Drug reference

Parecoxib

COX-2 Inhibitor · Analgesic, Anti-inflammatory

Also known as Parecoxib sodium, Dynastat

COX-2 InhibitorAnalgesic, Anti-inflammatory

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

Avoid unless potential benefit outweighs risk. Avoid during the third trimester due to risk of closure of fetal ductus arteriosus and persistent pulmonary hypertension of the newborn. May delay onset and increase duration of labor.

FDA category + note

Mechanism

Parecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor. It acts by blocking prostaglandin (PG) generation, which is the major mechanism for its analgesic and anti-inflammatory effects.

Indications

PainInflammationpostoperative painsimilar short-term pain

Dosing

Adult: 40 mg oral/i.m./i.v., repeated after 6–12 hours
Renal adjustment: Avoid if possible or use with caution. Use the lowest effective dose for the shortest possible duration. Monitor renal function as sodium and water retention may occur and renal function may deteriorate, possibly leading to renal failure.
Hepatic adjustment: In moderate hepatic impairment, reduce dose to half the usual recommended dose; maximum 40 mg daily. Avoid in severe hepatic impairment.
Max dose: 40 mg daily

Pharmacokinetics

Metabolism

Prodrug, metabolized to active form (valdecoxib)

Contraindications

Hypersensitivity
Severe hepatic impairment
Avoid during third trimester of pregnancy
patients with history of ischaemic heart disease/hypertension/cardiac failure/cerebrovascular disease
caution is needed, should be stopped at the first appearance of a rash

Side effects

Serious

Hypersensitivity reactions
Sodium and water retention
Renal function deterioration leading to renal failure
Closure of fetal ductus arteriosus (if used in third trimester of pregnancy)
Persistent pulmonary hypertension of the newborn (if used in third trimester of pregnancy)
serious cutaneous reactions (similar to valdecoxib)