A COX-2 selective NSAID

Etoricoxib

A once-daily COX-2 selective NSAID that eases joint pain with less stomach upset than older NSAIDs, but which can raise blood pressure and is avoided in uncontrolled hypertension or heart disease.

What is Etoricoxib?

Etoricoxib is a COX-2 selective anti-inflammatory painkiller (NSAID) used for osteoarthritis, rheumatoid arthritis and gout. It is taken once a day and tends to upset the stomach less than older NSAIDs, but it can raise blood pressure and carries a heart risk, so it is avoided in people with uncontrolled high blood pressure or established heart disease.

Class: NSAIDs · Brands: Arcoxia

Education and reference only. This is a plain-language guide to Etoricoxib — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review
Class: NSAIDs → Brands: Arcoxia
Etoricoxib (NSAIDs) — Meds Global Health reference card with 2D molecular structure
Etoricoxib — NSAIDs. The image shows the active ingredient's 2D molecular structure.

What it is

Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) that selectively targets the COX-2 enzyme. It is used to relieve pain and inflammation in arthritis and acute gout. In the UK it is sold as Arcoxia and as a generic medicine.

How it works

Etoricoxib mainly blocks COX-2, the enzyme that produces the prostaglandins responsible for pain and inflammation, while largely sparing COX-1, which protects the stomach lining. This selectivity means it tends to cause fewer stomach problems than older NSAIDs, but it still affects the kidneys and can raise blood pressure and cardiovascular risk.

Company & origin

Originated / developed by: Developed by Merck (MSD) and sold in the UK as Arcoxia and as generic etoricoxib..

Etoricoxib is a COX-2 selective NSAID developed by Merck and introduced in the early 2000s, used in the UK for arthritis, gout and other painful conditions.

What it treats

Conditions Etoricoxib is used for

OsteoarthritisThe most common form of arthritis, causing joint pain and stiffness as cartilage wears — m…

Practical use

How to take Etoricoxib

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Take it once a day, at roughly the same time each day.
  • It can be taken with or without food, though it may start working a little faster on an empty stomach.
  • Swallow the tablet whole with a drink of water.
  • Use the lowest helpful strength for the shortest time needed.
  • If you miss a dose, skip it and carry on with the next one; do not double up.
  • Do not combine it with other NSAIDs or aspirin painkillers unless a doctor tells you to.

Weighing it up

Advantages & disadvantages of Etoricoxib

Advantages

  • Convenient once-daily dosing with a long-lasting effect.
  • Gentler on the stomach than older non-selective NSAIDs.
  • Effective for osteoarthritis, rheumatoid arthritis and acute gout.
  • Can be a useful option for people who get indigestion with traditional NSAIDs.

Disadvantages

  • Raises blood pressure more than many other NSAIDs, so it is unsuitable in uncontrolled hypertension.
  • Carries a risk of heart attack and stroke and is avoided in established heart or circulation disease.
  • Can still reduce kidney function and cause fluid retention.
  • Needs blood-pressure monitoring, which adds to the burden of treatment.
  • Treats symptoms only and does not slow the underlying condition.

Practical use

Good to know

Etoricoxib is taken once a day and is gentler on the stomach than non-selective NSAIDs, but it has a notable effect on blood pressure. Because of this, your blood pressure should be controlled before you start and checked while you take it.

Who should not take it / use with caution

  • People with high blood pressure that is not well controlled.
  • Anyone with established heart disease, heart failure, previous stroke or peripheral arterial disease.
  • People who have had a stomach ulcer or bleeding from the gut, or a reaction to aspirin or another NSAID.
  • Those with significant kidney or liver disease.
  • Women in the later stages of pregnancy; discuss with a doctor if pregnant, planning pregnancy or breastfeeding.

Monitoring

  • Blood pressure should be controlled before starting, checked within the first couple of weeks of treatment, and then regularly — etoricoxib can raise blood pressure.
  • Kidney function, particularly in older people or those on blood-pressure medicines.
  • Signs of fluid retention such as swollen ankles or breathlessness.
  • Regular review of whether ongoing treatment is still needed.

Side effects

  • Raised blood pressure and swelling of the ankles from fluid retention.
  • Headache, dizziness or tiredness.
  • Indigestion, nausea or stomach discomfort, though usually less than with older NSAIDs.
  • Serious but less common: heart attack, stroke, stomach bleeding or a severe allergic reaction.
  • Seek urgent help for chest pain, breathlessness, sudden weakness, or black or bloodstained stools.

Key interactions

  • Other NSAIDs and aspirin, which add to bleeding and kidney risk.
  • Blood thinners and anticoagulants such as warfarin, raising bleeding risk and needing closer monitoring.
  • Blood-pressure medicines including ACE inhibitors, ARBs and diuretics, whose effect is blunted and whose kidney risk is increased.
  • Steroids and SSRI antidepressants, which add to stomach-bleeding risk.
  • Lithium and methotrexate, whose levels can rise.

Available as: Tablets.

Answers

Etoricoxib: frequently asked questions

Why does etoricoxib need blood-pressure checks?

Etoricoxib tends to raise blood pressure more than other NSAIDs. Your blood pressure should be well controlled before you start and monitored while you take it.

Is etoricoxib easier on the stomach?

Yes, because it targets COX-2 it generally causes fewer stomach problems than older NSAIDs like ibuprofen, although stomach side effects can still happen.

Can I take etoricoxib if I have heart problems?

It is usually avoided if you have established heart disease, heart failure, a previous stroke or poorly controlled blood pressure, because of the cardiovascular risk. Your doctor will assess this carefully.

Can I use etoricoxib for gout?

Yes, etoricoxib is licensed for the short-term relief of pain and inflammation during an acute gout attack.

Can I take etoricoxib with ibuprofen?

No. You should not combine etoricoxib with other anti-inflammatory painkillers, as this adds to the risk of stomach, kidney and heart problems.

The wider class

About NSAIDs

Etoricoxib belongs to the nsaids class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.

NSAIDsCommon anti-inflammatory painkillers with important gastrointestinal, renal and cardiovascular cautions. NaproxenA common anti-inflammatory painkiller (NSAID) for musculoskeletal pain, gout attacks and s…IbuprofenA widely used anti-inflammatory painkiller for pain, inflammation and fever — effective, b…DiclofenacA strong anti-inflammatory painkiller (NSAID) for pain and inflammation, with a comparativ…CelecoxibA COX-2 selective anti-inflammatory painkiller for arthritis, gentler on the stomach than …MeloxicamA once-daily NSAID that eases joint pain, swelling and stiffness in arthritis, with the us…Mefenamic acidAn anti-inflammatory painkiller widely used for period pain and heavy periods; it is taken…IndometacinA powerful non-steroidal anti-inflammatory (NSAID) used mainly for short, sharp flares suc…PiroxicamA long-acting NSAID for pain and inflammation that, because of higher risks, is now only s…KetoprofenAn NSAID used to relieve pain and inflammation, available as capsules and as a gel, and kn…NabumetoneAn NSAID used mainly for the pain and inflammation of osteoarthritis and rheumatoid arthri…EtodolacA non-steroidal anti-inflammatory (NSAID) used to ease the pain and stiffness of arthritis…DexketoprofenA non-steroidal anti-inflammatory used for the short-term relief of mild to moderate pain.…IndomethacinA strong anti-inflammatory painkiller used for gout, arthritis and other inflammatory pain…BromfenacAn anti-inflammatory eye drop used to reduce swelling and discomfort after eye surgery.…SulindacAn anti-inflammatory painkiller (NSAID) used to relieve pain and inflammation, including i…FlurbiprofenAn anti-inflammatory painkiller used for pain and inflammation, also available as a sore-t…OxaprozinA long-acting anti-inflammatory painkiller used mainly for arthritis, taken once a day.…FenoprofenAn anti-inflammatory painkiller used for pain and arthritis.…DiflunisalAn anti-inflammatory painkiller, related to aspirin, used for pain and inflammation such a…SalsalateA salicylate anti-inflammatory painkiller used to ease pain and inflammation in conditions…MeclofenamateAn anti-inflammatory painkiller (NSAID) used for pain and inflammation, known particularly…PhenylbutazoneAn older anti-inflammatory painkiller now restricted in the UK to ankylosing spondylitis u…TolmetinAn anti-inflammatory painkiller used to ease the pain, swelling and stiffness of arthritis…

Browse by body system

Bones, joints & musclesConditions and medicines for arthritis, osteoporosis, gout and inflammation of the joints …

Authoritative sources

  • BNF
  • NICE CKS

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