Valdecoxib

Indications

Valdecoxib is used for: Osteoarthritis, Rheumatoid arthritis, Dysmenorrhoea

Adult Dose

Oral Osteoarthritis, Rheumatoid arthritis Adult: 10 mg once daily. Dysmenorrhoea Adult: 20 mg bid. Hepatic Impairment Child-Pugh scale 7-9: Initiate with caution. Child-Pugh scale >10: Avoid.

Child Dose

Renal Dose

Renal Impairment CrCl Dosage <30 Initiate with caution.

Administration

May be taken with or without food.

Contra Indications

Hypersensitivity to sulfonamides, NSAIDs and other COX 2 inhibitors; asthma, urticaria; severe hepatic impairment; pregnancy (third trimester); lactation. Active GI bleed or ulceration, severe CHF, inflammatory bowel disease.

Precautions

Mild to moderate hepatic impairment; history of ulcer disease or GI bleeding; dehydration, hypertension, history of heart failure, left ventricular dysfunction, pre-existing oedema. Monitor Hb or haematocrit values for signs and symptoms of anaemia.

Pregnancy-Lactation

Interactions

Concomitant admin of aspirin may result in an increased risk of GI ulceration and complications. It decreases the antihypertensive effect of antihypertensives e.g. ACE inhibitors. It increases plasma conc of dextromethorphan. It significantly decreases lithium serum clearance and renal clearance.

Adverse Effects

Side effects of Valdecoxib : Hypertension, back pain, myalgia, peripheral oedema, influenza-like symptoms, dizziness, headache, abdominal fullness, abdominal pain, diarrhoea, dyspepsia, flatulence, nausea, myalgia, sinusitis. Potentially Fatal: Toxic epidermal necrolysis, exfoliative dermatitis.

Mechanism of Action

Valdecoxib acts by selectively inhibiting prostaglandin synthesis primarily by blocking cyclooxygenase (COX-2) enzyme. It was withdrawn worldwide, following risk of serious skin reactions and cardiovascular side effects.