Etoricoxib is a COX-2 selective anti-inflammatory used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout attacks and acute pain. It comes as 60 mg, 90 mg and 120 mg tablets. Its advantage over ordinary anti-inflammatories is that it is gentler on the stomach — but it raises blood pressure more than most.
What is Etoricoxib?
Etoricoxib is Schedule 3 in South Africa and available under many names — Extrib, Exorica, Rumator, Azcura, Thrytix, Ecoxar, Adco Etoricoxib and generics from several manufacturers:
| Strength | Typical use |
|---|---|
| 60 mg | Osteoarthritis |
| 90 mg | Rheumatoid arthritis, ankylosing spondylitis |
| 120 mg | Acute gout — short courses only |
Being dispensed one brand rather than another is ordinary generic substitution.
Etoricoxib is a COX-2 selective NSAID, and the selectivity is the point of the medicine.
Traditional NSAIDs such as ibuprofen and diclofenac block two enzymes:
- COX-1, which produces prostaglandins that maintain the stomach lining, support kidney blood flow, and help platelets clot.
- COX-2, switched on at sites of inflammation, producing the prostaglandins that drive pain and swelling.
Blocking COX-2 relieves inflammation; blocking COX-1 is what damages the stomach. Etoricoxib is highly selective for COX-2 — more so than celecoxib — so it delivers anti-inflammatory relief with substantially less risk of ulcers and gastrointestinal bleeding.
Two qualifications matter. “Selective” is not “exclusive” — stomach risk is reduced, not abolished. And COX-2 selectivity does not reduce cardiovascular risk. Etoricoxib in particular raises blood pressure more than most other NSAIDs, which is its most distinctive drawback and the reason blood pressure must be controlled before starting and monitored during treatment.
The 120 mg strength is specifically for acute gout, and is intended for a short course of a few days — not as a general higher dose for ongoing conditions.
What is Etoricoxib commonly used for?
- Osteoarthritis, for pain and stiffness.
- Rheumatoid arthritis, for symptom control alongside disease-modifying treatment.
- Ankylosing spondylitis, for spinal pain and stiffness.
- Acute gout attacks, at the higher strength for a short course.
- Acute pain, including after dental surgery.
- Musculoskeletal pain, where an anti-inflammatory is appropriate but ordinary NSAIDs are not tolerated.
It is often chosen for people at higher risk of stomach problems — those who have had an ulcer, are older, take a steroid, or need an anti-inflammatory long term.
Use the lowest effective dose for the shortest time that works. It relieves symptoms and does not slow joint damage in arthritis, and in gout it treats the attack rather than the underlying uric acid problem — which needs separate long-term treatment such as allopurinol.
How Etoricoxib fits into this medicine category
| Group | Examples | What it does |
|---|---|---|
| Simple analgesics | Paracetamol | Pain and fever; minimal anti-inflammatory effect |
| Non-selective NSAIDs | Ibuprofen, diclofenac, indomethacin | Pain and inflammation; higher stomach risk |
| COX-2 selective | Etoricoxib, celecoxib | Anti-inflammatory, gentler on the stomach |
| Topical NSAIDs | Diclofenac gel | Local relief, much less systemic exposure |
| Corticosteroids | Prednisone | Powerful anti-inflammatory, given as courses |
| Gout-specific | Colchicine, allopurinol | Attack treatment and long-term prevention |
For someone with a healthy stomach and no cardiovascular risk factors, a traditional NSAID is usually tried first. See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Etoricoxib
Your blood pressure should be controlled before starting, and checked during treatment. This is the most important practical point with etoricoxib specifically. It raises blood pressure more than other NSAIDs, and it should not be started if blood pressure is persistently high and untreated.
Do not take it with another anti-inflammatory. Adding ibuprofen or diclofenac reintroduces exactly the stomach risk etoricoxib was chosen to avoid, with no extra pain relief. Check cold, flu and period-pain products for hidden NSAIDs.
Speak to a pharmacist or doctor first if you:
- Have high blood pressure, particularly if not well controlled.
- Have heart disease, heart failure, or a history of heart attack or stroke. COX-2 inhibitors are generally avoided in established cardiovascular disease.
- Have peripheral arterial disease or cerebrovascular disease.
- Have had a stomach ulcer or gut bleeding. The risk is reduced but not removed.
- Have kidney disease, or are dehydrated.
- Have liver disease.
- Have asthma, particularly if aspirin or NSAIDs have caused wheezing.
- Have inflammatory bowel disease.
- Are over 65.
- Are pregnant. NSAIDs are generally avoided, particularly from around 20 weeks and definitely in the third trimester.
- Are breastfeeding.
- Take warfarin or another blood thinner.
- Take an ACE inhibitor, ARB or diuretic — etoricoxib reduces their blood-pressure-lowering effect, and the combination with a diuretic can cause kidney injury.
- Take lithium, methotrexate, an SSRI antidepressant, or rifampicin.
- Take low-dose aspirin for your heart — etoricoxib does not replace it, and combining them raises stomach risk.
Possible cautions and when to ask a pharmacist or doctor
Common effects are raised blood pressure, ankle swelling, indigestion, nausea, headache, dizziness and tiredness.
Stop and seek medical attention urgently if you notice:
- Chest pain, breathlessness, or sudden one-sided weakness or slurred speech — seek emergency care.
- Vomiting blood, or vomit resembling coffee grounds.
- Black, tarry stools.
- Severe stomach pain.
- Marked swelling of the ankles or legs, unexplained weight gain, or breathlessness lying flat — possible fluid retention or heart failure.
- Swelling of the face, lips or tongue, or difficulty breathing.
- A spreading rash, blistering or peeling skin, or sores in the mouth.
- Yellowing of the eyes or skin, or dark urine.
- Much less urine than usual.
- A severe headache with visual disturbance, which may indicate very high blood pressure.
Serious stomach bleeding can still occur, and can develop without warning pain first.
Have your blood pressure checked early in treatment and periodically thereafter — this is not optional monitoring with this particular medicine. Tell your doctor if it rises, if pain is not controlled, or if you need it continuously, as kidney function and cardiovascular risk should be reviewed during long-term use.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What is etoricoxib 90 mg used for? Rheumatoid arthritis and ankylosing spondylitis, and other inflammatory conditions where an anti-inflammatory is appropriate. It is a COX-2 selective NSAID.
What is etoricoxib 60 mg used for? Usually osteoarthritis, at the lowest effective strength.
What is etoricoxib 120 mg used for? Acute gout attacks, for a short course of a few days. It is not intended as a general higher dose for ongoing conditions.
How is it different from ibuprofen? It selectively blocks COX-2, so it is considerably gentler on the stomach. It is not gentler on the heart, and it raises blood pressure more than most NSAIDs.
Does it raise blood pressure? Yes, more than most anti-inflammatories. Blood pressure should be controlled before starting and monitored during treatment.
Is it safer than other anti-inflammatories? Safer for the stomach. The cardiovascular and kidney cautions are the same or greater, so it is not a safer NSAID overall.
Can I take it with paracetamol? They are different medicines and are sometimes used together on advice. Do not combine it with another anti-inflammatory.
Can I take it long term? Some people do, under supervision with blood pressure and kidney monitoring. Use the lowest effective dose for the shortest time that works.