Parecoxib (
parecoxib sodium) is an
injectable pro drug of
valdecoxib, which is a potent and selective inhibitor of cyclo-oxygenase-2. Intravenous (IV) or intramuscular (IM)
parecoxib >20 mg has
analgesic activity superior to that of placebo and similar to that of IV or IM
ketorolac 30 or 60 mg well controlled trials in patients with postoperative dental
pain (n = 304 to 457). In a well controlled trial (n = 202), IV
parecoxib 20 or 40mg showed
analgesic activity greater than that of placebo and IV
morphine 4mg and similar to that of IV
ketorolac 30 mg following gynaecological surgery Following orthopaedic surgery, the
analgesic activity of IV
parecoxib 20 or 40mg was similar to that of IV
ketorolac 30 mg and superior to that of IV
morphine 4 mg or placebo in well controlled trials (n = 175 and 208). IV
parecoxib (40 mg twice daily for 7 days) produced significantly fewer gastrointestinal erosions and/or
ulcers than
ketorolac (15 mg 4 times a day for 5 days) in healthy volunteers in a well controlled trial; effects on upper gastrointestinal mucosa were similar for
parecoxib and placebo.
Parecoxib is well tolerated after dental, gynaecological or orthopaedic surgery. The most common adverse events irrespective of treatment (
parecoxib,
ketorolac or placebo) after dental surgery were
nausea,
alveolar osteitis,
dizziness and
headache.
Nausea,
abdominal pain,
headache, abdominal fullness,
dizziness,
back pain,
fever, hypoactive bowel sounds,
vomiting,
tachycardia,
somnolence, abnor mal breath sounds and
pruritus occurred in > or = 10% of
parecoxib recipients after gynaecological surgery. Similar results were seen in placebo recipients.