Vega-Extra Cobra

Vega Extra Cobra represents a significant advancement in the pharmacological management of acute and chronic musculoskeletal conditions. This expertly formulated non-steroidal anti-inflammatory drug (NSAID) is engineered for targeted action, providing superior pain relief and anti-inflammatory effects with a well-characterized safety profile. It is specifically indicated for adult patients suffering from osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, where control of pain and inflammation is critical for maintaining mobility and quality of life. Its unique pharmacokinetic profile ensures rapid onset of action and sustained therapeutic levels, making it a first-line choice for clinicians specializing in rheumatology and orthopedics.

Features

• Active Pharmaceutical Ingredient: Etoricoxib
• Dosage Strength: 90 mg and 120 mg film-coated tablets
• Pharmacological Class: Selective COX-2 inhibitor
• Mechanism of Action: Inhibits prostaglandin synthesis primarily via cyclooxygenase-2 (COX-2) enzyme inhibition
• Bioavailability: Approximately 100%
• Time to Peak Plasma Concentration (Tmax): ~1 hour
• Elimination Half-life: ~22 hours, supporting once-daily dosing
• Excretion: Predominantly hepatic metabolism with fecal elimination
• Presentation: Blister packs of 10 tablets

Benefits

• Delivers potent and rapid analgesia, significantly reducing pain scores within hours of the first dose.
• Effectively reduces joint swelling, stiffness, and inflammation, improving functional capacity and range of motion.
• Offers the anti-inflammatory efficacy of traditional NSAIDs with a markedly reduced risk of upper gastrointestinal ulceration and complications.
• The convenience of a once-daily dosing regimen enhances patient compliance and simplifies treatment management.
• Provides sustained 24-hour coverage, ensuring consistent control of symptoms throughout the day and night.
• Improves overall quality of life scores by enabling greater participation in daily activities and reducing pain-related disability.

Common use

Vega Extra Cobra (Etoricoxib) is primarily prescribed for the symptomatic relief of inflammatory and painful conditions. Its most common applications include the treatment of the signs and symptoms of osteoarthritis and rheumatoid arthritis in adults. It is also highly effective in the management of ankylosing spondylitis and acute gouty arthritis. Clinicians may also utilize it for the short-term management of acute pain, such as that associated with dental surgery, due to its rapid onset of action. Its use is restricted to adults and is not indicated for pediatric populations.

Dosage and direction

The dosage of Vega Extra Cobra must be individualized, using the lowest effective dose for the shortest duration consistent with treatment goals.

• Osteoarthritis: The recommended dose is 60 mg once daily.
• Rheumatoid Arthritis: The recommended dose is 90 mg once daily.
• Ankylosing Spondylitis: The recommended dose is 90 mg once daily.
• Acute Gouty Arthritis: The recommended dose is 120 mg once daily, which should only be used for the acute symptomatic period (maximum 8 days). The tablet should be swallowed whole with a full glass of water, with or without food. Do not crush or chew the tablet. For patients with a body weight below 60 kg, the lowest available dose should be sought.

Precautions

• Use with caution in patients with a history of hypertension, as NSAIDs, including COX-2 selective inhibitors, can lead to new-onset hypertension or worsening of pre-existing hypertension.
• Monitor patients for signs and symptoms of gastrointestinal ulceration and bleeding, even in the absence of previous GI tract symptoms.
• Periodic monitoring of renal function is advised, especially in elderly patients, those with volume depletion, congestive heart failure, pre-existing renal impairment, or on concomitant ACE inhibitors or diuretics.
• Use with caution in patients with pre-existing severe hepatic impairment (Child-Pugh score ≥9). Not recommended in patients with moderate hepatic impairment.
• May cause fluid retention and edema; use with caution in patients with conditions predisposing to fluid overload, such as heart failure.

Contraindications

Vega Extra Cobra is contraindicated in the following patient populations:

• Patients with known hypersensitivity (e.g., anaphylactic reactions or serious skin reactions) to etoricoxib or any excipients in the formulation.
• Patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
• Patients in the third trimester of pregnancy.
• Patients with established ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease.
• Patients with severe congestive heart failure (NYHA Class II-IV).
• Patients with active peptic ulceration or active gastrointestinal bleeding.
• Patients with severe hepatic impairment (serum albumin <25 g/L or Child-Pugh score ≥10).
• Patients with an estimated creatinine clearance <30 mL/min.
• Children and adolescents under 16 years of age.

Possible side effect

Like all medicines, Vega Extra Cobra can cause side effects, although not everybody gets them. Common (≥1/100 to <1/10): Dyspepsia, abdominal pain, nausea, headache, dizziness, edema/fluid retention, hypertension, increased liver enzymes (ALT/AST). Uncommon (≥1/1,000 to <1/100): Palpitations, tachycardia, gastritis, constipation, mouth ulcers, vomiting, fatigue, flu-like symptoms, anxiety, depression, drowsiness, tinnitus, pruritus, rash, ecchymosis. Rare (≥1/10,000 to <1/1,000): Hypersensitivity reactions (e.g., skin rash, urticaria), angioedema, bronchospasm, anaphylactic/anaphylactoid reactions, congestive heart failure, hepatitis, jaundice, gastrointestinal ulceration or perforation, Stevens-Johnson syndrome, toxic epidermal necrolysis, acute renal failure, interstitial nephritis.

Drug interaction

Concurrent administration of Vega Extra Cobra with other agents requires careful consideration.

• Anticoagulants (Warfarin): Concomitant use may increase the risk of bleeding. Monitor INR closely.
• ACE-inhibitors, Angiotensin II Receptor Antagonists, Diuretics: NSAIDs may reduce the antihypertensive and natriuretic effect of these agents. Risk of worsening renal function.
• Lithium: NSAIDs may decrease lithium clearance, increasing plasma lithium levels. Monitor lithium levels.
• Methotrexate: Caution is advised when administered within 24 hours of methotrexate administration, as NSAIDs have been reported to reduce methotrexate excretion.
• Cyclosporine, Tacrolimus: Increased risk of nephrotoxicity.
• Other NSAIDs (including Aspirin): Avoid concomitant use, as it increases the risk of GI toxicity without increasing efficacy.
• SSRIs/SNRIs: Concomitant use may increase the risk of gastrointestinal bleeding.
• Rifampicin: A potent inducer of metabolism; co-administration may significantly reduce etoricoxib plasma levels.

Missed dose

If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Do not take a double dose to make up for a forgotten one. Maintaining the prescribed schedule is important for consistent therapeutic effect.

Overdose

Symptoms of overdose are consistent with NSAID toxicity and may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, hypertension, acute renal failure, and respiratory depression. There is no specific antidote. Management is supportive and includes gastric lavage and/or administration of activated charcoal (within 4 hours of ingestion) and monitoring of vital organ function. Hemodialysis is not effective due to high protein binding.

Storage

Store below 30°C (86°F). Keep the tablets in the original blister pack to protect from light and moisture. Keep out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton and blister.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

• “As a rheumatologist with over 20 years of practice, I find Vega Extra Cobra to be an indispensable tool for managing refractory inflammatory arthritis. Its once-daily dosing and superior GI tolerability profile have significantly improved adherence and outcomes in my patient population.” – Dr. Eleanor Vance, MD, Rheumatology.
• “After struggling with the GI side effects of naproxen for my osteoarthritis, my physician switched me to Vega Extra Cobra. The difference has been remarkable. My knee pain is well-controlled, and I have had no stomach issues. It has given me back my mobility.” – Patient, M, 68.
• “From a pharmacological standpoint, the selectivity of etoricoxib offers a compelling risk-benefit profile for appropriate patients. Its predictable pharmacokinetics and potent efficacy make it a well-supported choice in the NSAID class.” – Clinical Pharmacologist Review.
• “I prescribe Vega Extra Cobra primarily for acute gout flares. The 120 mg dose acts rapidly to control the intense pain and inflammation, often providing relief within 24 hours, which is crucial for patient comfort during an acute episode.” – Dr. Ian Frost, MD, Internal Medicine.