FORSANEC FILM COATED TABLETS 90mg

TABLET, FILM COATED

**DOSAGE AND MODE OF ADMINISTRATION** Etoricoxib is administered orally and may be taken with or without food. The onset of drug effect may be faster when etoricoxib is administered without food. This should be considered when rapid symptomatic relief is needed. Etoricoxib should be administered for the shortest duration possible and the lowest effective daily dose should be used. _**Osteoarthritis**_ The recommended dose is 30 mg once daily. In some patients with insufficient relief from symptoms, an increased dose of 60 mg once daily may increase efficacy. In the absence of an increase in therapeutic benefit, other therapeutic options should be considered. _**Rheumatoid arthritis**_ The recommended dose is 60 mg once daily. In some patients with insufficient relief from symptoms, an increased dose of 90 mg once daily may increase efficacy. Once the patient is clinically stabilised, down-titration to a 60 mg once daily dose may be appropriate. In the absence of an increase in therapeutic benefit, other therapeutic options should be considered. _**Ankylosing spondylitis**_ The recommended dose is 60 mg once daily. In some patients with insufficient relief from symptoms, an increased dose of 90 mg once daily may increase efficacy. Once the patient is clinically stabilised, down-titration to a 60 mg once daily dose may be appropriate. In the absence of an increase in therapeutic benefit, other therapeutic options should be considered. _**Acute gouty arthritis**_ The recommended dose is 120 mg once daily. Etoricoxib 120 mg should be used only for the acute symptomatic period, limited to a maximum of 8 days treatment. In clinical trials for acute gouty arthritis, etoricoxib was given for 8 days. _**Acute pain**_ For acute pain conditions, the recommended dose is 90 mg or 120 mg once daily. Etoricoxib should be used only for the acute symptomatic period, limited to a maximum of 8 days treatment. _**Primary Dysmenorrhea**_ The recommended dose is 120 mg once daily. _**Post procedure dental pain**_ The recommended dose is 90 mg once daily, limited to a maximum of 3 days. Some patients may require other post-operative analgesia. Doses greater than those recommended for each indication have either not demonstrated additional efficacy or have not been studied. Therefore, The dose for OA should not exceed 60 mg daily. The dose for RA should not exceed 90 mg daily. The dose for ankylosing spondylitis should not exceed 90 mg daily. The dose for acute gout should not exceed 120 mg daily. The dose for acute pain and primary dysmenorrhea should not exceed 120 mg daily. The dose for post-procedure dental surgery pain should not exceed 90 mg daily. As the cardiovascular risks of selective COA-2 inhibitors may increase with dose and duration of exposure, the shortest duration possible and the lowest effective daily dose should be used. The patient’s need for symptomatic relief and response to therapy should be re-evaluated periodically (see section ‘Special warnings and precautions for use’ – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). _**Renal insufficiency:**_ No dosage adjustment is necessary for patients with creatinine clearance ≥30 ml/min (see section Pharmacokinetic properties – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). The use of etoricoxib in patients with creatinine clearance <30 ml/min is contra-indicated (see sections Contraindications and Special warnings and precautions for use – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). _**Hepatic insufficiency:**_ In patients with mild hepatic insufficiency (Child-Pugh score 5–6) a dose of 60 mg once daily should not be exceeded. In patients with moderate hepatic insufficiency (Child-Pugh score 7–9) the recommended dose of 60 mg _**every other day**_ should not be exceeded; administration of 30 mg once daily can also be considered. Clinical experience is limited particularly in patients with moderate hepatic insufficiency and caution is advised. There is no clinical experience in patients with severe hepatic insufficiency (Child-Pugh score >9); therefore, its use is contra-indicated in these patients (see sections Contraindications, Special warnings and precautions for use and Pharmacokinetic properties – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). _**Paediatric use:**_ Etoricoxib is contra-indicated in children and adolescents under 16 years of age (see section Contraindications).