Oral etoricoxib is at least as effective as other drugs commonly used for pain relief after surgery. A Cochrane Systematic Review has confirmed the effectiveness of the drug, which is sold under the brand name of Arcoxia.
Developed as an alternative to conventional non-steroidal anti-inflammatory drugs (NSAIDs), which can cause intestinal bleeding, "coxibs" are licensed for chronic and acute pain. In primary care in England, 64,000 prescriptions for the highest etoricoxib dose (120 mg) were issued in 2007.
Five studies with 880 participants were included in the review. Four followed patients experiencing pain due to tooth extractions. The fifth focused on patients with pain following orthopaedic surgery. For two thirds of patients etoricoxib provided effective pain relief for 20 hours, compared to one in ten patients for just two hours with a placebo.
"Single dose oral etoricoxib produces high levels of good quality pain relief after surgery," says lead researcher Andrew Moore, of the Pain Research and Nuffield Department of Anaesthetics at the University of Oxford.
Moore adds that the long lasting action of etoricoxib makes it qualitatively different from other coxibs and ibuprofen. "We have effective analgesics, but often fail to deliver them effectively. A longer time before remedication is likely to benefit patients by providing long-lasting pain relief, and reduce demands on nursing staff," he says.
Sheena Derry, another author, comments, "Acute pain studies like these have been done for over 60 years, using similar patients, similar methods, and the same outcomes. This is just one of a series of new reviews and updates in acute pain aiming to cover one whole section of the British National Formulary. The end product should help providers construct consistent and effective ways of delivering good pain relief to patients."
- Clarke R, Derry S, Moore RA, McQuay HJ. Single dose oral etoricoxib for acute postoperative pain in adults. Cochrane Database of Systematic Reviews, 2009, Issue 2. Art. No.: CD004309 DOI: 10.1002/14651858.CD004309.pub2
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