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";s:4:"text";s:3645:"Cardiorenal adverse events were observed more frequently with etoricoxib than with diclofenac, and this effect was dose-dependent (see specific results below). However, the rate of these events was higher in patients receiving etoricoxib compared with those receiving naproxen 500 mg twice daily. The onset of the effect of the medicinal product may be faster when ARCOXIA is administered without food. Serious hypersensitivity reactions (such as anaphylaxis and angioedema) have been reported in patients receiving etoricoxib (see section 4.8). hypertension, hyperlipidaemia, diabetes mellitus, smoking) should only be treated with etoricoxib after careful consideration (see section 5.1).COX-2 selective inhibitors are not a substitute for acetylsalicylic acid for prophylaxis of cardiovascular thrombo-embolic diseases because of their lack of antiplatelet effect. If you are currently taking low dose aspirin for the prevention of a heart attack or stroke, you should continue to do so unless specified by your Doctor. For this reason, it is only available through prescription. All medicines can have adverse effects. Regardless of indication, in patients with mild hepatic dysfunction (Child-Pugh score 5-6) a dose of 60 mg once daily should not be exceeded. In a dose ranging study, etoricoxib 60 mg demonstrated significantly greater improvement than 30 mg for all 3 primary endpoints over 6 weeks of treatment. • Hypersensitivity to the active substance or to any of the excipients listed in section 6.1. The 30 mg dose has not been studied in osteoarthritis of hands. In a study evaluating the 60 mg dose compared to the 90 mg dose, etoricoxib 60 mg once daily and 90 mg once daily were both more effective than placebo. The rates of confirmed lower GI clinical events (small or large bowel perforation, obstruction, or haemorrhage, (POBs)) were not significantly different between etoricoxib and diclofenac.Etoricoxib was associated with a statistically significantly lower rate of discontinuations due to hepatic-related adverse experiences than diclofenac. Some people developed ulcers whether they were taking Arcoxia or placebo in these studies; however the rate was higher on Arcoxia.If any of the following symptoms: shortness of breath, chest pains or ankle swelling appear or worsen, stop your treatment with Arcoxia and consult a doctor, as soon as is practical.If you have kidney, liver or heart disease, your doctor will want to appropriately keep a check on you.If you develop any symptoms that could indicate a severe allergic reaction such as an inability to breathe or a serious skin reaction you must consult a doctor on an urgent basis.Your doctor will want to discuss your treatment from time to time. All Nonsteroidal Anti-inflammatory Drugs (NSAIDs), including etoricoxib, can be associated with new onset or recurrent congestive heart failure. Do this even if there are no signs of discomfort or poisoning.Note: Arcoxia has not been approved by the FDA for the U.S. market.If you become pregnant while taking Arcoxia, tell your doctor immediately.If you get an infection while taking Arcoxia, tell your doctor. In patients with rheumatoid arthritis (RA), etoricoxib 60 mg and 90 mg once daily both provided significant improvements in pain, inflammation, and mobility. In the subgroup of patients with moderate pain at baseline, etoricoxib 90 mg demonstrated a similar analgesic effect to that of ibuprofen 600 mg (16.11 vs. 16.39; P=0.722), and greater than that of paracetamol/codeine 600 mg/60 mg (11.00; P<0.001) and placebo (6.84; P<0.001) as measured by total pain relief over the first 6 hours (TOPAR6). 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