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Q. Is it safe to take Nucoxia for a long period?

Answered by
Dr. Akshay Kumar Saxena
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 07, 2016 and last reviewed on: Oct 23, 2019

Hi doctor,

I am a 39 year old male. I have been diagnosed with mechanical low back pain and SI joint pain. My doctor has advised me to take Nucoxia 60 once daily for three months. Is it safe to take Nucoxia an anti-inflammatory medicine for such a long period of three months? Doctor has not prescribed any antacid. Should I take some antacid like Omeprazole with this? All blood tests LFT, KFT, hemogram are normal. I am also taking Eltroxin 125 mg as I have hypothyroidism for the past 10 years. Please advise on long-term safety of Nucoxia 60.

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#

Hi,

Welcome to icliniq.com.

You have mentioned that you have been diagnosed as a case of mechanical back pain.

  • Since your question is specific for Nucoxia, I can tell you that Etoricoxib is actually a COX-2 inhibitor which is definitely safer than conventional NSAIDs (non steroidal anti-inflammatory drugs). But, it should not be taken continuously for a period of three months.
  • Also, you do not necessarily need an antacid with it, because it does not cause any acidity. But, if your are prone for it then there is no harm in taking an antacid like Omeprazole or Pantoprazole along with it.
  • What I would advise to you is to take it for three to four weeks and then switch your medicine to an opioid like Tramadol, etc., and if needed then a muscle relaxant can be added on SOS basis (as and when necessary).
  • Also, since your diagnosis is mechanical back pain, it needs more modification in your lifestyle, gentle anti-inflammatory medication for two to three weeks, adequate calcium and vitamin D intake and regular and intensive physical therapy.
  • Also, I would like to see your investigations such as x-ray and MRI scans if available for more discussion on your back pain.

Revert back with the investigation reports to an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

Further to my query .Since my lower back pain was persisting & previous MRI of spine was normal,doctor ordered MRI of SI joint .Enclosed MRI SI join .Please advise on treatment & diagnosis
# Hello Puneet,

Thanks for your query and welcome to Icliniq.

I have gone through your MRI films and it shows evidence of early Sacro- Ilitis.
So now our treatment approach will change because we need to actually rule out an inflammatory pathology which can lead to Sacroilitis.

Can you kindly send me your recent blood tests like CBC, ESR and CRP levels so that i can see whether any inflammatory marker is raised or not.
Also i will like to see your MRI images so that Sacro ilitis can be seen by me.

Once i have this information , i can then suggest what needs to be done further.
Also to tell you that this may be not be a part of mechanical back pain syndrome but a different issue.

Please get back to with these investigations or if you have done them recently.
Also till that time you are advised you to continue with anti inflammatory medication which you are taking and intensive physical therapy.

Thanks & Regards
Investigations to be done:

CBC, ESR and CRP
MRI films

Regarding follow up:

Follow up with investigations/SOS

Enclosed all blood reports.Unable to send the films as digital copy not available.Pls advise
# Hello Puneet,

Thanks for getting back to me.
I have gone through your reports and there are two things of mention :
Your CRP is slightly raised but all other inflammatory profile markers appear to be normal, so there is nothing to worry.

I think we can start with :

Physical Therapy : LASER therapy or Ultrasonics for Local application for 10-14 days
- Anti inflammatory medication which suits you , like Tab Etoricoxib as i had advised to you earlier
- If pain is acute, then Ice packs can be used initially for 3-5 days
- Dynapar QPS spray for Local application can be used after Ice fomentation

If this is not giving you any pain relief, then we can consider injecting you a local steroid injection for Pain relief, it is a simple procedure which can reduce inflammation in your SI joints.

Start with this treatment protocol and let me know in 2-3 weeks time how you are feeling.
Also try sending your MRI images as it will help me in understanding the situation better

Thanks & Regards
Treatment plan:

As advised

Regarding follow up:

Follow up after 2-3 weeks/SOS

I took the treatment you suggested but pain was persisting in Right side lower back with tingling,pins & needles,burning sensation.Slight touch on skin in right side of lower back also gave pins & needle sensation.So doctor ordered MRI L-Spine.Enclosed report which shows some abnormalities.Please advise diagnosis & treatment.
# Hello Puneet,

Thanks for reaching out to me on Icliniq.

Since now we have tried conservative management in your case and it appears that it has not worked, i would like to clinically examine you in details before i can suggest you some thing else.

Also i would like to see your MRI images and other tests done by you.

Do not hesitate to get back to me should you need any further information/SOS

Thanks & Regards
Regarding follow up:

Follow with with a personal appointment for a thorough physical examination and further advice


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