BITOR 60, 90, 120mg tablets: Uses, Dosage, FAQ, Side effects, Warnings

Bitor (Etoricoxib) used to manage the symptoms of joint pain and swelling that accompany osteoarthritis (OA), rheumatoid arthritis (RA), gouty arthritis, and ankylosing spondylitis (AS).

Your doctor will prescribe Bitor for you only after you have used other medicines, i.e paracetamol for your condition and it has not been suitable for you. Your doctor will want to discuss your treatment with Bitor from time to time.

It is important that you use the lowest dose that controls your pain and you should not take Bitor for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.

INDICATIONS: What Bitor is used for

Bitor is used for the following:

  1. acute and chronic treatment of the signs and symptoms of osteoarthritis (OA) :Osteoarthritis is a joint disease. It results from the gradual breakdown of the cartilage that covers the joints and cushions the ends of bones. Symptoms of osteoarthritis include pain, tenderness, stiffness of one or more joints, and physical disability. The hips and knees are the most commonly affected joints, but other joints such as those of the hands and spine may also be affected. Osteoarthritis is more common in women than in men. Many factors can lead to the development of osteoarthritis including obesity and joint injury (eg. from sport).
  2. acute and chronic treatment of the signs and symptoms of rheumatoid arthritis: (RA) Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling and loss of function in the joints and inflammation in other body organs.
  3. management of ankylosing spondylitis:( AS) Ankylosing spondylitis is an inflammatory disease of the spine and large joints.
  4. relief of chronic musculoskeletal pain.
  5. relief of acute pain, including pain associated with minor dental procedures.
  6. to treat acute gouty arthritis: (GA) Gout is a disorder characterized by sudden, recurring attacks of pain and inflammation in one or more joints. 

Dosage and administration

There are different strengths available for this medicinal product and depending on your disease your doctor will prescribe the tablet strength that is appropriate for you.

  • Osteoarthritis– The recommended dose is: 30 mg once a day, increase to a maximum of 60 mg once a day if needed.
  • Rheumatoid arthritis– The recommended dose is: 60 mg once a day, increased to a maximum of 90 mg once a day if needed.
  • Ankylosing spondylitis– The recommended dose is:  60 mg once a day, increased to a maximum of 90 mg once a day if needed.

Acute pain conditions

  • Gout- The recommended dose is 120 mg once a day which should only be used for the acute painful period, limited to a maximum of 8 days treatment.
  • Postoperative dental surgery pain– The recommended dose is: 90 mg once daily, limited to a maximum of 3 days treatment.

Special population dosage

  • People with liver problems: If you have mild liver disease, you should not take more than 60 mg a day. If you have moderate liver disease, you should not take more than 30 mg a day.
  • Use in children and adolescents: Bitor tablets should not be taken by children or adolescents under 16 years of age.
  • Elderly: No dose adjustment is necessary for elderly patients. As with other medicines, caution should be exercised in elderly patients.

General Consideration

  • Always take this medicine exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
  • Do not take more than the recommended dose for your condition. Your doctor will want to discuss your treatment from time to time. It is important that you use the lowest dose that controls your pain and you should not take Bitor for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.
  • Bitor is for oral use. Take the tablets once a day. Bitor can be taken with or without food.
  • If you take more Bitor than you should: You should never take more tablets than the doctor recommends. If you do take too many Bitor tablets, you should seek medical attention immediately.
  • If you forget to take Bitor: It is important to take Bitor as your doctor has prescribed. If you miss a dose, just resume your usual schedule the following day. Do not take a double dose to make up for the forgotten tablet.

Bitor- FAQ

How long does Bitor take to work? The onset of analgesia with Bitor occurred as early as 24 minutes after dosing and persisted for as long as 24 hours.

Is Bitor better than ibuprofen? A study has shown that cyclooxygenase-2 (COX-2) inhibitor Etoricoxib (Bitor) to be as effective as ibuprofen for treating pain associated with arthritis.

The analgesic effect of a 120 mg dose of Bitor was similar to a maximum analgesic dose of naproxen sodium (550 mg) or ibuprofen (400 mg) and greater than paracetamol (600 mg) with codeine (60 mg).

Which is better: diclofenac or Etoricoxib? Etoricoxib is clinically effective in the therapy of osteoarthritis providing a magnitude of effect comparable to that of the maximum recommended daily dose of diclofenac. The onset of clinical benefit with Etoricoxib on day one is more rapid than that of diclofenac.

When should I take Bitor.. morning or night?

Bitor tablets should be taken once a day, preferably at the same time each day. You can take your tablet either with or without food, but if you take it without food it may start to work faster. If you have arthritis you’ll usually need to take a tablet every day on a regular basis to reduce inflammation and pain. Take your Bitor at about the same time each day. Taking Bitor at the same time each day will have the best effect.

Can I take Bitor on an empty stomach? Bitor tablets can be taken with or without food, although they may work quicker when taken on an empty stomach – try to take them at around the same time each day. While you are taking Bitor, it is recommended that you also take a medicine to protect your stomach against irritation.

For How long should I take Bitor? Depending on your condition, you may need Bitor for a few days or for longer periods. Bitor will not cure your condition but should help control pain, swelling and stiffness. Keep taking Bitor for as long as your doctor advises. Do not exceed the dose recommended by your doctor. 

Long duration treatment: Your risk of developing heart or blood vessel diseases (e.g., heart attack) may increase with dose and duration of use even if you don’t have a history of heart or blood vessel disease. If you need to take Bitor for a long time see your doctor for regular check-ups so your doctor can monitor your condition and treatment.

Does Bitor make you sleepy? Yes, In rare cases, Etoricoxib may cause drowsiness, dizziness or, sometimes, blurred vision.

Is Bitor bad for kidneys? Although this Clinical Inquiry concludes that Bitor does not appear to worsen renal function, it should still be used with caution for patients who are elderly, hospitalized, or at risk of developing serious complications such as acute renal failure, heart failure, and gastrointestinal bleeding.

What is the difference between Bitor and Gabapentin?

Gabapentin is an anticonvulsant drug that has an analgesic effect in post-herpetic neuralgia, diabetic neuropathy, and neuropathic pain( Gabapentin used in Neurogenic pain associated with diabetes, herps ..etc.)

Etoricoxib (Bitor) is one of the NSAIDs,  used to relieve some symptoms caused by arthritis, such as inflammation, swelling, stiffness, and joint pain. Etoricoxib( Bitor), cannot be recommended for the long-term administration needed to treat patients with neuropathic pain syndromes( not recommended for neurogenic pain). 

Does Bitor affect the heart? Taking Bitor, for longer duration or with high doses, may increases the risk of having heart attacks, other heart problems, strokes, or cardiovascular disease death, compared with people who don’t take the drug.

Will there be any problems with driving or using machinery?

Very occasionally people have reported that Bitor have made them feel dizzy, tired or sleepy. Problems with eyesight have also been reported. If you are affected in this way, you should not drive or operate machinery. 

What are the side effects of Bitor?

  • Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Bitor. Bitor helps most people, but it may have unwanted side effects in a few people.
  • As with most medicines, if you are over 65 years of age, you may have an increased chance of getting side effects.
  • All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Tell your doctor if you notice any of the following and they worry you( the following side effects are usually mild):

  • feeling sick (nausea), vomiting.
  • heartburn, indigestion, uncomfortable feeling or pain in the stomach.
  • diarrhoea.
  • dizziness.
  • Headache.
  • Buzzing or ringing in the ears or other trouble hearing.
  • Sleeplessness.
  • Changes in mood, for example, depression, confusion, nervousness.

Tell your doctor immediately if you notice any of the following( the following side effects may be serious- You may need urgent medical attention. Serious side effects are rare.):

  • Severe pain or tenderness in the stomach.
  • Eye problems such as blurred vision, sore red eyes, itching.
  • Signs of frequent or worrying infections such as fever, severe chills, sore throat or mouth ulcers.
  • Bleeding or bruising more easily than normal, reddish or purplish blotches under the skin.
  • Signs of anaemia, such as tiredness, headaches, being short of breath, and looking pale.
  • Yellowing of the skin and/or eyes, also called jaundice.
  • Unusual weight gain, swelling of ankles or legs.
  • Tingling of the hands and feet.
  • Symptoms of sunburn (such as redness, itching, swelling, blistering) which may occur more quickly than normal.
  • Severe or persistent headache.
  • Fast or irregular heartbeats, also called palpitations.

If any of the following happen, stop taking Bitor and tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

  • Vomiting blood or material that looks like coffee grounds.
  • Bleeding from the back passage, black sticky bowel motions (stools) or bloody diarrhoea.
  • Swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing.
  • Asthma, wheezing, shortness of breath.
  • Sudden or severe itching, skin rash, hives.
  • Severe blisters and bleeding in the lips, eyes, mouth, nose and genitals (Stevens-Johnson Syndrome).
  • Fever, generally feeling unwell, nausea, stomach ache, headache and stiff neck.

Bitor may be associated with a small increased risk of:

  • heart attack (myocardial infarction).
  • Blood disorders and kidney problems 

These may be very serious side effects of Bitor. You may need urgent medical attention or hospitalisation,these side effects are rare.

Etoricoxib while Pregnant

Are you pregnant or planning to become pregnant? Although not common, abnormalities have been reported in babies whose mothers have taken NSAIDs during pregnancy. You should not have a Etoricoxib( Bitor) during the last 3 months of pregnancy as it may affect the baby’s circulation.  

Are you trying for a baby? Having Etoricoxib( Bitor)  may make it more difficult to conceive. You should talk to your doctor if you are planning to become pregnant, or if you have problems getting pregnant.

When you must not use Bitor?

Some people MUST NOT have this medicine. Talk to your doctor if: 

  • you think you may be allergic to Etoricoxib, aspirin, ibuprofen or any other NSAID, or to any of the other ingredients of Bitor tablets. (These are listed at the patient information leaflet.). Signs of a hypersensitivity reaction include swelling of the face and mouth (angioedema), breathing problems, chest pain, runny nose, skin rash or any other allergic type reaction.
  • you have now, or have ever had, a stomach (gastric) or duodenal (peptic) ulcer, or bleeding in the digestive tract (this can include blood in vomit, bleeding when emptying bowels, fresh blood in faeces or black, tarry faeces).
  • you have had stomach or bowel problems after you have taken other NSAIDs.
  • you have heart, kidney or liver failure.
  •  if you have established heart disease and/or cerebrovascular disease e.g. if you have had a heart attack, stroke, mini-stroke (TIA) or blockages to blood vessels to the heart or brain or an operation to clear bypass blockages.
  • if you have or have had problems with your blood circulation (peripheral arterial disease).
  • you are more than six months pregnant.

Special Warnings

  • You should take the lowest dose of Bitor for the shortest possible time, particularly if you are underweight or elderly.  
  • There is a small increased risk of heart attack or stroke when you are taking any medicine like Bitor. The risk is higher if you are taking high doses for a long time.  If at any time while taking Bitor you experience any signs or symptoms of problems with your heart or blood vessels such as chest pain, shortness of breath, weakness, or slurring of speech, contact your doctor immediately.  
  • If you have a history of stomach problems when you are taking NSAIDs, particularly if you are elderly, you must tell your doctor straight away if you notice any unusual symptoms. 
  • Because it is an anti-inflammatory medicine, Bitor may reduce the symptoms of infection, for example, headache and high temperature.
  • If you feel unwell and need to see a doctor, remember to tell him or her that you are taking Bitor. 
  • Tell your doctor if you recently had or you are going to have a surgery of the stomach or intestinal tract before taking Bitor tablets, as Bitor tablets can sometimes worsen wound healing in your gut after surgery.

Summary of information about Bitor

  • Bitor is an NSAID indicated for use in adults for the management of moderate or severe pain. 
  • Pregnancy: Avoid using Bitor after 30 weeks gestation because this may affect the baby’s circulation.  
  • Nursing Mothers: Use Etoricoxib( Bitor) with caution as Etoricoxib may be present/ secreted in human milk.
  • The usual adult dose is one tablet (60 to 120 mg Etoricoxib) each day .
  • Your doctor may also prescribe another drug to protect the stomach to be taken at the same time with Bitor, particularly if you have had stomach problems before, or if you are elderly, or taking certain other drugs as well.
  • Your doctor will prescribe the lowest dose of Bitor for the shortest possible time, particularly if you are underweight or elderly.
  • Before taking Bitor, tell your doctor if you have kidney or liver problems.


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