- Is Arcoxia (etoricoxib) safe for gout pain?
- What alternatives to etoricoxib (Arcoxia ) for gout?
Gout and Etoricoxib Discussion
As a European, I have access to the new drug extoricoxib, marketed as Arcoxia. Medicine is taken once a day one 120mg tablet for acute pain and effect for me has been as good as with indomethacin & gout, except Arcoxia is much easier for stomach. I can take it on an empty stomach, and have not had any problems.
Arcoxia is not yet approved in US (“On April 27, 2007, the Food and Drug Administration issued Merck a ‘non-approvable letter’ for Arcoxia. The letter said Merck needs to provide more test results showing that Arcoxia’s benefits outweigh its risks before it has another chance of getting approved.” ? wikipedia )
The fact that the FDA refused to approve this drug speaks volumes to me. On the approval refusal, there was a great deal of news about Arcoxia/Etoricoxib, including some harsh criticism for the manufacturers, Merck.
Medically, Etoricoxib belongs to a group of drugs called Cox-2 inhibitors. This group is part of the Non-Steroidal Anti-Inflammatory Drugs class (NSAIDs).
Unlike traditional NSAIDs (ibuprofen, indomethacin, etc), Cox-2 inhibitors do not inhibit Cox-1 enzymes which are prevalent in the stomach, so are much less likely to cause ulcers and stomach bleeding.
Unfortunately, Cox-2 inhibitors appear to be linked with higher risks of heart disease. FDA approval has been withheld from Arcoxia because Merck have not shown that the increased risk of heart disease outweighs any significant benefit of etoricoxib. In the wake of Vioxx (another Cox-2 inhibitor) controversy, Merck appear to have been criticized for failure to present data in a suitable way. Type FDA Arcoxia into the search box on the GoutPal Worldwide Search page for more information.
On the other hand, The European Medicines Agency Committee for Medicinal Products for Human Use (CHMP), have approved 120mg once a day for gout. Amongst other recommendations they warn against taking etoricoxib if blood pressure is above 140/90. See the complete report, Questions and Answers on the Review of Etoricoxib-Containing Medicines.
So, Americans have no choice – you can’t have it. [We had no response from other countries]
Current medical opinion is, if you do have access to Arcoxia (or other etoricoxib containing drugs – Algix, Auxib, Etoricoxib MSD, Exxiv, Ranacox, Tauxib and Turox) you should take the precaution of regular blood pressure and heart checks.
Also, never forget that this is simply pain relief. It will do nothing to lower excess uric acid, which is the real gout danger.
Arcoxia 120mg is currently prescribed only for seven days in Finland for people who don’t have any heart related problems. For me it is much better alternative than indomethacin, since the latter one makes my stomach “hard” and timid. Like GoutPal mentioned, it is only for gout attacks.
I have been taking Arcoxia (etoricoxib) for a couple of years now. I have only developed gout in my late 30s and other prescribed medicines just didn`t work. I am now a visiting professor in China and am afraid I have no access to this drug. My gout is now playing up again and I fear it will be an uncomfortable 9 months unless I find a source.
Etoricoxib & Gout – Next Steps
More than most gout pain relievers, etoricoxib is definitely short term only. As such, it might be a useful choice for the occasional acute gout flare, but you must seek other choices for longer than a week.