Drug Class: Selective COX-2 Inhibitor (Coxib) NSAID | Form: Oral Tablet | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Berica 90mg Tablet? Berica 90mg contains Etoricoxib 90mg — an intermediate strength selective COX-2 inhibitor positioned between the 60mg maintenance dose and the 120mg acute dose. It is prescribed where stronger anti-inflammatory coverage is needed than the standard 60mg provides — particularly for active ankylosing spondylitis, acute gout, and moderate to severe chronic arthritis flare-ups. Like all COX-2 selective NSAIDs, Etoricoxib provides effective pain and inflammation relief with comparatively less stomach irritation than traditional NSAIDs — however cardiovascular risks remain and must be carefully assessed before prescribing. Always used at the lowest effective dose for the shortest time necessary.
What is Berica 90mg Used For?
- Rheumatoid arthritis — active painful joint inflammation and swelling (ریمیٹائیڈ گٹھیا)
- Osteoarthritis — moderate to severe joint pain and stiffness flare-ups (جوڑوں کا درد)
- Ankylosing spondylitis — chronic inflammatory spine stiffness and pain (ریڑھ کی ہڈی کی سوزش)
- Acute gouty arthritis — sudden severe joint pain from uric acid crystals (گنٹھیا کا شدید دورہ)
- Post-dental surgical pain — moderate to severe pain after tooth extraction (دانت کے آپریشن کے بعد درد)
- Acute musculoskeletal pain — severe soft tissue injuries and sprains (شدید پٹھوں کا درد)
How Does it Work? Etoricoxib selectively inhibits COX-2 enzyme — the isoform predominantly responsible for prostaglandin production at sites of inflammation and pain. By blocking COX-2 with high selectivity while largely sparing stomach-protective COX-1, Etoricoxib reduces pain receptor sensitisation, tissue swelling, and inflammatory response with less gastrointestinal irritation than non-selective NSAIDs. The 90mg dose provides stronger and more sustained COX-2 inhibition than 60mg — making it suitable for conditions requiring more intensive anti-inflammatory coverage while remaining below the maximum acute dose of 120mg.
Dosage and Administration
⚠️ Always use at the lowest effective dose for the shortest time necessary. Always take with food. Never combine with other NSAIDs or Aspirin above 75mg. Blood pressure must be monitored throughout treatment. Cardiovascular risk assessment required before prescribing.
| Indication | Usual Adult Dose | Frequency | Maximum Duration |
|---|---|---|---|
| Acute gouty arthritis | 90 – 120mg | Once daily | 8 days maximum |
| Ankylosing spondylitis | 90mg | Once daily | Long-term under supervision |
| Rheumatoid arthritis | 90mg | Once daily | Lowest effective dose — review regularly |
| Post-dental surgical pain | 90mg | Once daily | Maximum 3 days |
| Osteoarthritis flare-up | 60 – 90mg | Once daily | Shortest duration needed |
Active Ingredients
| Ingredient | Strength |
|---|---|
| Etoricoxib | 90mg |
Who Should NOT Take Berica 90mg?
- Allergy to Etoricoxib, Aspirin, or any NSAID including other COX-2 inhibitors
- Established cardiovascular disease — heart attack, stroke, TIA, or peripheral artery disease
- Uncontrolled hypertension — blood pressure consistently above 140/90mmHg
- Active stomach ulcer or history of gastrointestinal bleeding
- Severe liver impairment or active liver disease
- Severe kidney impairment
- Inflammatory bowel disease — Crohn's disease or ulcerative colitis
- Heart failure — any degree
- Third trimester of pregnancy — strictly contraindicated
- Aspirin-sensitive asthma or NSAID-induced bronchospasm
- Children and adolescents under 16 years
Side Effects
Common: Headache, dizziness, ankle swelling (ٹخنوں کی سوجن), elevated blood pressure, mild stomach discomfort, heartburn, nausea, mild fatigue — take with food to minimise gastrointestinal effects.
Serious — Stop and seek emergency help immediately: Chest pain, sudden breathlessness, or sudden weakness and numbness on one side — heart attack or stroke (دل کا دورہ یا فالج — فوری ہسپتال جائیں), significant uncontrolled blood pressure rise, dark tarry stools or vomiting blood (پیٹ سے خون — فوری مدد لیں), severe liver toxicity — yellowing of skin or eyes (یرقان — فوری مدد لیں), significant reduction in urination indicating kidney failure, severe allergic reaction with swelling of face or throat, severe skin blistering or peeling.
Drug Interactions
| Medicine | Interaction |
|---|---|
| Other NSAIDs or Aspirin above 75mg | Greatly increased gastrointestinal bleeding risk — never combine |
| Warfarin / blood thinners | Etoricoxib significantly increases anticoagulant effect — close INR monitoring essential |
| Antihypertensives (ACE inhibitors, ARBs, diuretics) | Etoricoxib reduces their effectiveness and raises blood pressure — monitor closely |
| Methotrexate | Etoricoxib increases Methotrexate toxicity — avoid combination |
| Lithium | Etoricoxib increases Lithium blood levels — monitor closely |
| Ciclosporine / Tacrolimus | Increased kidney toxicity risk — monitor renal function carefully |
| Rifampicin | Significantly reduces Etoricoxib blood levels — reduced effectiveness |
| SSRIs (Fluoxetine, Sertraline) | Increased gastrointestinal bleeding risk with COX-2 inhibitor combination |
Storage: Store below 25°C in a cool, dry place. Protect from moisture and direct sunlight. Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں). Do not use after expiry date.
FAQs
Q: What is the difference between Berica 90mg and Berica 120mg — when is each used? Berica 120mg is reserved strictly for acute short-term conditions like gout attacks and dental pain for maximum 8 days. Berica 90mg is used for conditions needing stronger ongoing coverage like ankylosing spondylitis — where 60mg is insufficient but the full 120mg acute dose is not required.
Q: Can Berica 90mg be taken long-term for ankylosing spondylitis? Long-term use at 90mg is possible under specialist supervision — however regular cardiovascular assessment, blood pressure monitoring, and kidney function checks are essential as COX-2 inhibitor risks accumulate with prolonged use.
Q: Does Berica 90mg protect the heart like low-dose Aspirin does? No — Etoricoxib does not provide any cardioprotective antiplatelet effect. Patients already taking cardiac Aspirin 75mg must continue it alongside Etoricoxib and inform their cardiologist about combined use.
Medical Disclaimer: This information is for general awareness only and does not replace medical advice. Always consult a qualified doctor or pharmacist before taking any prescription medicine.