NSAID Selector Tool
Your Health Profile
Your Recommendations
Recommended NSAID
Best FitKey Considerations
When chronic pain or inflammation strikes, the first question is usually "which pill will work best without turning my stomach into a battlefield?" etoricoxib-sold under the brand name Arcoxia-has become a popular answer, but it’s not the only one. This guide breaks down how Arcoxia stacks up against the most common NSAID alternatives, so you can pick the right drug for your situation.
What is Arcoxia (Etoricoxib)?
Arcoxia is a selective COX-2 inhibitor whose active ingredient is Etoricoxib. It was first approved in the European Union in 2002 and later in the United States, where it is prescribed for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute pain after surgery. By sparing the COX‑1 enzyme, Etoricoxib aims to reduce gastrointestinal side‑effects that plague traditional NSAIDs.
How Do NSAIDs Differ?
All NSAIDs work by blocking cyclooxygenase enzymes (COX‑1 and/or COX‑2) that produce prostaglandins, the chemicals that cause pain, fever, and inflammation. The key differences lie in how selectively they inhibit COX‑2 versus COX‑1, their half‑life, dosing frequency, and safety profile. Below are the main categories you’ll encounter when comparing options:
- Selective COX‑2 inhibitors - e.g., Etoricoxib, Celecoxib. Designed to lower stomach‑related risks but may raise cardiovascular concerns.
- Non‑selective NSAIDs - e.g., Ibuprofen, Naproxen, Diclofenac, Meloxicam (moderately selective). Provide broader pain relief but carry higher gastrointestinal risk.

Decision Criteria: What to Compare
When weighing Arcoxia against alternatives, focus on these six factors:
- Efficacy: How well does the drug reduce pain and inflammation?
- Onset of Relief: How quickly do you feel better?
- Dosing Convenience: Once‑daily or multiple doses?
- Gastrointestinal Safety: Risk of ulcers, bleeding, or dyspepsia.
- Cardiovascular Risk: Potential for heart attack or stroke.
- Cost & Availability: Prescription vs OTC, price per daily dose.
Each drug scores differently on these axes, so the "best" choice depends on your personal health profile and priorities.
Side‑by‑Side Comparison Table
Drug | COX Selectivity | Typical Dose | Onset (hours) | GI Risk | Cardio Risk | Prescription? | Average UK Cost per Day (2025) |
---|---|---|---|---|---|---|---|
Arcoxia (Etoricoxib) | Highly selective COX‑2 | 30‑90mg once daily | 1‑2 | Low | Elevated (especially >60mg) | Yes | £0.90 |
Celecoxib | Selective COX‑2 | 100‑200mg once daily | 1‑2 | Low | Moderate | Yes | £0.70 |
Ibuprofen | Non‑selective | 200‑400mg every 4‑6h | 0.5‑1 | High | Low‑moderate | OTC | £0.15 |
Naproxen | Non‑selective | 250‑500mg twice daily | 1‑2 | Moderate‑high | Low | OTC (low dose) | £0.20 |
Diclofenac | Non‑selective (COX‑2 preference) | 50‑75mg three times daily | 1‑2 | Moderate | High | Prescription (topical OTC) | £0.45 |
Meloxicam | Moderately selective COX‑2 | 7.5‑15mg once daily | 1‑2 | Low‑moderate | Moderate | Prescription | £0.60 |

When Arcoxia Is the Right Choice
If you need strong, consistent pain relief for a chronic joint condition and have a clean cardiovascular history, Arcoxia’s once‑daily dosing can be a game‑changer. Its high COX‑2 selectivity reduces ulcer risk-a major plus for older adults on aspirin or anticoagulants. However, patients with known heart disease, uncontrolled hypertension, or a history of stroke should avoid high‑dose Etoricoxib because the cardiovascular signal grows sharply above 60mg per day.
When an Alternative Might Suit You Better
Consider these scenarios:
- Short‑term acute pain (e.g., migraine, minor injury): Ibuprofen or Naproxen work fast, are cheap, and are available over the counter.
- Low‑cost chronic therapy: Low‑dose Naproxen or Diclofenac gel offer decent efficacy with a smaller price tag, especially for patients on a tight budget.
- High cardiovascular risk: Celecoxib at the lowest effective dose has a slightly better cardiac profile than Etoricoxib, and the non‑selective NSAID Naproxen may even have a protective effect.
- Renal concerns: All NSAIDs can affect kidney function, but short‑term Ibuprofen at the recommended dose is often tolerated better than the longer half‑life Etoricoxib.

Practical Tips & Common Pitfalls
Here are a few actionable take‑aways to keep you safe and get the most out of your medication:
- Never exceed the prescribed dose. Taking more Arcoxia to speed relief can tip the cardiovascular balance.
- Take with food if you have a sensitive stomach, even though Etoricoxib is gentler on the gut.
- Watch for drug interactions. Anticoagulants (warfarin, DOACs) and certain antihypertensives may need dose tweaks.
- Schedule regular check‑ups. If you stay on any NSAID for longer than three months, a liver and kidney panel is wise.
- Consider the “prescription vs OTC” factor. OTC options give you instant access but may require more frequent dosing, affecting adherence.
Frequently Asked Questions
Is Arcoxia stronger than ibuprofen?
Yes, in most clinical trials Etoricoxib provides greater reduction in joint pain scores than standard doses of ibuprofen, especially for osteoarthritis.
Can I take Arcoxia if I have a history of heart disease?
You should discuss it with your doctor. Etoricoxib’s cardiovascular risk is dose‑dependent, and many clinicians prefer low‑dose celecoxib or a non‑selective NSAID with a better cardiac safety record for such patients.
How quickly does Arcoxia start working?
Pain relief usually begins within 1-2 hours, with peak anti‑inflammatory effect around 4-6 hours after the first dose.
Do I need a prescription for Etoricoxib in the UK?
Yes, Arcoxia is a prescription‑only medicine in the United Kingdom.
What are the common side effects of Arcoxia?
Headache, mild gastrointestinal upset, and occasional dizziness. Serious risks include hypertension, edema, and increased chance of heart attack or stroke at higher doses.
Is it safe to combine Arcoxia with a proton‑pump inhibitor?
Combining a COX‑2 inhibitor with a PPI (e.g., omeprazole) is a common strategy to further lower ulcer risk and is generally considered safe, but always check with your prescriber.
Choosing the right NSAID is a balance of pain relief, safety, and personal circumstances. By weighing efficacy, onset, dosing convenience, gastrointestinal and cardiovascular risks, plus cost, you can decide whether Arcoxia’s targeted approach fits your needs or if a traditional NSAID or another COX‑2 inhibitor is a better match.
Oliver Harvey
October 15, 2025 AT 13:30Oh, because we all love a good side‑effect roulette, right? The article does a decent job of laying out the GI‑safety vs. cardio‑risk trade‑off, but let’s not pretend Etoricoxib is a miracle pill. 🙂 It’s effective, yes, but only if you’re comfortable flirting with elevated heart‑attack odds at higher doses. And, of course, you still need a prescription – because the NHS loves paperwork as much as you love your joints feeling like steel.