Abstract

Background: Drug-induced hypertension is a form of secondary hypertension caused by a response to a drug or medication. Its severity may range from asymptomatic mild to severe elevations in blood pressure levels leading to renal damage as end-organ damage and death in some. Etoricoxib is a selective cyclo-oxygenase enzyme-2 (COX-2) inhibitor that is majorly indicated in the treatment of inflammatory disorders such as rheumatoid arthritis, osteoarthritis, and gout. Etoricoxib selectively inhibits COX 2 thereby inhibiting the conversion of arachidonic acid to prostaglandins (PGs). Case Presentation: A 48-year-old male patient presented with early morning headaches, nosebleeds, vision changes, and buzzing in the ears. His clinical examination revealed elevated blood pressure (170/100mmHg). A medication history interview was done to collect information regarding his past as well as current medications, which revealed that he had taken 2 tablets of 90 mg etoricoxib for his neck and lower back ache which was prescribed by an orthopedician during his earlier visit. Later he was advised to stop etoricoxib and serial monitoring of blood pressure had fallen to 140/90mmHg and 130/80mmHg respectively not requiring any other antihypertensive therapy. Conclusion: Regular monitoring of blood pressure is essential in patients who have been prescribed etoricoxib. Other appropriate NSAIDs should be considered for patients who have poor hypertensive control. These elevations in blood pressure levels are usually short-lived and rare hypertensive emergencies are associated with concurrent use of these drugs and are reversed once the suspected drug is de-challenged and thus achieves adequate blood pressure control.