Why can I only take this marvellous NSAID once a day?

May 7, 2020 1:43 PM

My blessed, blessed GP has prescribed me a muscle relaxant and an NSAID and an opiate for a shoulder in spasm. To my surprise, I can take the Valium 3x a day, the codeine 4x a day, but the Etoricoxib only once per day.

I mean obviously, this is cumulatively an extremely pleasant surprise, but I am curious about what is so unique about Etoricoxib that I can only take it once per day. I've been prescribed a shitload of painkillers of all varieties but never a once-per-day NSAID.

PS: This is all very effective and the world is lovely.

posted by DarlingBri to Health & Fitness (8 answers total)

Here's a summary.
posted by blob at 1:51 PM on May 7, 2020

Only guessing but the tablet may be designed to release over and extended period of time, so it take 24 hours to fully dissolve.
posted by tman99 at 1:53 PM on May 7, 2020 [1 favorite]

IANYD. Nor a pharacist. Etoricoxib is a drug in the family of COX-2 inhibitors. Some earlier approved COX-2 inhibitors were withdrawn from the market (e.g. Vioxx) after they showed a doubling of serious cardiovascular problems among users. So my guess is Etoricoxib is prescribed one-a-day from an abundance of caution, altho in trials so far, the cardiovascular problems cause by earlier COX-2 inhibitors have not occurred with Etoricoxib.
posted by tmdonahue at 1:56 PM on May 7, 2020 [1 favorite]

Best answer: Because it has an elimination half life of 22 hours. You don't need to take more.
posted by wwax at 2:07 PM on May 7, 2020 [8 favorites]

Valium and codeine are both actually pretty easy on the system. NSAIDs are pretty hard on the tummy, and COX-2 inhibitors have their own (cardiovascular) issues. I have a few different NSAIDs that I'm only allowed to take one at a time, once a day. I was on 4x daily ibuprofen for about a year and tolerated it well, but eventually got gastritis and had to stop. Which is a bummer, because it was great for my complicated pain, but ehhh.
posted by fiercecupcake at 2:11 PM on May 7, 2020

In general, reducing the number of doses required is a feature, not a bug, if it actually maintains effectiveness for the entire time, which Etoricoxib has been found to do. "The duration of analgesic effect was >24 hours for etoricoxib 120–240 mg, and 12.1 hours for etoricoxib 60 mg. The duration of effect was significantly longer with all four etoricoxib doses than with ibuprofen..." If the pain relief is not lasting long enough, speak with your doctor and/or pharmacist, but "the world is lovely" sounds positive!
posted by Mr.Know-it-some at 2:16 PM on May 7, 2020 [2 favorites]

Response by poster: Because it has an elimination half life of 22 hours. You don't need to take more.

Aha, that makes complete sense. Thank you.
posted by DarlingBri at 2:36 PM on May 7, 2020

Anti-inflammatories can cause multiple issues, like kidney and liver damage, along with interfering with your immune system.
They are dangerous as xxxx when used to any extent.
posted by dustpuppy at 11:47 AM on May 8, 2020