Parecoxib


Full Prescribing Info
Dosage/Direction for Use

Parenteral
Postoperative pain
Adult: 40 mg via slow IM or IV inj, then 20 or 40 mg 6-12 hrly as required. Max: 80 mg/day.
Elderly: <50 kg: Half the usual dose. Max: 40 mg/day.
Hepatic impairment:
Mild (Child-Pugh score 5-6): No dosage adjustment needed. Moderate (Child-Pugh score 7-9): Half the usual dose. Max: 40 mg/day. Severe (Child-Pugh score ≥10): Contraindicated.
Contraindications
Hypersensitivity; history of allergy to sulfonamides; history bronchospasm, acute rhinitis, nasal polyps, angioneurotic oedema, urticaria or allergic-type reactions after taking aspirin, NSAIDs including COX-2 inhibitors. Patient w/ inflammatory bowel disease, CHF (NYHA class II-IV), ischaemic heart disease, peripheral arterial disease, or cerebrovascular disease; treatment of post-op pain following CABG; active peptic ulceration or GI bleeding. Severe hepatic impairment (Child-Pugh score ≥10). Pregnancy (3rd trimester) and lactation.
Special Precautions
Patient w/ risk factor for CV disease (e.g. HTN, DM, hyperlipidaemia), history of cerebrovascular disease and upper GI perforation. Obese or dehydrated patient. Severe renal impairment (CrCl <30 mL/min) and moderate hepatic impairment (Child-Pugh score 7-9). Elderly and childn. Patient Counselling May impair ability to drive or operate machinery.
Adverse Reactions
Nausea, pharyngitis, alveolar osteitis (dry socket), anaemia post-op, hypokalaemia, agitation, insomnia, hypoaesthesia, dizziness, HTN, hypotension, resp insufficiency, abdominal pain, vomiting, constipation, dyspepsia, flatulence, pruritus, hyperhidrosis, back pain, oliguria, peripheral oedema, MI, deep-vein thrombosis, pulmonary embolism, stroke, deep surgical infections, sternal wound complications, renal impairment, increased blood creatinine.
Potentially Fatal: Anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis.
Drug Interactions
May reduce the effect of diuretics and antihypertensives. May increase the nephrotoxic effect of tacrolimus and ciclosporin. May increase risk of bleeding complications w/ warfarin or other anticoagulants. May increase lithium level leading to toxicity.
Action
Parecoxib is a prodrug of valdecoxib. It is a selective cyclo-oxygenase-2 (COX-2) inhibitor primarily responsible to reduce mediators of pain and inflammation. Its action is due to inhibition of prostaglandin synthesis via inhibition of COX-2.
Distribution: Plasma protein binding: Approx 98%.
Metabolism: Immediately hydrolysed in the liver to its active metabolite, valdecoxib, and propionic acid.
Excretion: Mainly via urine as inactive metabolites (approx 70%); faeces (trace amounts). Plasma half-life: Approx 22 min.
ATC Classification
M01AH04 - parecoxib ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, coxibs.
Disclaimer: This information is independently developed by CIMS based on parecoxib from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
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