Tocox
Tocox Uses, Dosage, Side Effects, Food Interaction and all others data.
Tocox is a non-steroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic, and antipyretic activities. Tocox is a potent, orally active & highly selective cyclooxygenase-2 (COX-2) inhibitor. COX-2 is primarily responsible for the synthesis of prostanoid mediators of pain, inflammation and fever. Tocox decreases these clinical signs and symptoms effectively with decreased GI toxicity. Moreover it has no effect on platelet function.
Tocox is a COX-2 selective inhibitor (approximately 106 times more selective for COX-2 inhibition over COX-1).
| Trade Name | Tocox |
| Generic | Etoricoxib |
| Etoricoxib Other Names | Etoricoxib, étoricoxib, Etoricoxibum |
| Type | Tablet |
| Formula | C18H15ClN2O2S |
| Weight | Average: 358.842 Monoisotopic: 358.054276131 |
| Protein binding | 92% |
| Groups | Approved, Investigational |
| Therapeutic Class | Non-steroidal Anti-inflammatory Drugs (NSAIDs) |
| Manufacturer | Beulah Biomedics |
| Available Country | India |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Tocox is used for relief of pain and inflammation in-
- Osteoarthritis
- Rheumatoid arthritis
- Other chronic musculoskeletal disorders
- Acute gout
- Dysmenorrhoea
- Following dental surgery
Tocox is also used to associated treatment for these conditions: Ankylosing Spondylitis (AS), Gouty Arthritis, Osteoarthritis (OA), Rheumatoid Arthritis, Moderate Pain
How Tocox works
Like any other COX-2 selective inhibitor Tocox selectively inhibits isoform 2 of cyclo-oxigenase enzyme (COX-2), preventing production of prostaglandins (PGs) from arachidonic acid.
Dosage
Tocox dosage
The recommended dose for adult and patient over 16 years:
- Acute pain: 120 mg once daily. Tocox 120 mg should be used only for acute symptomatic period, limited to a maximum of 8 days treatment.
- Chronic musculoskeletal pain: 60 mg once daily.
- Osteoarthritis: 30 mg once daily, increased if necessary to 60 mg once daily.
- Rheumatoid arthritis and ankylosing spondylitis: 90 mg once daily.
- Acute gout: 120 mg once daily for max. 8 days. Max. 60 mg daily in mild hepatic impairment; max. 60 mg on alternate days or 30 mg once daily in moderate hepatic impairment.
Side Effects
Dry mouth, taste disturbance, mouth ulcer, flatulence, constipation, appetite and weight changes, chest pain , fatigue, paraesthesia, influenza like syndrome, myalgia etc. may occur.
Toxicity
This reduced activity is the cause of reduced gastrointestinal toxicity, as demonstrated in several large clinical trials performed with different COXIB (see below links on NEJM and The Lancet). Some clinical trials and meta-analysis showed that treatment with COXIB lead to increased incidence of cardiovascular adverse events compared to placebo
Precaution
A patient with decreased liver & kidney function, dehydration, hypertension, heart failure, GI perforation & patients over 65 years of age. Use in Pregnancy and Lactation As with other drugs known to inhibit prostaglandin synthesis, use of it should be avoided in late pregnancy because it may cause premature closure of the ductus arteriosus. It should be used during the first two trimesters of pregnancy only if the potential benefit justifies the potential risk to the foetus. It is not known whether this drug is excreted in human milk.
Interaction
Oral anticoagulants, diuretics and ACE inhibitors, Acetylsalicylic acid, Cyclosporin and Tacrolimus, Lithium, Methotrexate, oral contraceptives, Prednisone/Prednisolone, Digoxin, drugs metabolized by sulfotransferases (Ethinyl Estradiol), drugs metabolized by CYP isoenzymes, Ketoconazole, Rifampicin, and Antacids have interaction with Tocox.
Food Interaction
- Take with or without food. The absorption is unaffected by food.
Elimination Route
Bioavailability is 100% following oral administration.
Half Life
22 hours
Pregnancy & Breastfeeding use
As with other drugs known to inhibit prostaglandin synthesis, use of it should be avoided in late pregnancy because it may cause premature closure of the ductus arteriosus. It should be used during the first two trimesters of pregnancy only ifthe potential benefit justifies the potential risk to the foetus. It is not known whether this drug is excreted in human milk.
Contraindication
It is contraindicated in patients with hypersensitivity to Tocox or any component of this product, congestive heart failure, patients with inflammatory bowel disease, severe hepatic dysfunction.
Acute Overdose
Symptoms: GI and cardiorenal events.
Management: Symptomatic and supportive treatment. Remove unabsorbed material from the GI tract.
Storage Condition
Store at a cool & dry place protected from light & moisture. Keep out of reach of children.
Innovators Monograph
You find simplified version here Tocox
Tocox contains Etoricoxib see full prescribing information from innovator Tocox Monograph, Tocox MSDS, Tocox FDA label
FAQ
What is the use of Tocox?
Tocox helps to reduce the pain and swelling (inflammation) in the joints and muscles of people 16 years of age and older with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and gout. Tocox is also used for the short term treatment of moderate pain after dental surgery in people 16 years of age and older.
What is Tocox?
Tocox (Etoricoxib) is a selective inhibitor of cyclooxygenase-2 (COX-2), an enzyme involved in pain and inflammation. It is a member of the COX-2-selective (coxib) class of nonsteroidal antiinflammatory drugs (NSAIDs). Extensive clinical trials have confirmed its analgesic and antiinflammatory efficacy to be at least as good as and in some cases superior to nonselective NSAIDs in a number of disease and patient treatment settings. Tocox displays improved gastrointestinal safety compared with nonselective NSAIDs and has a favorable overall safety and tolerability profile. It is rapidly and completely absorbed following oral administration providing a rapid onset of action. Its long plasma half-life allows for once-daily dosing. Tocox is currently approved in a number of countries for various indications including the treatment of acute pain, acute gouty arthritis, chronic low back pain, primary dysmenorrhea, and chronic treatment for the signs and symptoms of osteoarthritis and rheumatoid arthritis.
Is Tocox a strong painkiller?
Tocox eases pain and swelling (inflammation) in conditions like osteoarthritis, rheumatoid arthritis and ankylosing spondylitis, and it may also be used for short periods of time in gout. Tocox works by blocking the effect of a natural chemical called cyclo-oxygenase-2 (COX-2) enzyme.
What are the side effects of Tocox?
The most common side effects of Tocox are stomach ache, indigestion, wind, feeling sick, diarrhoea, constipation, headache, feeling tired or dizzy, wheezing, palpitations and increased blood pressure.
How long does Tocox take to work?
The onset of pain relief was rapid, with similar benefit reported within 4 hours of the first dose of Tocox.
What is the best time to take Tocox?
Taking Tocox at the same time each day will have the best effect. It will also help you remember when to take the dose. It does not matter if you take Tocox before or after food.
Can I take Tocox for toothache?
The 120 mg dose of Tocox was reported to be as effective as, or better than other commonly used analgesics. Studies on Tocox in the dental extraction pain model have proved the superior efficacy of Tocox with fewer adverse effects as compared to oxycodone/acetaminophen.
How many days can I take Tocox?
Tocox should be used only for the acute symptomatic period, limited to a maximum of 8 days treatment. Doses greater than those recommended for each indication have either not demonstrated additional efficacy or have not been studied. Therefore: The dose for OA should not exceed 60 mg daily.
How many Tocox can I take a day?
Osteoarthritis: The recommended Tocox dose is 30 mg or 60 mg once daily.
Rheumatoid Arthritis: The recommended Tocox dose is 60 mg or 90 mg once daily. The minimum effective daily dose is 60 mg once daily. In some patients, 90 mg once daily may provide increased therapeutic benefit.
Is Tocox safe for elderly?
Tocox is generally well tolerated in clinical trials of patients with OA and other types of arthritis. We observed an improvement of the quality of life in the extremely elderly patients, with the given treatment dose and period that was shorter compared to the other trials.
Can I cut Tocox in half?
Do not halve tablet. Studies on divided tablets have not been performed.
Is Tocox a sulfa drug?
Tocox is a methylsulfone and does not contain the sulfonamide moiety that has been associated with an increased risk of hypersensitivity reactions.
Is Tocox safe during pregnancy?
The potential for human risk in pregnancy is unknown. Tocox, as with other medicinal products inhibiting prostaglandin synthesis, may cause uterine inertia and premature closure of the ductus arteriosus during the last trimester. Tocox is contraindicated in pregnancy.
Is Tocox safe during breastfeeding?
Tocox is excreted in the milk of lactating rats. Women who use Tocox must not breast feed. The use of Tocox, as with any drug substance known to inhibit COX-2, is not recommended in women attempting to conceive.
