects are greater, which is precisely why the duration is capped.
If you have been given 120 mg for ongoing arthritis, check with your prescriber — a lower strength is usually intended for continuous use.
What is Azcura 120 commonly used for?
- Acute gout attacks — the main use of this strength. Gout is caused by uric acid crystals in a joint provoking intense inflammation, typically in the big toe, and etoricoxib 120 mg is an established treatment for the flare.
- Acute pain, short-term, including after dental surgery.
- Severe acute musculoskeletal pain, for a limited period.
What it does not do in gout is prevent the next attack. That is the most important distinction on this page.
Gout treatment has two entirely separate halves:
Treating the attack — an anti-inflammatory such as etoricoxib, or colchicine, or a steroid. This settles the flare and does nothing about the underlying problem.
Preventing attacks — lowering uric acid with allopurinol or febuxostat, taken daily and long term. This is what actually stops gout recurring, dissolves crystal deposits, and prevents joint damage and tophi.
Someone treating repeated gout attacks with anti-inflammatories alone is managing the fire and ignoring the fuel. If you have had more than one attack, ask about uric-acid-lowering treatment. It is one of the more clearly beneficial long-term treatments in medicine, and it is chronically under-prescribed.
Start it early. Gout responds far better to treatment begun in the first hours of an attack than to treatment started on day three.
How Azcura 120 fits into this medicine category
| Group | Examples | Role in gout |
|---|---|---|
| COX-2 selective | Etoricoxib (Azcura 120), celecoxib | Acute attack; fewer stomach problems |
| Traditional NSAIDs | Indomethacin, naproxen, diclofenac | Acute attack; stomach cautions |
| Colchicine | Colchicine | Acute attack; also cover when starting allopurinol |
| Corticosteroids | Prednisone | Acute attack where NSAIDs are unsuitable |
| Xanthine oxidase inhibitors | Allopurinol, febuxostat | Prevention — lowering uric acid long-term |
| Simple analgesics | Paracetamol (Donapan) | Limited help — little anti-inflammatory effect |
Only the fifth row changes the course of the disease. See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Azcura 120
Blood pressure is the specific concern with etoricoxib, and more so at this strength. It raises blood pressure more than most NSAIDs — enough that uncontrolled hypertension is a contraindication, and blood pressure should be checked before starting.
Tell your doctor or pharmacist if you:
- Have high blood pressure, particularly if not well controlled.
- Have heart disease, heart failure, or a history of heart attack or stroke. Etoricoxib is avoided in established cardiovascular disease, and the cardiovascular risk of COX-2 inhibitors is dose-related — which is another reason 120 mg is capped at short courses.
- 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 NSAIDs have triggered symptoms.
- Have inflammatory bowel disease.
- Take warfarin, ACE inhibitors or ARBs, diuretics, lithium, methotrexate, or rifampicin.
- Are pregnant — etoricoxib is contraindicated — or breastfeeding, or over 65.
Practical points:
- Take it once daily, with or without food. Food slows the onset, so on the first day of a gout attack take it without.
- Do not exceed eight days at this strength without medical advice.
- Stay well hydrated, which also helps gout.
- Do not combine it with another NSAID.
- If you already take allopurinol, keep taking it through an attack. Do not start or stop allopurinol during a flare — starting it mid-attack makes things worse, and stopping it prolongs the problem.
Possible cautions and when to ask a pharmacist or doctor
Common effects are raised blood pressure, swollen ankles, indigestion, nausea, headache and dizziness.
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.
See a doctor urgently rather than assuming gout if a joint is hot, red, swollen and very painful with a fever, or if you feel generally unwell. Septic arthritis — infection in a joint — looks very like gout, and it destroys a joint within days if untreated. A first attack, or an attack that feels different from your usual ones, should be assessed rather than self-treated.
Contact your doctor if:
- Attacks keep recurring. More than one attack is the signal to discuss uric-acid-lowering treatment.
- The attack is not settling within a few days.
- Your blood pressure rises, or ankles swell.
- You develop lumps under the skin around joints, ears or fingers — tophi, which indicate long-standing high uric acid.
- You need this strength for more than eight days.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What is Azcura 120 used for? Acute gout attacks and short-term acute pain. It contains etoricoxib 120 mg and is intended for courses of up to about eight days.
Is it just a stronger version for everyday use? No. Etoricoxib strengths map to conditions — 120 mg is the acute short-course strength. Lower strengths are used for ongoing arthritis.
How long can I take it? Usually no more than eight days without medical advice. The cardiovascular and blood pressure effects are dose-related.
Does it prevent gout attacks? No. It treats the attack. Preventing attacks requires uric-acid-lowering treatment such as allopurinol, taken daily and long term.
Should I start allopurinol during an attack? No. Starting it mid-attack can worsen the flare. But if you already take it, keep taking it through the attack.
Can I take it with high blood pressure? Only if well controlled, and with monitoring. Uncontrolled hypertension is a contraindication.
When should I start taking it in an attack? As early as possible. Gout responds much better to treatment started in the first hours.
How do I know it is gout and not an infection? You may not. A hot, red, very painful joint with fever needs urgent assessment — septic arthritis looks similar and destroys joints within days.