The Full Wiki

More info on Parecoxib

Parecoxib: Wikis

  

Note: Many of our articles have direct quotes from sources you can cite, within the Wikipedia article! This article doesn't yet, but we're working on it! See more info or our list of citable articles.

Encyclopedia

From Wikipedia, the free encyclopedia

Parecoxib
Systematic (IUPAC) name
N-{[4-(5-methyl-3-phenylisoxazol-4-yl)phenyl]
sulfonyl}propanamide
Identifiers
CAS number 202409-33-4
ATC code M01AH04
PubChem 119828
Chemical data
Formula C 19H18N2O4S 
Mol. mass 370.422 g/mol
Pharmacokinetic data
Bioavailability 100%
Protein binding 98%
Metabolism Hepatic to valdecoxib and propionic acid
CYP extensively involved (mainly CYP3A4 and 2C9)
Half life 22 minutes (parecoxib)
8 hours (valdecoxib)
Excretion Renal (70%, metabolites)
Therapeutic considerations
Licence data

EU EMEA:link

Pregnancy cat. Not recommended
Legal status POM (UK)
Routes Intravenous and intramuscular

Parecoxib is a water soluble and injectable prodrug of valdecoxib. It is marketed as Dynastat in the European Union. Parecoxib is a COX2 selective inhibitor in the same category as celecoxib (Celebrex) and rofecoxib (Vioxx). As it is injectable, it can be used perioperatively when patients are unable to take oral medications. It is approved through much of Europe for short term perioperative pain control much in the same way ketorolac (Toradol) is used in the United States. However, unlike ketorolac, parecoxib has no effect on platelet function and therefore does not promote bleeding during or after surgery. In addition, ketorolac has a much higher gastrointestinal toxicity profile compared to most other nonsteroidal antiinflammatory drugs (NSAIDs) including ibuprofen and naprosyn. However, in the United States ketorolac is the only injectable NSAID, although it is banned in many European countries due to concerns about surgical bleeding and stomach ulcers after surgery.

In 2005, the U.S. Food and Drug Administration (FDA) issued a letter of non-approval for parecoxib in the United States. No reasons were ever documented publicly for the non-approval, although one study noted increased occurrences of heart attacks following cardiac bypass surgery compared to placebo when high doses of parecoxib were used to control pain after surgery. It is also important to remember that rare but severe allergic reactions (Stevens-Johnson Syndrome, Lyell Syndrome) have been described with valdecoxib, the molecule in which parecoxib is converted [1] . The drug is not approved for use after cardiac surgery in Europe. Ketorolac, still banned in much of Europe, is therefore the only option in the United States, and it is not clear whether parecoxib will be resubmitted to the FDA in the future.

It should be noted that all antiiflammatory medications in the U.S. carry the same warning regarding skin reactions, and none are approved for use during CABG surgery, so the reason for the FDA denying the approval of parecoxib remains unknown.== References ==

  1. ^ Health Canada Endorsed Important Safety Information on Valdecoxib Tablets, A Selective Cyclo-oxygenase-2 (COX-2) Inhibitor Non-Steroidal Anti-Inflammatory Drug (NSAID), April 21, 2005

See also








Got something to say? Make a comment.
Your name
Your email address
Message