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Hypersensitivity reactions including anaphylaxis and angioedema have occurred in patients receiving etorixocib; it should be stopped at the first signs of hypersensitivity.
Etoricoxib should not be used in patients with ischemic heart disease, peripheral arterial disease, or cerebrovascular disease. It should be used with caution in patients with significant risk factors for cardiovascular disease such as hypertension, hyperlipidemia, and diabetes mellitus.
Etoricoxib particularly at high doses, may be associated with more frequent and severe hypertension compared with other NSAIDs and selective cyclooxygenase-2 (COX-2) inhibitors; blood pressure monitoring during etoricoxib treatment is recommended. Etoricoxib should not be used in patients with hypertension whose blood pressure is not controlled.
Etoricoxib is also contraindicated in patients with inflammatory bowel disease, moderate to severe heart failure (NYHA class II to IV), and renal impairment associated with a creatinine clearance of less than 30 mL/min. It should be avoided in patients with severe hepatic impairment (Child-Pugh score of 10 or more). Therapy should be stopped if persistently abnormal liver enzyme values are seen.
Caution is recommended when using etoricoxib in dehydrated patients; it may be advisable to hydrate patients before giving etoricoxib.
Caution is advised with treatment of patients most at risk of developing a gastrointestinal complication with NSAIDs, the elderly patients using any other NSAID or acetylsalicylic acid concomitantly or patients with a prior history of gastrointestinal disease, such as ulceration and GI bleeding.
