Maximum Recommended Dose of Etoricoxib
The maximum recommended dose of etoricoxib is 120 mg once daily, which should only be used temporarily for acute conditions like gouty arthritis, while chronic conditions require lower maximum doses of 60-90 mg daily. 1, 2
Standard Dosing by Indication
The dosing of etoricoxib is indication-specific and should not exceed the following limits:
- Osteoarthritis: 60 mg once daily 2
- Rheumatoid arthritis: 90 mg once daily 2
- Acute gouty arthritis: 120 mg once daily (temporarily) 1, 2
- Chronic non-bacterial osteitis (CNO): 90 mg daily, with temporary escalation to 120 mg/day possible during active treatment phases 1
Critical Dosing Considerations
The 120 mg dose represents the absolute maximum and is intended only for short-term use in acute conditions. 1, 2 For chronic inflammatory conditions requiring long-term NSAID/COX-2 inhibitor therapy, the guideline explicitly recommends 90 mg/day as the standard maximum, with 120 mg reserved only for temporary escalation during disease flares 1.
The pharmacokinetic profile supports once-daily dosing due to etoricoxib's approximately 20-hour elimination half-life, and the area under the curve increases proportionally with doses between 5-120 mg 3.
Safety Profile at Maximum Dosing
Clinical trial data demonstrates that etoricoxib 120 mg provides high-quality pain relief with adverse event rates similar to placebo in acute postoperative pain studies 4. The number needed to treat for at least 50% pain relief over 6 hours was 1.9 (1.7 to 2.1) for the 120 mg dose 4.
Common pitfall: Do not use 120 mg chronically for osteoarthritis or rheumatoid arthritis, as this exceeds recommended dosing and increases cardiovascular and renal risks without additional efficacy benefit 2, 3.
The gastrointestinal safety profile of etoricoxib appears favorable compared to traditional NSAIDs, though cardiovascular and renal adverse effects require ongoing clinical monitoring at all doses 3, 5.