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Rofecoxib
Aka: Rofecoxib, Vioxx
- See Also
- COX2 Inhibitor
- Celecoxib
- Precaution
- Vioxx voluntarily withdrawn from market October 2004
- Withdrawal due to increased risk of MI and CVA
- Class
- NSAID: COX2 Inhibitor
- Similar to Celecoxib (Celebrex)
- Advantages
- Less gastrointestinal adverse effects than other NSAIDs
- See NSAID Gastrointestinal Adverse Effects
- Appears safe in Aspirin and NSAID-induced Asthma
- Martin-Garcia (2002) Chest 121:1812-7 [PubMed]
- Dosing
- Osteoarthritis: 12.5 to 25 mg PO qd
- Acute pain or Dysmenorrhea: 50 mg PO qd
- 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
- Efficacy: Equivalent analgesia to 50 mg Vioxx
- Ibuprofen 400 mg
- NaproxenSodium (e.g. Anaprox) 550 mg
-
Drug Interactions
- Decreased Vioxx serum concentrations
- Antacids (decrease Vioxx serum concentrations 20%)
- Rifampin (decrease Vioxx serum concentrations 50%)
- Increased concentrations of other medications
- Raises serum Methotrexate levels 23%
- Raises Warfarin levels - increases ProTime 10%
- Adverse Effects
- See COX-2 Inhibitor for Nonfatal MI risk
- Confirmed in larger trial and withdrawn from market
- Diarrhea
- Nausea
- Dyspepsia
- Abdominal Pain
- Lower extremity edema
- Increased Blood Pressure
- References
- Daniels (1999) Clin Pharmacol Ther 65:118 [PubMed]
- Ehrich (1999) Clin Pharmacol Ther 65:336 [PubMed]
- Fricke (1999) Clin Pharmacol Ther 65:119 [PubMed]
- (1999) Med Lett Drugs Ther 41(1056): 59-61 [PubMed]