Danilo tablets are indicated for the symptomatic relief of:
Osteoarthritis (OA)
Rheumatoid arthritis (RA)
Ankylosing spondylitis
Pain and signs of inflammation associated with acute gouty arthritis
Short-term treatment of moderate pain associated with dental surgery
Use this medication only as per the advice of a registered physician.
Etoricoxib is a potent, orally active cyclooxygenase-2 (COX-2) specific inhibitor. Two isoforms of cyclooxygenase have been identified: COX-1 and COX-2. COX-1 is responsible for normal physiological functions such as gastric cytoprotection and platelet aggregation. Inhibition of COX-1 by non-selective NSAIDs has been associated with gastric damage and inhibition of platelet aggregation.
COX-2 is primarily responsible for the synthesis of prostanoid mediators of pain, inflammation, and fever. Selective inhibition of COX-2 by Etoricoxib decreases these symptoms with a lower risk of gastrointestinal toxicity and platelet aggregation inhibition. Etoricoxib inhibits COX-2 without affecting COX-1 at doses up to 150 mg daily, and it does not inhibit gastric prostaglandin synthesis.
Adults and adolescents (over 16 years):
Osteoarthritis: 30 mg once daily, which may be increased to 60 mg if necessary.
Rheumatoid arthritis: 90 mg once daily.
Ankylosing spondylitis: 90 mg once daily.
Acute gouty arthritis: 120 mg once daily for up to 8 days.
Postoperative dental surgery pain: 90 mg once daily for a maximum of 3 days.
As the cardiovascular risks of Etoricoxib may increase with dose and duration, the lowest effective dose for the shortest duration should be used. Patients should be re-evaluated periodically, especially those with osteoarthritis.
Use this medication only as per the advice of a registered physician.
With other medications:
Oral anticoagulants: May increase prothrombin time in patients stabilized on chronic warfarin therapy.
Diuretics, ACE inhibitors, and Angiotensin II Antagonists: May reduce the effectiveness of these antihypertensive drugs.
Acetylsalicylic Acid: Can be used with low-dose aspirin for cardiovascular prophylaxis.
Ciclosporin & Tacrolimus: May increase nephrotoxic effects.
Lithium: May decrease lithium excretion, increasing its plasma levels.
With food and others: Can be taken with or without food.
Danilo tablets should not be used in patients with:
Hypersensitivity to Etoricoxib or its excipients
Active peptic ulceration or gastrointestinal bleeding
History of allergic reactions to aspirin or NSAIDs
Severe hepatic dysfunction (serum albumin <25 g/L or Child-Pugh score ≥10)
Renal impairment (creatinine clearance <30 ml/min)
Inflammatory bowel disease
Congestive heart failure (NYHA Class II-IV)
Uncontrolled hypertension (>140/90 mmHg)
Established ischemic heart disease, peripheral arterial disease, or cerebrovascular disease
Possible side effects include palpitations, fatigue, flu-like symptoms, bruising, dry mouth, taste disturbances, mouth ulcers, appetite changes, weight changes, atrial fibrillation, transient ischemic attack, chest pain, flushing, cough, shortness of breath, nosebleeds, anxiety, impaired mental acuity, paresthesia, electrolyte disturbances, myalgia, and arthralgia. Rarely, confusion and hallucinations may occur.
Etoricoxib is not recommended for women attempting to conceive. It is unknown whether the drug is excreted in human milk, but it has been found in the milk of lactating rats. Women using Etoricoxib should not breastfeed.
Caution is advised for patients at high risk of gastrointestinal complications, such as the elderly or those with a history of ulcers or bleeding.
Patients with cardiovascular risk factors (e.g., hypertension, hyperlipidemia, diabetes, smoking) should only use Danilo after careful assessment.
May impair renal function; monitoring is recommended in at-risk patients.
Caution is necessary for patients with a history of cardiac failure, left ventricular dysfunction, or hypertension.
Liver function should be monitored in patients with pre-existing liver conditions.
Discontinue use if signs of hypersensitivity, such as skin rash or mucosal lesions, appear.
May mask fever and inflammation symptoms.
Use caution when co-administering with warfarin or other anticoagulants.
Single doses of up to 500 mg and multiple doses of up to 150 mg/day for 21 days have not shown significant toxicity. In case of overdose, usual supportive measures should be taken, including removing unabsorbed material from the gastrointestinal tract and providing clinical monitoring and supportive therapy.
Store below 30°C, protected from light and moisture. Keep out of reach of children.
