Parecoxib: a shift in pain management?
Parecoxib (Dynastat) is a parenteral cyclooxygenase-2 inhibitor available in Europe. Clinical trials have reported a benefit in reducing pain following oral, orthopedic, gynecologic and cardiac surgeries. The overall efficacy was dose-related and similar to ketorolac (Toradol). Several trials reported an opioid-sparing effect with parecoxib. No trials have reported significantly fewer opioid-related gastrointestinal side effects (e.g., nausea, vomiting, constipation and intestinal ileus) when opioids were administered with parecoxib versus placebo. Gastroduodenal ulcers, gastric ulcers and duodenal ulcers or erosions were less common with parecoxib than ketorolac. Parecoxib does not affect platelet aggregation, interfere with the antiplatelet affect of aspirin, affect prothrombin and partial thromboplastin time or platelet counts when administered with heparin.
Dalpiaz
Anthony S
AS
Department of Pharmacy Services, University of Utah Hospitals and Clinics, 50 North Medical Drive, Salt Lake City, UT 84132, USA. Anthony.Dalpiaz@hsc.utah.edu
Peterson
Dave
D
D000818:Animals; D002986:Clinical Trials as Topic / Q000639:trends; D016861:Cyclooxygenase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007555:Isoxazoles / Q000494:pharmacology / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000201:enzymology; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods
D016861:Cyclooxygenase Inhibitors; D007555:Isoxazoles; C409945:parecoxib