Ecoxar is etoricoxib, in 60 mg, 90 mg and 120 mg tablets — an anti-inflammatory for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and acute gout. The three strengths map to three different conditions, which is unusual and worth getting right.
What is Ecoxar?
The South African Medicine Price Registry lists Ecoxar 60 mg, Ecoxar 90 mg and Ecoxar 120 mg as Schedule 3 film-coated tablets containing etoricoxib.
Etoricoxib is a COX-2 selective inhibitor, or coxib — a non-steroidal anti-inflammatory (NSAID), but a selective one.
Ordinary anti-inflammatories block two enzymes. COX-2 produces the prostaglandins driving pain and swelling — blocking that is the benefit. COX-1 produces prostaglandins that protect the stomach lining — blocking that causes ulcers and bleeding. Etoricoxib blocks COX-2 and largely spares COX-1, giving a genuinely lower rate of stomach ulcers.
The strengths are condition-specific, and this is the practical point:
| Strength | Intended for | Duration |
|---|---|---|
| 60 mg | Osteoarthritis | Ongoing, reviewed |
| 90 mg | Rheumatoid arthritis, ankylosing spondylitis | Ongoing, reviewed |
| 120 mg | Acute gout only | Short course, up to about 8 days |
The 120 mg is not simply a stronger everyday dose. It is a short-course dose for an acute gout attack, and taking it long term substantially raises the cardiovascular and blood pressure risks. If you were given 120 mg for gout and have tablets left over, they are not the right dose for ordinary joint pain.
Two cautions define this class. Coxibs carry a small increased risk of heart attack and stroke, rising with dose and duration. And etoricoxib raises blood pressure more than most anti-inflammatories — its most distinctive drawback, and the reason blood pressure should be checked before and during treatment.
Etoricoxib is also sold as Thrytix, Coricib and Arcoxia. Same active ingredient, different manufacturers.
What is Ecoxar commonly used for?
- Osteoarthritis — the wear-related joint disease of knees, hips, hands and spine, at 60 mg.
- Rheumatoid arthritis, for pain and stiffness alongside disease-modifying treatment, at 90 mg.
- Ankylosing spondylitis and inflammatory spinal conditions, where anti-inflammatories are a mainstay of treatment rather than only symptom relief.
- Acute gout, at 120 mg for a short course — where it works well and is a useful alternative when colchicine or steroids are unsuitable.
- Acute pain, including after dental surgery.
It is chosen mainly where stomach risk is the concern — a previous ulcer, older age, or a need for long-term treatment. For a short course in a healthy young person, plain ibuprofen is the sensible and far cheaper option.
Gout deserves particular attention, since the 120 mg exists for it. Treating the attack is only half the problem. Recurrent gout is caused by persistently raised uric acid, and that is treated with allopurinol or febuxostat — long-term medicines that prevent attacks, protect the joints and kidneys, and are considerably under-prescribed in South Africa. If you are reaching for an anti-inflammatory for gout more than once or twice a year, ask about urate-lowering treatment. Managing attacks one at a time while the uric acid stays high leads to joint damage that does not reverse.
In osteoarthritis, weight loss, strengthening exercise and physiotherapy change the trajectory in a way no anti-inflammatory does.
How Ecoxar fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| COX-2 selective | Etoricoxib (Ecoxar), celecoxib | Gentler on the stomach; cardiovascular and blood pressure caution |
| Traditional NSAIDs | Ibuprofen, diclofenac, naproxen | Effective; more stomach risk |
| Oxicams | Meloxicam, lornoxicam | Longer acting |
| Simple analgesics | Paracetamol | Pain and fever; no anti-inflammatory effect; safest |
| Colchicine | — | Acute gout, and while starting allopurinol |
| Urate-lowering | Allopurinol, febuxostat | Prevent gout attacks |
| Corticosteroids | Prednisone | Powerful anti-inflammatory, in courses |
See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Ecoxar
Uncontrolled high blood pressure is a specific contraindication, and this matters more with etoricoxib than with other anti-inflammatories. Blood pressure should be checked before starting and within a couple of weeks, then periodically.
Tell your doctor or pharmacist if you:
- Have high blood pressure, treated or not.
- Have established heart disease, have had a heart attack or stroke, or have heart failure. Coxibs are generally avoided in these.
- Have or have had a stomach ulcer or gut bleeding. Lower risk is not no risk.
- Have kidney disease or liver disease.
- Have asthma triggered by anti-inflammatories, or nasal polyps.
- Are over 65.
- Smoke, or have diabetes or high cholesterol.
- Have inflammatory bowel disease.
- Take warfarin or another blood thinner, low-dose aspirin, steroids, an SSRI antidepressant, an ACE inhibitor, ARB or diuretic, lithium, methotrexate, ciclosporin or rifampicin.
- Are pregnant, particularly after 20 weeks, breastfeeding, or planning pregnancy.
Practical points:
- Take it once daily, with or without food.
- Use the strength prescribed for your condition, and do not use leftover 120 mg tablets for ordinary joint pain.
- Keep the 120 mg to short courses.
- Do not take another anti-inflammatory alongside it, and check cold and flu products.
- Monitor your blood pressure.
- Drink enough fluid, particularly in hot weather.
Possible cautions and when to ask a pharmacist or doctor
Common effects: raised blood pressure, ankle swelling, indigestion, abdominal pain, headache, dizziness and tiredness.
Get emergency help for:
- Chest pain, sudden breathlessness, or signs of a stroke — face drooping, arm weakness, difficulty speaking.
- Vomiting blood or material like coffee grounds, or black tarry stools.
- Severe abdominal pain.
- A widespread rash, particularly with blistering, peeling, mouth sores or fever.
- Swelling of the face, lips or tongue, or difficulty breathing.
Seek prompt advice for:
- A rise in blood pressure readings. The effect most likely to need action, and easy to miss without checking.
- Swollen ankles, breathlessness on exertion, or sudden weight gain.
- Any rash, however mild.
- Wheezing or worsening asthma.
- Persistent indigestion or stomach pain. Do not just take an antacid and continue — an ulcer can bleed without warning.
- Reduced urine output or unusual tiredness.
- Yellowing of the skin or eyes.
Contact your doctor if pain is not controlled, if you need it continuously for months, if your circumstances change, or if you are using it repeatedly for gout — in which case urate-lowering treatment is the conversation worth having.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What is Ecoxar used for? Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gout and short-term acute pain. It contains etoricoxib, a COX-2 selective anti-inflammatory.
What is Ecoxar 60 mg used for? Usually osteoarthritis.
What is Ecoxar 90 mg used for? Rheumatoid arthritis and ankylosing spondylitis.
What is Ecoxar 120 mg used for? Acute gout, as a short course of up to about eight days. It is not an everyday dose.
Can I use leftover 120 mg tablets for my knee? No. That is a short-course gout dose, and taking it long term substantially raises cardiovascular and blood pressure risks.
How is it different from ibuprofen? It blocks only COX-2, sparing the enzyme that protects the stomach, so it causes fewer ulcers. It carries a small cardiovascular risk and raises blood pressure more than most anti-inflammatories.
Does it raise blood pressure? Yes, more than most NSAIDs. Have it checked before starting and periodically afterwards.
Should I take it long term for gout? No. For repeated gout, ask about allopurinol or febuxostat, which lower uric acid and prevent attacks rather than treating each one.
Is it the same as Thrytix or Arcoxia? Yes in content — all contain etoricoxib. Different manufacturers.