II. Precautions
- Listed for historical purposes (and any international use that may still exist)
- Vioxx voluntarily withdrawn from market October 2004
- Withdrawal due to increased risk of MI and CVA
III. Mechanism
- Rofecoxib is an NSAID that is more COX2 selective (COX2 Inhibitor)
- Similar to Celecoxib (Celebrex)
IV. Dosing
- Osteoarthritis: 12.5 to 25 mg PO qd
- Acute pain or Dysmenorrhea: 50 mg PO qd
V. Adverse Effects
-
Cardiovascular Risk for Non-fatal MI
- See COX-2 Inhibitor for Nonfatal MI risk
- Confirmed in larger trial and withdrawn from market
- Less gastrointestinal adverse effects than other NSAIDs
- Appears safe in Aspirin and NSAID-induced Asthma
- Diarrhea
- Nausea
- Dyspepsia
- Abdominal Pain
- Lower Extremity Edema
- Increased Blood Pressure
VI. Pharmacokinetics
- Oral Bioavailability: 92%
- Peaks: 2-3 hours (delayed by food intake)
- Half life: 17 hours
- Metabolized by hepatic reduction
- Factors increasing serum concentrations
- Age over 65 years old
- Hepatic insufficiency
VII. Drug Interactions
- Decreased Vioxx serum concentrations
- Increased concentrations of other medications
- Raises serum Methotrexate levels 23%
- Raises Warfarin levels - increases ProTime 10%
VIII. Efficacy: Equivalent analgesia to 50 mg Vioxx
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Related Studies
| Definition (NCI_NCI-GLOSS) | A drug that was being used for pain relief and was being studied for its ability to prevent cancer and to prevent the growth of new blood vessels that tumors need to grow. It is a type of nonsteroidal anti-inflammatory drug and a type of antiangiogenesis agent. Rofecoxib was taken off the market in the U.S. because of safety concerns. |
| Definition (NCI) | A synthetic, nonsteroidal derivative of phenyl-furanone with antiinflammatory, antipyretic and analgesic properties and potential antineoplastic properties. Rofecoxib binds to and inhibits the enzyme cyclooxygenase-2 (COX-2), resulting in an inhibition of the conversion of arachidonic acid to prostaglandins. COX-related metabolic pathways may represent key regulators of cell proliferation and neo-angiogenesis. Some epithelial tumor cell types overexpress pro-angiogenic COX-2. (NCI04) |
| Definition (PDQ) | A synthetic, nonsteroidal derivative of phenyl-furanone with antiinflammatory, antipyretic and analgesic properties and potential antineoplastic properties. Rofecoxib binds to and inhibits the enzyme cyclooxygenase-2 (COX-2), resulting in an inhibition of the conversion of arachidonic acid to prostaglandins. COX-related metabolic pathways may represent key regulators of cell proliferation and neo-angiogenesis. Some epithelial tumor cell types overexpress pro-angiogenic COX-2. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=38568&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=38568&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1832" NCI Thesaurus) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C116926 |
| SnomedCT | 363596000, 116095002, 387008005 |
| LNC | LP171636-6 |
| English | 4-[4'-(Methylsulfonyl)phenyl]-3-phenyl-2(5H)-furanone, rofecoxib (medication), rofecoxib, rofecoxib [Chemical/Ingredient], Rofecoxib product (substance), Rofecoxib product, Rofecoxib (product), Rofecoxib (substance), Rofecoxib, 4-(4-methylsulfonylphenyl)-3-phenyl-5H-furan-2-one, ROFECOXIB |
| Spanish | rofecoxib (producto), rofecoxib (sustancia), rofecoxib |
Ontology: Vioxx (C0876768)
| Definition (CHV) | a kind of nonsteroidal anti-inflammatory drugs |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C116926 |
| English | Vioxx, vioxx, Cahill May Roberts brand of rofecoxib, MSD brand of rofecoxib, Merck Frosst brand of rofecoxib, Merck Sharp & Dhome brand of rofecoxib, Merck brand of rofecoxib, Vioxx Dolor |
