Arcoxia is used for the following:

• acute and chronic treatment of the signs and symptoms of osteoarthritis and rheumatoid arthritis
• management of ankylosing spondylitis
• relief of chronic musculoskeletal pain
• relief of acute pain
• to treat acute gouty arthritis

Your doctor will prescribe Arcoxia for you only after you have used other medicines for your condition and they have not been suitable for you.

Your doctor will want discuss your treatment with Arcoxia from time to time. It is important that you use the lowest dose that controls your pain and you should not take Arcoxia for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.

Do not take Arcoxia if:

• you have an allergy to Arcoxia or any of the ingredients listed at the end of this leaflet
• the packaging is torn or shows signs of tampering
• the expiry date on the pack has passed.
• If you take this medicine after the expiry date has passed, it may not work.
• You have had heart failure, a heart attack, bypass surgery, chest pain (angina), narrow or blocked arteries of the extremities (peripheral arterial disease), a stroke or mini stroke (TIA or transient ischaemic attack).
• You have high blood pressure that is not well controlled on blood pressure medication.
• You are having major surgery and have conditions which increase your risk of coronary artery disease or atherosclerosis such as high blood pressure, diabetes, high cholesterol or smoking.
• You are having major surgery on you heart or arteries.

Before you start to taking Arcoxia tell your doctor if:

• you are pregnant or intend to become pregnant. Arcoxia is not recommended for use during late pregnancy. If there is a need to consider using Arcoxia during your pregnancy, your doctor will discuss with you the benefits and risks of using it.
• you are breast-feeding or plan to breast-feed. It is not known if Arcoxia passes into breast milk. You and your doctor should discuss whether you should stop breast-feeding or not take Arcoxia.
• you have or have had any medical conditions, especially the following:
  • history of angina
  • heart attack or a blocked artery in your heart
  • narrow or blocked arteries of the extremities
  • kidney disease
  • liver disease
  • heart failure
  • high blood pressure
• you have had an allergic reaction to aspirin or other anti-inflammatory medicines (commonly known as NSAIDs)
  Symptoms of an allergic reaction may include asthma, pinkish itchy swellings on the skin (hives), runny or blocked nose.
• you have an infection
  If you take Arcoxia while you have an infection, it may hide fever and may make you think, mistakenly, that you are better or that your infection is less serious than it might be.
• you have any allergies to any other medicines or any other substances, such as foods, preservatives or dyes.
• you have a history of stroke or mini stroke
• you have conditions which increase your risk of coronary artery disease or atherosclerosis such as high blood pressure, diabetes, high cholesterol or smoking.
• Take Arcoxia only when prescribed by your doctor.

  For osteoarthritis, the recommended dose is 60 mg once a day.

  For rheumatoid arthritis the recommended dose is 90 mg once a day.

  For ankylosing spondylitis the recommended dose is 90 mg once a day.

  For the relief of gout attacks the recommended dose is 120 mg once a day, which should only be used for the acute painful period.

  For the relief of chronic musculoskeletal pain the recommended dose is 60 mg once a day.

  Doses greater than those recommended for each condition have either not demonstrated additional efficacy or have not been studied. Therefore, the daily doses stated above for each condition should not be exceeded.

  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 60 mg every other day.

  Follow all directions given to you by your doctor carefully. They may differ from the information contained in this leaflet.

  If you do not understand the instructions on the box, ask your doctor or pharmacist for help. Arcoxia comes as tablets.

  When taking the tablets, swallow them with a glass of water. Do not halve the tablet.

  Take your Arcoxia at about the same time each day.

  Taking Arcoxia at the same time each day will have the best effect. It will also help you remember when to take the dose.

  It does not matter if you take Arcoxia before or after food.

  Do not use Arcoxia for longer than your doctor says.