Objectives: The objectives of the study were to study the efficacy, safety, and cost-effective analysis of low-dose etoricoxib and add-on paracetamol versus therapeutic dose etoricoxib in patients who experienced pain after tooth extraction. Methods: Patients were recruited and randomized to two study groups E1P and E2 on etoricoxib 30 mg and add-on paracetamol 500 mg 8 hourly and etoricoxib 60 mg once respectively for 3 days. The efficacy was assessed by visual analog scale, pain relief score, and global evaluation score. Patients were assessed at 0, 6, 24, 48, and 72 h. Safety was assessed by adverse drug reactions reported by the patients after 72 h. Cost-effective analysis was done by calculating the cost of treatment and the cost-effective ratio in both groups. Results: Eighty patients completed the study having 40 patients in each group. Mean pain intensity reduction, mean pain relief score, and global evaluation score all showed significantly better results (p<0.05) in Group E1P as compared to Group E2 at 6, 24, 48, and 72 h, respectively. No patient had reported any serious adverse drug reaction in both the groups; however, incidence of headache and fatigue was twice in the etoricoxib only treated group (n=4) than low-dose etoricoxib-treated group (n=2). The treatment cost of Group E1P was lesser than Group E2 and was also cost effective. Conclusion: Low-dose etoricoxib with add-on paracetamol is a better analgesic than therapeutic dose etoricoxib and is also found to be safer and cost effective.

Objective: To study the safety and efficacy of low-dose etoricoxib and low-dose paracetamol versus ibuprofen and low-dose paracetamol treatments in patients who experienced acute pain after tooth extraction. Methods: A total of 80 patients were recruited and randomized to two study groups, i.e., EP and IP. Group EP received etoricoxib 30 mg once a day and add-on paracetamol 325 mg eight-hourly, and Group IP received ibuprofen 400 mg and paracetamol 325 mg eight-hourly for three days. The analgesic efficacy was assessed by a visual analog scale, pain relief score, and global evaluation score. Patients were assessed at 0, 6, 24, 48, and 72 h. Safety was assessed by the patient’s estimation of the severity of adverse drug reactions using a 3-point scale and the type of adverse drug reactions reported by the patients after 72 h. Results: Mean pain intensity reduction, mean pain relief score, and global evaluation score all showed better analgesic efficacy results in Group EP as compared to Group IP but were not significant ( P > 0.05) at 6, 24, 48, and 72 h, respectively. No patient had reported any serious adverse drug reaction in both the groups. Mild to moderate adverse reactions were reported in 20% cases in the IP group and 10% cases in the EP group; however, the incidence of GIT intolerance was seen in 17.5% of the cases in the IP group and none in the EP group. Conclusion: Low-dose etoricoxib with low-dose paracetamol has comparable analgesic efficacy with better safety than therapeutic dose ibuprofen and low-dose paracetamol.