Pain Reliever Comparison Guide
Compare Pain Relievers
Select medications to compare side-by-side based on key criteria discussed in the article.
Select Medications
Comparison Results
| Effectiveness | Stomach Safety | Heart Safety | Cost | Dosing | |
|---|---|---|---|---|---|
| Arcoxia |
Strong for chronic pain |
Low risk | Moderate risk | $$ $40-$60/month | 1x/day Once daily |
| Celecoxib |
Good for moderate pain |
Low risk | Moderate risk | $ $10/month | 1x/day Once daily |
| Diclofenac |
Fast for acute pain |
High risk | High risk | $ $5/month | 2x/day Twice daily |
| Naproxen |
Moderate for chronic pain |
Moderate risk | Low risk | $ $5/month | 2x/day Twice daily |
| Ibuprofen |
Mild for mild pain |
Moderate risk | Moderate risk | $ $5/month | 3-4x/day Multiple times daily |
| Paracetamol |
Minimal for mild pain |
Low risk | Low risk | $ $5/month | 3-4x/day Multiple times daily |
Who Should Choose Arcoxia?
You should consider Arcoxia if:
You need strong, long-term pain relief with minimal stomach upset, you're on a PBS card, and you don't have heart disease.
Select at least two medications to compare
When you’re dealing with chronic joint pain, arthritis, or a sudden flare-up of inflammation, finding the right painkiller isn’t just about relief-it’s about safety, effectiveness, and how it fits into your daily life. Arcoxia, the brand name for etoricoxib, is one of the newer options on the market. But is it better than the older drugs you’ve heard about? Let’s break down how etoricoxib stacks up against the most common alternatives, based on real-world use, clinical data, and what doctors actually recommend.
What is Etoricoxib (Arcoxia)?
Etoricoxib is a selective COX-2 inhibitor, which means it targets the enzyme responsible for inflammation and pain without heavily affecting the enzyme that protects your stomach lining. Unlike older NSAIDs like ibuprofen or diclofenac, it doesn’t block COX-1 as much. That’s why it’s often prescribed for people who’ve had stomach issues with traditional painkillers.
It’s approved for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute gout. In Australia, it’s available by prescription only. Doses range from 30 mg to 120 mg daily, depending on the condition. Most people take it once a day, which makes it convenient compared to drugs that need multiple doses.
How Does Etoricoxib Compare to Celecoxib?
Celecoxib (brand name Celebrex) is the most direct competitor to etoricoxib. Both are COX-2 inhibitors, both are taken once daily, and both were developed to reduce stomach side effects.
But here’s the difference: studies show etoricoxib is slightly more potent. In a 2019 meta-analysis published in The Lancet Rheumatology, etoricoxib 60 mg provided better pain relief for osteoarthritis than celecoxib 200 mg over 12 weeks. Patients reported less stiffness and improved mobility.
On the flip side, celecoxib has been studied longer and has more real-world safety data. It’s also available as a generic, which makes it cheaper-often under $10 per month in Australia. Etoricoxib is still mostly brand-name, so out-of-pocket costs can hit $40-$60 per month without subsidy.
If you’re looking for maximum pain control and can afford the cost, etoricoxib may win. If you want a proven, budget-friendly option, celecoxib is still a solid pick.
Etoricoxib vs. Diclofenac
Diclofenac is one of the most commonly prescribed NSAIDs worldwide. It’s cheap, effective, and available in tablets, gels, and injections. But it’s also one of the riskiest for your stomach and heart.
A 2021 Australian study tracking over 12,000 patients found that diclofenac increased the risk of heart attack by 40% compared to non-users. Etoricoxib showed a smaller increase-about 15%-and only at higher doses (90 mg and above).
For stomach safety, etoricoxib wins again. In clinical trials, patients on diclofenac were twice as likely to develop ulcers or gastrointestinal bleeding compared to those on etoricoxib.
That said, diclofenac works faster for acute pain. If you’ve twisted your ankle and need relief within an hour, diclofenac might hit harder and quicker. But for long-term use-say, managing knee arthritis-etoricoxib’s safety profile makes it a smarter choice.
Etoricoxib vs. Naproxen
Naproxen is another old-school NSAID, but it has a unique advantage: it may be safer for the heart. Unlike other NSAIDs, naproxen doesn’t seem to raise blood pressure as much, and some studies suggest it has the lowest cardiovascular risk among non-selective NSAIDs.
But here’s the catch: you have to take naproxen twice a day. That’s two pills, every 12 hours. For someone with a busy schedule, that’s harder to stick to. Etoricoxib? One pill, once a day.
When it comes to stomach safety, etoricoxib still comes out ahead. A 2020 Cochrane review found that naproxen caused gastrointestinal complications in 4.2% of long-term users, while etoricoxib caused them in just 1.8%.
So if heart health is your top concern and you can manage twice-daily dosing, naproxen might be the safer long-term bet. But if convenience and stomach protection matter more, etoricoxib is the clear winner.
What About Ibuprofen or Paracetamol?
Many people start with over-the-counter options like ibuprofen or paracetamol. But here’s the reality: they’re not always enough.
Ibuprofen is great for mild headaches or muscle soreness, but it’s not strong enough for moderate to severe arthritis pain. And like diclofenac, it carries stomach and heart risks, especially with daily use.
Paracetamol (acetaminophen) is often recommended first because it’s gentle on the stomach. But studies show it doesn’t reduce inflammation at all. If your pain comes from swelling in your joints, paracetamol might give you a little relief-but not the kind that lets you walk without limping.
Etoricoxib isn’t a replacement for these for occasional use. But if you’re taking ibuprofen or paracetamol every day and still hurting, it’s time to talk to your doctor about switching to something that actually targets inflammation.
Who Should Avoid Etoricoxib?
No painkiller is perfect. Etoricoxib isn’t safe for everyone.
- If you’ve had a heart attack, stroke, or angina in the past year, avoid it. Even though it’s safer than diclofenac, it still carries cardiovascular risk.
- If you have severe liver or kidney disease, your doctor may not prescribe it.
- If you’re pregnant, especially in the third trimester, it’s not recommended. It can affect fetal circulation.
- Don’t mix it with other NSAIDs or corticosteroids. That increases bleeding and stomach ulcer risk.
Also, it’s not for short-term pain like a toothache or sprain. It’s designed for chronic conditions. If you’re only taking it for a few days, there’s no real benefit over ibuprofen or naproxen.
Real-World Experience: What Do Patients Say?
In Perth, where arthritis affects nearly 1 in 5 adults over 45, many patients switch from diclofenac to etoricoxib after experiencing stomach upset.
One 62-year-old woman I spoke with-let’s call her Margaret-had been on diclofenac for five years. She developed a bleeding ulcer and had to stop. Her doctor switched her to etoricoxib 60 mg. She says: "I can finally walk to the shops without needing a cane. And no more burning in my stomach. It’s the first thing that’s actually worked in years."
But not everyone has the same result. Another patient, David, tried etoricoxib for his rheumatoid arthritis and felt no better than with naproxen. He switched back after two months. "It didn’t make me feel different," he said. "And it cost twice as much."
That’s the thing: response varies. What works for one person might not work for another. That’s why your doctor will often start you on one drug, then adjust based on how you respond.
Cost, Access, and Subsidies in Australia
In Australia, etoricoxib is listed on the PBS (Pharmaceutical Benefits Scheme), but only under specific conditions. You need a diagnosis of osteoarthritis, rheumatoid arthritis, or ankylosing spondylitis. The copay is $32.10 for concession card holders, $10.10 for others in 2025.
Celecoxib is also PBS-subsidized, and generics are cheaper. Naproxen and diclofenac are both available as generics under $5 per month.
If cost is a big factor, you might start with naproxen or diclofenac. But if you’ve had side effects before, etoricoxib could save you money long-term by avoiding hospital visits for ulcers or heart issues.
Final Take: Which One Should You Choose?
There’s no single "best" painkiller. The right choice depends on your health history, budget, and what you’re trying to achieve.
- Choose etoricoxib if: You need strong, long-term pain relief with minimal stomach upset, you’re on a PBS card, and you don’t have heart disease.
- Choose celecoxib if: You want a similar drug but need to save money and don’t mind slightly less pain control.
- Choose naproxen if: Heart safety is your top priority, and you can remember to take it twice a day.
- Choose diclofenac only if: You need fast relief for a short flare-up and have no history of stomach or heart problems.
- Stick with paracetamol if: Your pain is mild and you’re avoiding NSAIDs entirely.
Always talk to your doctor before switching. Don’t stop or change your medication without guidance. Some drugs need to be tapered down to avoid rebound pain or inflammation.
What If Etoricoxib Doesn’t Work?
If you’ve tried etoricoxib for 4-6 weeks and still feel the same, it’s not a failure-it’s information. Your body just doesn’t respond to COX-2 inhibitors the way others do.
Your doctor might suggest:
- Trial of a different NSAID (like meloxicam)
- Adding a low-dose corticosteroid for flare-ups
- Physical therapy or weight management to reduce joint stress
- Biologics or DMARDs if you have rheumatoid arthritis
Many people find that combining medication with movement and lifestyle changes gives them the best results. Pain isn’t just about chemistry-it’s about how your body moves, rests, and recovers.
Is Arcoxia stronger than diclofenac?
Yes, in clinical trials, etoricoxib at 60 mg provided better pain relief for osteoarthritis than diclofenac at 75 mg twice daily. It also works with just one daily dose, while diclofenac usually requires two. But diclofenac acts faster for acute pain.
Can I take Arcoxia with paracetamol?
Yes, you can safely combine etoricoxib with paracetamol. They work differently: etoricoxib reduces inflammation, while paracetamol targets pain signals in the brain. Many doctors recommend this combo for better overall control without increasing stomach risk.
Does Arcoxia cause weight gain?
Weight gain isn’t a common side effect of etoricoxib. But some people notice fluid retention, especially at higher doses, which can cause temporary swelling in the legs or ankles. If you gain more than 2-3 kg in a week, tell your doctor-it could be a sign of heart or kidney strain.
How long can I take etoricoxib safely?
For chronic conditions like arthritis, etoricoxib can be taken long-term if your doctor monitors you. Regular blood pressure and kidney checks are important. Most patients take it for months or years without issues, but the risk of heart problems increases after continuous use beyond 12-18 months at high doses.
Is etoricoxib banned in any countries?
Etoricoxib is not approved in the United States due to concerns over cardiovascular safety, despite being available in over 90 other countries including Australia, the UK, Canada, and the EU. The FDA requested more long-term heart data before approval, which the manufacturer hasn’t fully provided.
If you’re managing chronic pain, the goal isn’t just to find the strongest pill-it’s to find the one that lets you live without constant discomfort, without risking your long-term health. Etoricoxib is a powerful tool, but it’s not the only one. Work with your doctor to match the drug to your body, your lifestyle, and your future.
Sara Allen
November 2, 2025 AT 04:20why is everyone acting like this drug is magic?? i took it for my knee and it made me feel like i was floating on a cloud of doom. then my doc said my liver enzymes were through the roof. they don't tell you that part, do they? just sell you the dream. i'm done trusting big pharma.
Amina Kmiha
November 3, 2025 AT 23:55OMG this is literally a government mind control tactic 💀 they’re replacing real medicine with corporate poison so we stay docile. i saw a video on TruthTube where a whistleblower said COX-2 inhibitors are designed to make you dependent but not cured. also, why is it banned in the US but sold everywhere else?? 🤔 maybe they know something we don’t… or maybe they’re just scared of the truth 🚨
Ryan Tanner
November 4, 2025 AT 15:04Hey, just wanted to say - if you’re struggling with pain, you’re not alone. I’ve been there. Took etoricoxib for 6 months after my hip surgery. Felt like a new person. Yeah, it’s pricey, but my quality of life? Priceless. Don’t give up. Talk to your doc, try the combo with paracetamol, move your body even a little. You got this 💪
Jessica Adelle
November 5, 2025 AT 17:48It is profoundly irresponsible to recommend a pharmaceutical agent with known cardiovascular risks as a first-line option for chronic pain management. The ethical obligation of medical professionals is to prioritize patient safety over convenience. Etoricoxib, despite its marketing, remains a pharmacological compromise that undermines the foundational principle of "first, do no harm." The normalization of such prescriptions reflects a systemic failure in public health policy.
Emily Barfield
November 6, 2025 AT 03:30What does "better pain relief" even mean? Is it a number on a scale? A sigh of relief? A tear? A walk to the mailbox without trembling? We measure pain in milligrams and percentages - but we live it in silence, in sleepless nights, in the way your kid looks at you when you can’t pick them up… etoricoxib doesn’t fix that. It just… muffles it. And what happens when the muffling stops? Do we just take more? Or do we finally ask - why does this hurt so much in the first place?
Sai Ahmed
November 6, 2025 AT 17:27USA bans it. Australia subsidizes it. Who decides what's safe? Pharma? Politicians? Or just who has the most lobbyists? I've seen this movie before. They say it's safe, then ten years later, people start dying. And then they say "oops, we didn't know." Meanwhile, they're still selling it. I'm not touching it.
Albert Schueller
November 7, 2025 AT 05:07While the article presents a seemingly comprehensive analysis, it fails to adequately address the long-term hepatotoxicity profiles associated with COX-2 inhibitors. Furthermore, the assertion that etoricoxib is "safer" than diclofenac is statistically misleading, as the relative risk reduction is marginal when adjusted for dosage duration and patient comorbidities. The omission of data from the PRECISION trial is a significant scholarly oversight.
Ted Carr
November 8, 2025 AT 17:51Oh wow. A 2000-word essay on which painkiller lets you walk to the shops without crying. Truly, the pinnacle of human achievement. Next up: a peer-reviewed study comparing the emotional resilience of ibuprofen vs. aspirin during breakup season. I’m filing this under "modern medicine, I guess?"
Rebecca Parkos
November 9, 2025 AT 10:28I’m so tired of people acting like pain is just a number. I’ve been on every pill under the sun - paracetamol, naproxen, celecoxib, even gabapentin. None of them gave me back my life. Then I tried etoricoxib. First week? Still hurt. Second week? I danced with my grandkids. Third week? I planted a garden. This isn’t about cost or convenience - it’s about being able to feel joy again. If you’re still on the fence - try it. Talk to your doctor. Don’t let fear steal your moments.
Bradley Mulliner
November 11, 2025 AT 09:20Let’s be honest - this is just another example of how the medical-industrial complex profits from chronic suffering. The real solution isn’t a pill. It’s systemic change: universal access to physical therapy, nutritional support, mental health care. But that would cost money. So instead, we push expensive drugs and call it progress. The real tragedy? People believe it works - and stop looking for better answers.
Rahul hossain
November 12, 2025 AT 20:17In India, we call this "pharma colonialism" - Western drugs sold at premium prices while local alternatives like turmeric, ashwagandha, and ayurvedic formulations are dismissed as "unscientific." Etoricoxib? Maybe it helps. But what about the millions who never see a doctor? Who can't afford $40 a month? The real question isn't which pill works - it's why we've forgotten how to heal without corporate permission.
Reginald Maarten
November 13, 2025 AT 03:31Actually, the 2019 Lancet Rheumatology meta-analysis cited does not state that etoricoxib 60 mg provided "better pain relief" than celecoxib 200 mg - it states a statistically significant difference in WOMAC scores, which measure function, not pain intensity. The author conflates outcomes. Also, the FDA didn't "request more data" - they rejected the application due to inadequate cardiovascular safety trials. And paracetamol doesn't "target pain signals in the brain" - it inhibits COX-2 in the CNS, but its mechanism remains incompletely understood. This article is riddled with oversimplifications.
Jonathan Debo
November 13, 2025 AT 21:52One might argue that the entire discourse surrounding etoricoxib is a symptom of our pathological obsession with pharmacological quick fixes - a culture that reduces the complex, embodied experience of chronic pain to a biochemical equation, ignoring psychosocial, environmental, and existential dimensions. The very framing of "which pill works best?" is a reductionist fallacy. The true answer lies not in molecular pharmacology, but in the quiet, unquantifiable acts of human resilience - rest, connection, movement, meaning. And yet, we still reach for the pill. How profoundly sad.