{"id":4282,"date":"2025-03-31T18:12:03","date_gmt":"2025-03-31T18:12:03","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/parecoxib-txt\/"},"modified":"2025-03-31T18:12:03","modified_gmt":"2025-03-31T18:12:03","slug":"parecoxib-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/parecoxib-txt\/","title":{"rendered":"Parecoxib.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nCox 2 inhibitor:Short-term treatment of postoperative pain

DOSE IN NORMAL RENAL FUNCTION <\/H3>40 mg initially then 20\u201340 mg every 6\u201312 hours if required; maximum dose 80 mg daily

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :392.4 (as sodium salt)<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :98<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : <5 (as valdecoxib)<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :55 litres<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :8 (as valdecoxib)\/Unchanged

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>30\u201350 Dose as in normal renal function. Use with caution10\u201330 Dose as in normal renal function, but avoid if possible
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function, but only use if ERF on dialysis

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10\u201330 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugsACE inhibitors and angiotensin-II antagonists: antagonism of hypotensive effect; increased risk of nephrotoxicity and hyperkalaemia\n
  • Analgesics: avoid concomitant use of 2 or more NSAIDs, including aspirin (increased side effects); avoid with ketorolac (increased risk of side effects and haemorrhage)\n
  • Antibacterials: possible increased risk of convulsions with quinolones\n
  • Anticoagulants: enhanced anticoagulant effect of coumarins and phenindione; increased risk of bleeding with heparin\n
  • Antidepressants: increased risk of bleeding with SSRIs and venlafaxineAntidiabetics: possibly enhanced effect of sulphonylureas\n
  • Anti-epileptics: possibly enhanced effect of phenytoin\n
  • Antifungals: if used with fluconazole reduce the dose of parecoxib\n
  • Antivirals: increased risk of haematological toxicity with zidovudine; concentration possibly increased by ritonavir\n
  • Ciclosporin: potential for increased risk of nephrotoxicityCytotoxic agents: reduced excretion of methotrexate (possible increased risk of toxicity); increased risk of bleeding with erlotinib\n
  • Diuretics: increased risk of nephrotoxicity; possible antagonism of diuretic effect; increased risk of hyperkalaemia with potassium-sparing diuretics\n
  • Lithium: reduced excretion of lithium (risk of toxicity)Pentoxifylline: possibly increased risk of bleeding\n
  • Tacrolimus: increased risk of nephrotoxicity

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>2 mL sodium chloride 0.9%

    Route <\/H4>IV, IM

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>

    OTHER INFORMATION <\/H4>Clinical trials have shown renal effects similar to those observed with comparative NSAIDs. Monitor patient for deterioration in renal function and fluid retention.562 PArECoXiBInhibition of renal prostaglandin synthesis by NSAIDs may interfere with renal function, especially in the presence of existing renal disease \u2013 avoid if possible; if not, check serum creatinine 48\u201372 hours after starting NSAID \u2013 if raised, discontinue NSAID therapyUse normal doses in patients with ERF on dialysisUse with caution in renal transplant recipients (can reduce intrarenal autocoid synthesis)Parecoxib should be used with caution in uraemic patients predisposed to gastrointestinal bleeding or uraemic coagulopathiesWorks within 30 minutes Rapidly converted to valdecoxib\n
  • Contraindicated in patients with ischaemic heart disease or cerebrovascular disease and class II-IV NYHA congestive heart failure.
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Cox 2 inhibitor:Short-term treatment of postoperative pain DOSE<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4282","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4282","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4282"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4282\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4282"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4282"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4282"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}