Rofecoxib

What is Rofecoxib

Rofecoxib is a selective cyclooxygenase-2 (COX-2), nonsteroidal anti-inflammatory drug (NSAID). Compared to celecoxib, another COX-2 selective NSAID, rofecoxib lacks a sulfonamide chain and is not primarily dependent on cytochrome P-450 enzymes for metabolism.

Rofecoxib demonstrates comparable efficacy to non-selective NSAIDs (e.g. ibuprofen and diclofenac) in patients with osteoarthritis or acute pain.

In addition, rofecoxib provides similar efficacy compared with other NSAIDs for pauciarticular or polyarticular course juvenile rheumatoid arthritis (JRA). 

Brand Name

Vioxx

Indications

1. bone pain
2. dental pain
3. dysmenorrhea
4. headache
5. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
6. migraine
7. migraine prophylaxis
8. mild pain
9. moderate pain
10. osteoarthritis
11. rheumatoid arthritis

Side Effects

1. abdominal pain
2. anaphylactoid reactions
3. anemia
4. angina
5. angioedema
6. aseptic meningitis
7. asthenia
8. atrial fibrillation
9. back pain
10. bradycardia
11. cholecystitis
12. constipation
13. diarrhea
14. dizziness
15. dysgeusia
16. dyspepsia
17. dysphagia
18. elevated hepatic enzymes
19. esophageal stricture
20. esophageal ulceration
21. esophagitis
22. fatigue
23. fever
24. flatulence
25. gastritis
26. gastroesophageal reflux
27. GI bleeding
28. GI obstruction
29. GI perforation
30. headache
31. heart failure
32. hemorrhoids
33. hepatic failure
34. hepatic necrosis
35. hepatitis
36. hyperbilirubinemia
37. hypertension
38. jaundice
39. melena
40. myocardial infarction
41. nausea
42. odynophagia
43. oral ulceration
44. palpitations
45. pancreatitis
46. peptic ulcer
47. peripheral edema
48. premature ventricular contractions (PVCs)
49. pyrosis (heartburn)
50. rash
51. renal failure (unspecified)
52. sinusitis
53. stomatitis
54. stroke
55. urticaria
56. vomiting
57. weakness
58. weight gain
59. xerostomia

Monitoring Parameters

• (drug no longer available)
• CBC
• LFTs
• serum creatinine/BUN
• stool guaiac

Contraindications

• acute bronchospasm
• acute myocardial infarction
• alcoholism
• anemia
• angina
• anticoagulant therapy
• asthma
• bone marrow suppression
• breast-feeding
• cardiac disease
• chemotherapy
• children
• coronary artery bypass graft surgery (CABG)
• coronary artery disease
• corticosteroid therapy
• dehydration
• diabetes mellitus
• edema
• geriatric
• GI bleeding
• GI disease
• GI perforation
• heart failure
• hepatic disease
• hypertension
• hypovolemia
• immunosuppression
• infants
• jaundice
• labor
• nasal polyps
• neonates
• neutropenia
• NSAID hypersensitivity
• obstetric delivery
• peptic ulcer disease
• peripheral edema
• pregnancy
• renal disease
• renal failure
• renal impairment
• rheumatoid arthritis
• salicylate hypersensitivity
• stroke
• systemic lupus erythematosus (SLE)
• tobacco smoking
• ulcerative colitis
• urticaria

Interactions

• Abciximab
• Acebutolol
• Acetohexamide
• Acyclovir
• Adefovir
• Aldesleukin, IL-2
• Aliskiren
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Aliskiren; Valsartan
• Alpha-blockers
• Alteplase
• Altretamine
• Ambenonium Chloride
• Amikacin
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminolevulinic Acid
• Amiodarone
• Amlodipine; Benazepril
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Anagrelide
• Angiotensin II receptor antagonists
• Angiotensin-converting enzyme inhibitors
• Antithrombin III
• Antithymocyte Globulin
• Apixaban
• Aprotinin
• Argatroban
• Aspirin, ASA; Dipyridamole
• Atenolol
• Atenolol; Chlorthalidone
• Atropine; Edrophonium
• Azathioprine
• Azelastine; Fluticasone
• Azilsartan
• Azilsartan; Chlorthalidone
• Bacitracin
• Beclomethasone
• Benazepril
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendamustine
• Bendroflumethiazide; Nadolol
• Beta-blockers
• Betamethasone
• Betaxolol
• Betrixaban
• Bexarotene
• Bictegravir; Emtricitabine; Tenofovir Alafenamide
• Bisoprolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bisphosphonates
• Bivalirudin
• Bleomycin
• Brimonidine; Timolol
• Budesonide
• Budesonide; Formoterol
• Bumetanide
• Busulfan
• Calcium Phosphate, Supersaturated
• Calcium-channel blockers
• Candesartan
• Candesartan; Hydrochlorothiazide, HCTZ
• Capreomycin
• Captopril
• Captopril; Hydrochlorothiazide, HCTZ
• Carmustine, BCNU
• Carteolol
• Carvedilol
• Cefotaxime
• Chlorambucil
• Chlorpropamide
• Chlorthalidone; Clonidine
• Cholinesterase inhibitors
• Ciclesonide
• Cidofovir
• Cilostazol
• Citalopram
• Cladribine
• Clofarabine
• Clonidine
• Clopidogrel
• Colchicine; Probenecid
• Colistimethate, Colistin, Polymyxin E
• Corticosteroids
• Corticotropin, ACTH
• Cortisone
• Cyclosporine
• Cytarabine, ARA-C
• Dabigatran
• Dacarbazine, DTIC
• Dactinomycin, Actinomycin D
• Dalteparin
• Danaparoid
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasatinib
• Decitabine
• Deferasirox
• Deflazacort
• Denileukin Diftitox
• Desirudin
• Desmopressin
• Desvenlafaxine
• Dexamethasone
• Diazoxide
• Dipyridamole
• Docetaxel
• Donepezil
• Donepezil; Memantine
• Doravirine; Lamivudine; Tenofovir disoproxil fumarate
• Dorzolamide; Timolol
• Doxazosin
• Drospirenone
• Drospirenone; Estradiol
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Drotrecogin Alfa
• Duloxetine
• Edoxaban
• Edrophonium
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Eltrombopag
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Emtricitabine
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Emtricitabine; Tenofovir alafenamide
• Emtricitabine; Tenofovir disoproxil fumarate
• Enalapril, Enalaprilat
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Enoxaparin
• Entecavir
• Eplerenone
• Epoprostenol
• Eprosartan
• Eprosartan; Hydrochlorothiazide, HCTZ
• Eptifibatide
• Erlotinib
• Escitalopram
• Esmolol
• Ethacrynic Acid
• Ethanol
• Fenoldopam
• Flavocoxid, Flavocoxid; Citrated Zinc Bisglycinate
• Floxuridine
• Fludrocortisone
• Flunisolide
• Fluorouracil, 5-FU
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluticasone
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fluvoxamine
• Fondaparinux
• Formoterol; Mometasone
• Foscarnet
• Fosinopril
• Fosinopril; Hydrochlorothiazide, HCTZ
• Furosemide
• Gadoterate meglumine
• Galantamine
• Gallium Ga 68 Dotatate
• Ganciclovir
• Garlic, Allium sativum
• Gentamicin
• Ginger, Zingiber officinale
• Ginkgo, Ginkgo biloba
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Gold
• Guanabenz
• Guanfacine
• Heparin
• Hyaluronidase, Recombinant; Immune Globulin
• Hydralazine
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocortisone
• Ibritumomab Tiuxetan
• Ibuprofen lysine
• Iloprost
• Immune Globulin IV, IVIG, IGIV
• Indapamide
• Inotersen
• Iodipamide Meglumine
• Iohexol
• Ionic Contrast Media
• Iopamidol
• Iopromide
• Ioversol
• Ioxaglate Meglumine; Ioxaglate Sodium
• Irbesartan
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isosulfan Blue
• Kanamycin
• Labetalol
• Lamivudine; Tenofovir Disoproxil Fumarate
• Leflunomide
• Lepirudin
• Levobetaxolol
• Levobunolol
• Levomilnacipran
• Lisinopril
• Lithium
• Lomustine, CCNU
• Losartan
• Macimorelin
• Magnesium Salts
• Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
• Mannitol
• Mecamylamine
• Mechlorethamine, Nitrogen Mustard
• Melphalan
• Mesalamine, 5-ASA
• Methotrexate
• Methoxsalen
• Methyldopa
• Methylprednisolone
• Methylsulfonylmethane, MSM
• Metoprolol
• Mifepristone
• Milnacipran
• Minoxidil
• Mitomycin
• Mitoxantrone
• Moexipril
• Mometasone
• Nadolol
• Nebivolol
• Nebivolol; Valsartan
• Nelarabine
• Neomycin
• Neostigmine
• Nitroprusside
• Non-Ionic Contrast Media
• Olmesartan
• Omacetaxine
• Paclitaxel
• Paroxetine
• Pegaspargase
• Penbutolol
• Pentosan
• Pentostatin
• Perindopril
• Perindopril; Amlodipine
• Phenoxybenzamine
• Phentermine; Topiramate
• Phentolamine
• Photosensitizing agents (topical)
• Physostigmine
• Pindolol
• Platelet Inhibitors
• Pneumococcal Vaccine, Polyvalent
• Polyethylene Glycol; Electrolytes
• Polyethylene Glycol; Electrolytes; Ascorbic Acid
• Polymyxin B
• Polymyxins
• Potassium
• Pralatrexate
• Prasugrel
• Prazosin
• Prednisolone
• Prednisone
• Probenecid
• Procarbazine
• Propranolol
• Pyridostigmine
• Quinapril
• Quinolones
• Ramipril
• Reserpine
• Reteplase, r-PA
• Rifampin
• Rivaroxaban
• Rivastigmine
• Ropivacaine
• Sacubitril; Valsartan
• Selective serotonin reuptake inhibitors
• Sertraline
• Sodium Hyaluronate, Hyaluronic Acid
• Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Sotalol
• Spironolactone
• Streptokinase
• Streptomycin
• Streptozocin
• Sulfinpyrazone
• Sulfonylureas
• Tacrine
• Tacrolimus
• Telavancin
• Telbivudine
• Telmisartan
• Temozolomide
• Tenecteplase
• Teniposide
• Tenofovir Alafenamide
• Tenofovir, PMPA
• Terazosin
• Theophylline, Aminophylline
• Thiazide diuretics
• Thioguanine, 6-TG
• Thrombolytic Agents
• Ticagrelor
• Ticlopidine
• Timolol
• Tinzaparin
• Tirofiban
• Tobramycin
• Tolazamide
• Tolbutamide
• Topiramate
• Torsemide
• Tositumomab
• Trandolapril
• Trandolapril; Verapamil
• Trazodone
• Treprostinil
• Triamcinolone
• Triamterene
• Urea
• Urokinase
• Valacyclovir
• Valganciclovir
• Valsartan
• Vancomycin
• Vasodilators
• Venlafaxine
• Verteporfin
• Vilazodone
• Vinblastine
• Vorapaxar
• Vorinostat
• Vortioxetine
• Warfarin
• Zafirlukast
• Zileuton