Ribox 90

Indications

Ribox is used for the effective symptomatic relief of:

• Osteoarthritis (OA)
• Rheumatoid arthritis (RA)
• Ankylosing spondylitis
• Pain and inflammation related to acute gouty arthritis
• Short-term management of moderate pain following dental surgery

Pharmacology

Ribox contains Etoricoxib, a potent selective COX-2 inhibitor, designed to reduce pain and inflammation by specifically targeting COX-2 enzymes. Unlike non-selective NSAIDs, Etoricoxib minimizes gastrointestinal toxicity and does not affect platelet aggregation. It inhibits COX-2 activity effectively at doses up to 150 mg daily without impacting COX-1 or gastric prostaglandin synthesis.

Dosage & Administration

For adults and adolescents over 16 years:

• Osteoarthritis: 30 mg daily; can be increased to 60 mg daily if necessary
• Rheumatoid arthritis: 90 mg daily
• Ankylosing spondylitis: 90 mg daily
• Acute gouty arthritis: 120 mg daily for up to 8 days
• Postoperative dental pain: 90 mg daily for a maximum of 3 days

Adjustments should be made based on the patient’s response and cardiovascular risk.

Interactions

• Oral Anticoagulants: May increase prothrombin time.
• Diuretics, ACE Inhibitors: NSAIDs may reduce effectiveness.
• Acetylsalicylic Acid: Can be used simultaneously for cardiovascular protection.
• Ciclosporin/Tacrolimus: May increase nephrotoxic effects.
• Lithium: May increase lithium plasma levels.

Contraindications

• Known hypersensitivity to Etoricoxib or any excipients
• Active peptic ulcer or gastrointestinal bleeding
• History of bronchospasm, angioedema, or allergic reactions to NSAIDs
• Severe hepatic dysfunction or renal impairment
• Pregnant or breastfeeding women
• Children under 16 years of age

Side Effects

Common side effects include palpitations, fatigue, and flu-like symptoms. Rare effects may involve confusion or hallucinations.

Pregnancy & Lactation

Etoricoxib is not recommended for women trying to conceive or breastfeeding. It is known to be excreted in rat milk but not confirmed in human milk.

Precautions & Warnings

• Monitor for gastrointestinal and cardiovascular complications
• Caution in patients with renal impairment or a history of cardiac issues
• Discontinue if signs of liver dysfunction or hypersensitivity appear

Overdose Effects

No significant toxicity observed with single doses up to 500 mg or multiple doses up to 150 mg/day for 21 days. Standard supportive measures should be taken in case of overdose.

Therapeutic Class

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Storage Conditions

Store below 30°C, protected from light and moisture. Keep out of reach of children.