in pictures and a few words
What it is and why it matters
Etoricoxib (Arcoxia) is a pain tablet. Among non-opioid painkillers, it has the best result in large research summaries.
- It belongs to the anti-inflammatory pain medicines
- Available only on prescription
Eases pain well after surgery
After surgery, a single 120 mg dose of etoricoxib eases acute pain well.
- Most people who took it had their pain drop by at least half
- Much more often than after a dummy pill
- The effect was assessed over the first six hours
Tested in people. Tested in people: a summary of several studies, high-quality evidence.
The best result in its group
In large research summaries on pain tablets, etoricoxib has the very best figure among non-opioid medicines.
- By the numbers it is ahead of naproxen and ketoprofen — other well-known pain tablets
- These data are about pain after surgery
And for toothache
For toothache, the result was calculated separately — it is just as high.
Tested in people. Tested in people: a separate calculation from dental studies.
Gentler on the stomach
Etoricoxib acts selectively, so the stomach tolerates it better than anti-inflammatory pain tablets that act non-selectively.
- The risks of such tablets for the heart, blood pressure and kidneys still remain
How it is prescribed
Etoricoxib is available only on prescription — in Germany, France and Italy. A doctor prescribes it.
- Tablets come in 30, 60, 90 and 120 mg
- In Europe, the 120 mg dose is allowed only for an acute gout attack and for a short course
- In other cases — lower doses
When it fits
Etoricoxib is a sensible choice where the pain is expected to be strong and short.
Who should see a doctor first
The decision on etoricoxib is made by a doctor: they weigh the risk for the heart, blood pressure and kidneys. The medicine can raise blood pressure — with high blood pressure, monitoring is needed.
- Heart ischemia, heart failure, stroke, diseased leg or brain arteries — not allowed
- Blood pressure persistently above 140/90 that can’t be brought down — not allowed
- Chronic kidney disease or dehydration
Important. Two anti-inflammatory painkillers are never taken at the same time: the relief doesn’t add up, but the risk to the stomach and kidneys does.
In one sentence
Etoricoxib is one of the strongest non-opioid medicines for acute pain after surgery; a doctor prescribes it, weighing the risk for the heart, blood pressure and kidneys.
Key points
Etoricoxib (Arcoxia) is a selective COX-2 inhibitor (coxib) and carries the best figure of any non-opioid painkiller covered by the Cochrane single-dose reviews.
| Where | How it helps | What human studies showed |
|---|---|---|
| Acute postoperative pain | a single 120 mg dose at least halves the pain in most people | 120 mg dose: 66% had their pain at least halved, against 12% on placebo, over six hours; NNT 1.8 (95% CI 1.7–2.0) — best among non-opioids; 6 studies, 798 participants, high certainty |
| Dental pain | a result of the same high level | dental studies: NNT 1.6 (95% CI 1.5–1.8) |
How it helps
Acute postoperative pain
An NNT of 1.8 means that fewer than two people need treating for one of them, over and above placebo, to have their pain at least halved. The result was obtained after a single 120 mg dose, over six hours.
Dental pain
The figure for dental studies was calculated separately: an NNT of 1.6 (95% CI 1.5–1.8) — at the same high level as the overall 1.8 (1.7–2.0).
Its place among other painkillers
The Cochrane overview pooled 39 reviews, some 460 studies and roughly 50,000 participants. Of the five drugs in this series, etoricoxib is the only one whose interval does not overlap those of naproxen and ketoprofen: it separates from the bottom of the list.
Gentler on the stomach
Etoricoxib selectively inhibits COX-2, so the stomach tolerates it better than non-selective NSAIDs.
How to take it
Etoricoxib is prescription-only; the doses are 30, 60, 90 and 120 mg.
Where it is sold
- Germany — registered, prescription-only.
- France — registered, prescription-only; 30 and 60 mg plus generics.
- Italy — 384 packs under sixteen trade names (Arcoxia, Algix, Tauxib and generics), doses of 30, 60, 90 and 120 mg. Not one over-the-counter pack.
The drug is in the catalogue: Arcoxia (etoricoxib) 90 mg. No price is shown — prescription medicines are ordered through the chat, and the administrator confirms availability and cost.
Who should see a doctor first
Selective action on COX-2 does not cancel the class effects of NSAIDs, and those are worth knowing:
- Cardiovascular risk. Under the EU product information, etoricoxib is contraindicated in established coronary heart disease, peripheral arterial disease and/or cerebrovascular disease (including previous stroke), heart failure (NYHA II–IV) and hypertension with blood pressure persistently above 140/90 mmHg and not adequately controlled.
- Blood pressure. The drug can raise it; monitoring is needed in hypertension.
- Kidneys. Like all NSAIDs it reduces renal blood flow; caution in chronic kidney disease and dehydration.
- Never take two NSAIDs together. The analgesia does not add up; the risk to stomach and kidneys does.
It is prescription-only in all three countries, and the decision belongs to a doctor weighing cardiovascular risk, blood pressure and kidney function.
Bottom line
Etoricoxib is legitimately a strong drug, and its figure is honest: the best NNT among non-opioid painkillers in acute pain after surgery. That makes it a sound choice where pain is expected to be severe and short.
Caveats
- What it was measured on. The pain is acute and postoperative — not headache, not menstrual, not back pain; the dose is single, not a course; the observation window is six hours. The 1.8 cannot be carried to other kinds of pain — not because the drug fails there, but because this review holds no such data.
- How the outcome was obtained. It is calculated, not measured directly: the proportion was derived from the area under the pain-relief curve using validated equations.
- Dental pain. The two confidence intervals overlap, and the review reports no formal test of the difference between subgroups. So saying «etoricoxib works better for dental pain» is not permitted: the difference exists on paper and is not statistically established.
- Comparison with others. The Cochrane overview undertook no statistical comparison between drugs. Within the middle of the list the order is not established by the numbers: the intervals overlap, and position there owes as much to chance as to pharmacology. So etoricoxib is not a universal «strongest painkiller».
- The 120 mg dose. The NNT of 1.8, obtained precisely at 120 mg, describes a dose that is not always the one prescribed.
- How recent the data are. The review's data close at 2014: no new studies entered the latest update.
The prescribing stays with a doctor: this guide explains what is known about the drug, it does not replace a consultation.
Key facts
- NNT 1.8 (95% CI 1.7–2.0) for the 120 mg dose — the best figure among non-opioid painkillers in Cochrane single-dose reviews.
- Measured in acute pain after surgery, after a single dose, over six hours: 66% had their pain at least halved, against 12% on placebo (6 studies, 798 participants, high certainty).
- In dental pain the NNT is 1.6 (95% CI 1.5–1.8) — a result of the same high level.
- Etoricoxib selectively inhibits COX-2, so the stomach tolerates it better than non-selective NSAIDs; the class effects of NSAIDs on the heart, blood pressure and kidneys remain.
- The drug is prescription-only in Germany, France and Italy; Italy has 30, 60, 90 and 120 mg registered, and in the EU the 120 mg dose is authorised only for an acute gout attack, as a short course.
