PARECOXIB

Details

Stereochemistry	ACHIRAL
Molecular Formula	C19H18N2O4S
Molecular Weight	370.422
Optical Activity	NONE
Defined Stereocenters	0 / 0
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

CCC(=O)NS(=O)(=O)C1=CC=C(C=C1)C2=C(C)ON=C2C3=CC=CC=C3

InChI

InChIKey=TZRHLKRLEZJVIJ-UHFFFAOYSA-N

InChI=1S/C19H18N2O4S/c1-3-17(22)21-26(23,24)16-11-9-14(10-12-16)18-13(2)25-20-19(18)15-7-5-4-6-8-15/h4-12H,3H2,1-2H3,(H,21,22)

HIDE SMILES / InChI

Molecular Formula	C19H18N2O4S
Molecular Weight	370.422
Charge	0
Count

Stereochemistry	ACHIRAL
Additional Stereochemistry	No
Defined Stereocenters	0 / 0
E/Z Centers	0
Optical Activity	NONE

Description
Sources: https://www.drugbank.ca/drugs/DB08439 | http://www.fda.gov/ohrms/dockets/ac/05/briefing/2005-4090B1_28_CC-FDA-Tab-Q.htmhttp://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf | http://www.rotlaw.com/legal-library/bextra-valdecoxib/
Curator's Comment: Description was created based on several sources, including https://www.medicines.org.uk/emc/medicine/8771

Valdecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, is classified as a nonsteroidal anti-inflammatory drug (NSAID). Valdecoxib was manufactured and marketed under the brand name Bextra. Bextra was indicated for relief of the signs and symptoms of osteoarthritis and adult rheumatoid arthritis. For the treatment of primary dysmenorrhea. But in 2005 FDA requested that Pfizer withdraw Bextra from the American market, because the Agency had concluded that the overall risk versus benefit profile of Bextra was unfavorable. That conclusion was based on the potential increased risk for serious cardiovascular (CV) adverse events, an increased risk of serious skin reactions (e.g., toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme) compared to other NSAIDs, and the fact that Bextra had not been shown to offer any unique advantages over the other available NSAIDs.

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Condition	Potency
Cyclooxygenase-2 192 Target ID: CHEMBL230 Sources: https://www.ncbi.nlm.nih.gov/pubmed/15494548	Inhibitor 8228		0.005 µM [IC50]
Cyclooxygenase-2 192 Target ID: CHEMBL230 Sources: http://www.fda.gov/ohrms/dockets/ac/05/briefing/2005-4090B1_28_CC-FDA-Tab-Q.htm \| https://www.medicines.org.uk/emc/PIL.14519.latest.pdf \| https://www.ncbi.nlm.nih.gov/pubmed/25135338	Inhibitor 8228		5.0 nM [IC50]

Conditions

Condition	Modality	Highest Phase	Product
Pain, postoperative 9 Sources: https://www.medicines.org.uk/emc/PIL.14519.latest.pdf	Palliative	Approved 8360	Dynastat Approved Use Dynastat is used for the short-term treatment of pain in adults after an operation. Launch Date 1.01666882E12
Osteoarthritis 157 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf	Palliative	Withdrawn	BEXTRA Approved Use BEXTRA Tablets are indicated: For relief of the signs and symptoms of osteoarthritis and adult rheumatoid arthritis. For the treatment of primary dysmenorrhea. Launch Date 1.00586881E12
Rheumatoid arthritis 313 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf	Palliative	Withdrawn	BEXTRA Approved Use BEXTRA Tablets are indicated: For relief of the signs and symptoms of osteoarthritis and adult rheumatoid arthritis. For the treatment of primary dysmenorrhea. Launch Date 1.00586881E12
Primary dysmenorrhea 16 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf	Primary	Withdrawn	BEXTRA Approved Use BEXTRA Tablets are indicated: For relief of the signs and symptoms of osteoarthritis and adult rheumatoid arthritis. For the treatment of primary dysmenorrhea. Launch Date 1.00586881E12

C_max

Value	Dose	Analyte	Population
161.1 ng/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341se8-003_bextra_lbl.pdf	10 mg 1 times / day steady-state, oral dose: 10 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN
12 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
14 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
16 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
26 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	5 mg 2 times / day steady-state, oral dose: 5 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
24 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	10 mg 2 times / day steady-state, oral dose: 10 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
26 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	20 mg 2 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
1385 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16599270/	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:	VALDECOXIB serum	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN
0.8 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
1 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
1 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
2 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	5 mg 2 times / day steady-state, oral dose: 5 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
2 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	10 mg 2 times / day steady-state, oral dose: 10 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
2 ng/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	20 mg 2 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN

AUC

Value	Dose	Analyte	Population
1479 ng × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341se8-003_bextra_lbl.pdf	10 mg 1 times / day steady-state, oral dose: 10 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN
167 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
175 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
198 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
332 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	5 mg 2 times / day steady-state, oral dose: 5 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
341 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	10 mg 2 times / day steady-state, oral dose: 10 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
371 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	20 mg 2 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
9062 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16599270/	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:	VALDECOXIB serum	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN
15 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
18 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	5 mg single, oral dose: 5 mg route of administration: Oral experiment type: SINGLE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
19 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
31 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	5 mg 2 times / day steady-state, oral dose: 5 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
33 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	10 mg 2 times / day steady-state, oral dose: 10 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN
36 ng × h/mL OTHER GOV https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf	20 mg 2 times / day steady-state, oral dose: 20 mg route of administration: Oral experiment type: STEADY-STATE co-administered:	1-HYDROXYVALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN

T_1/2

Value	Dose	Co-administered	Analyte	Population
8.11 h DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341se8-003_bextra_lbl.pdf	10 mg 1 times / day steady-state, oral dose: 10 mg route of administration: Oral experiment type: STEADY-STATE co-administered:		VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN
3.7 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/16599270/	20 mg single, oral dose: 20 mg route of administration: Oral experiment type: SINGLE co-administered:		VALDECOXIB serum	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN

F_unbound

Value	Dose	Co-administered	Analyte	Population
2% DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341se8-003_bextra_lbl.pdf	10 mg 1 times / day steady-state, oral dose: 10 mg route of administration: Oral experiment type: STEADY-STATE co-administered:		VALDECOXIB plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN

Doses

Dose	Population	Adverse events
80 mg 1 times / day multiple, oral Highest studied dose Dose: 80 mg, 1 times / day Route: oral Route: multiple Dose: 80 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P2.pdf Page: p.28	unhealthy, 18-92 n = 420 Health Status: unhealthy Condition: Rheumatoid arthritis Age Group: 18-92 Sex: M+F Population Size: 420 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P2.pdf Page: p.28	Other AEs: Gastrointestinal ulcer haemorrhage... Other AEs: Gastrointestinal ulcer haemorrhage (significant, 0.48%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P2.pdf Page: p.28
40 mg 1 times / day multiple, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: multiple Dose: 40 mg, 1 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/17133774 Page: p.462	unhealthy, 32.3 ±10.9 n = 101 Health Status: unhealthy Condition: Acute ankle sprain Age Group: 32.3 ±10.9 Sex: M+F Population Size: 101 Sources: https://pubmed.ncbi.nlm.nih.gov/17133774 Page: p.462	Disc. AE: Allergic rash, Dizziness... Other AEs: Dyspepsia, Gastritis... AEs leading to discontinuation/dose reduction: Allergic rash (grade 2, 1%) Dizziness (grade 2, 1%) Other AEs: Dyspepsia (2%) Gastritis (5.9%) Sources: https://pubmed.ncbi.nlm.nih.gov/17133774 Page: p.462
40 mg 2 times / day multiple, oral Highest studied dose Dose: 40 mg, 2 times / day Route: oral Route: multiple Dose: 40 mg, 2 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.71	unhealthy n = 430 Health Status: unhealthy Condition: Rheumatoid arthritis Sex: M+F Population Size: 430 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.71	Disc. AE: Hypertension, Peripheral edema... AEs leading to discontinuation/dose reduction: Hypertension (1.7%) Peripheral edema (1.7%) Abdominal pain (2.7%) Duodenal ulcer (0.2%) Dyspepsia (2.2%) Gastric ulcer (1.5%) Nausea (0.5%) Vomiting (0.2%) Rash (1%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.71
10 mg 1 times / day multiple, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: https://ec.europa.eu/health/documents/community-register/2005/200501269150/anx_9150_en.pdf Page: p.3	unhealthy Health Status: unhealthy Condition: Osteoarthritis \| Adult rheumatoid arthritis Sources: https://ec.europa.eu/health/documents/community-register/2005/200501269150/anx_9150_en.pdf Page: p.3	Disc. AE: Gastrointestinal perforation, Gastrointestinal ulcer... Other AEs: Exfoliative dermatitis... AEs leading to discontinuation/dose reduction: Gastrointestinal perforation (grade 3-5) Gastrointestinal ulcer (grade 3-5) Gastrointestinal bleeding (grade 3-5) Other AEs: Exfoliative dermatitis Sources: https://ec.europa.eu/health/documents/community-register/2005/200501269150/anx_9150_en.pdf Page: p.3
10 mg 1 times / day multiple, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Osteoarthritis \| Adult rheumatoid arthritis Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.1	Disc. AE: Toxic epidermal necrolysis, Stevens-Johnson syndrome... AEs leading to discontinuation/dose reduction: Toxic epidermal necrolysis (grade 3-5) Stevens-Johnson syndrome (grade 3-5) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.1
10 mg 1 times / day multiple, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.1, 9	unhealthy Health Status: unhealthy Condition: Osteoarthritis \| Adult rheumatoid arthritis Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.1, 9	Other AEs: Erythema multiforme... Other AEs: Erythema multiforme (grade 3-5) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.1, 9
10 mg 1 times / day multiple, oral Recommended Dose: 10 mg, 1 times / day Route: oral Route: multiple Dose: 10 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.9	unhealthy Health Status: unhealthy Condition: Osteoarthritis \| Adult rheumatoid arthritis Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.9	Other AEs: Anaphylactic reaction, Angioedema... Other AEs: Anaphylactic reaction Angioedema Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21341lbl.pdf Page: p.9
20 mg 1 times / day multiple, oral (max) Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.70	unhealthy n = 1114 Health Status: unhealthy Condition: Rheumatoid arthritis Sex: M+F Population Size: 1114 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.70	Disc. AE: Peripheral edema, Halitosis... AEs leading to discontinuation/dose reduction: Peripheral edema (2.2%) Halitosis (0.3%) Abdominal pain (5.5%) Dyspepsia (6.2%) Gastroenteritis (1.2%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.70
40 mg 1 times / day multiple, oral Recommended Dose: 40 mg, 1 times / day Route: oral Route: multiple Dose: 40 mg, 1 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.69	unhealthy n = 430 Health Status: unhealthy Condition: Arthritis Sex: M+F Population Size: 430 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.69	Disc. AE: Abdominal pain, Diarrhea... AEs leading to discontinuation/dose reduction: Abdominal pain (1.6%) Diarrhea (0.7%) Dyspepsia (1.4%) Nausea (0.9%) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_medr_P3.pdf Page: p.69

AEs

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
substrate 1709 inhibitor 1579	substrate 1010 inhibitor 1752	substrate 1193 inhibitor 1837

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
CYP2C19 1463 CYP1A2 1509 CYP2E1 876 OAT1 595 OAT3 636	CYP2C19 985 CYP1A2 1032 UGT 187

Drug as perpetrator

Target	Modality	Activity	Metabolite
CYP1A2 1673	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	no
CYP2D6 1875	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	no
CYP2E1 964	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	no
CYP3A4 1909	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	no
OAT1 599	inhibitor 3240 Sources: https://www.jstage.jst.go.jp/article/dmpk/advpub/0/advpub_DMPK-10-RG-048/_pdf/-char/ja#page=11 Page: 11.0	no
CYP2C19 1537	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	yes
CYP2C19 1537	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	yes	SC-66905 3
CYP2C9 1803	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	yes
CYP2C9 1803	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	yes	SC-66905 3
CYP2D6 1875	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	yes	SC-66905 3
CYP3A4 1909	inhibitor 3240 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=21 Page: 21.0	yes	SC-66905 3
OAT3 638	inhibitor 3240 Sources: https://www.jstage.jst.go.jp/article/dmpk/advpub/0/advpub_DMPK-10-RG-048/_pdf/-char/ja#page=11 Page: 11.0	yes

Drug as victim

Target	Modality	Activity	Metabolite	Clinical evidence
CYP2C19 985	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=12 Page: 12.0	major
CYP3A4 1709	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=12 Page: 12.0	major		yes (co-administration study) Comment: co-administration with ketoconazole or Fluconazole increase VALDECOXIB AUC and Cmax Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=12 Page: 12.0
CYP1A2 1032	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=12 Page: 12.0	minor
CYP2C9 1010	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=12 Page: 12.0	yes
CYP2D6 1193	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=12 Page: 12.0	yes
UGT 187	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=13 Page: 13.0	yes
UGT 187	substrate 3326 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-341_Bextra_biopharmr_P1.pdf#page=36 Page: 36.0	yes	SC-66905 3

Sourcing

Vendor/Aggregator	ID	URL
ChEBI	CHEBI:63634	https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:63634
ChemicalBook	CB4754453	https://www.chemicalbook.com/ChemicalProductProperty_EN_CB4754453
MolPort	MolPort-000-883-874	https://www.molport.com/shop/molecule-link/MolPort-000-883-874
Selleck Chemicals	valdecoxib	http://www.selleckchem.com/products/valdecoxib.html
ZINC	ZINC000000006694	http://zinc15.docking.org/substances/ZINC000000006694
eMolecules	877479	https://www.emolecules.com/cgi-bin/more?vid=877479

PubMed

Title	Date	PubMed
A double-blind, randomized comparison of intramuscularly and intravenously administered parecoxib sodium versus ketorolac and placebo in a post-oral surgery pain model.	2001 Jul	11519767
Concluding remarks. C0X-2-selective inhibition: a new advance in pain management.	2002	12596801
COX-2-selective inhibitors: clinical relevance in surgical and acute pain.	2002	12449673
Development and clinical application of COX-2-selective inhibitors for the treatment of osteoarthritis and rheumatoid arthritis.	2002	12086294
Cox-2 inhibitors: today and tomorrow.	2002 Apr	12003372
Upper GI mucosal effects of parecoxib sodium in healthy elderly subjects.	2002 Jan	11808971
Effects of parecoxib, a parenteral COX-2-specific inhibitor, on the pharmacokinetics and pharmacodynamics of propofol.	2002 Jan	11753007
Effect of parecoxib, a novel intravenous cyclooxygenase type-2 inhibitor, on the postoperative opioid requirement and quality of pain control.	2002 Jun	12170040
Intravenous parecoxib sodium foracute pain after orthopedic knee surgery.	2002 Jun	12083587
The influence of parecoxib, a parenteral cyclooxygenase-2 specific inhibitor, on the pharmacokinetics and clinical effects of midazolam.	2002 Sep	12198057
COX-2: where are we in 2003?--distinction from NSAIDs becoming blurred.	2003	12723976
Meloxicam and selective COX-2 inhibitors in the management of pain in the palliative care population.	2003 Jul-Aug	12911075
Clinical pharmacology of selective COX-2 inhibitors.	2003 May-Aug	14552704
Stability of reconstituted parecoxib for injection with commonly used diluents.	2003 Oct	14632960
Effects of rofecoxib, celecoxib, and parecoxib on anti-IgE-induced histamine release from human skin mast cells and basophils.	2003 Oct	14510734
Single doses of parecoxib sodium intravenously are as effective as ketorolac in reducing pain after oral surgery.	2003 Sep	12966478
[Valdecoxib (Bextra)].	2004 Apr	15182039
Cyclooxygenase-2 specific inhibitors in the treatment of dysmenorrhea.	2004 Apr	15050982
Pharmacological profile of parecoxib: a novel, potent injectable selective cyclooxygenase-2 inhibitor.	2004 Apr 26	15102535
Quantitation of Valdecoxib in human plasma by high-performance liquid chromatography with ultraviolet absorbance detection using liquid-liquid extraction.	2004 Apr 5	15018787
The second generation of COX-2 inhibitors: clinical pharmacological point of view.	2004 Aug	15279595
First and second generations of COX-2 selective inhibitors.	2004 Aug	15279593
Parecoxib sodium demonstrates gastrointestinal safety comparable to placebo in healthy subjects.	2004 Aug	15232360
[Review of analgesics].	2004 Dec	15669520
Effective treatment of laparoscopic cholecystectomy pain with intravenous followed by oral COX-2 specific inhibitor.	2004 Feb	14742366
S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. [ISRCTN36233495].	2004 Feb 26	15102339
Renal effects of etoricoxib and comparator nonsteroidal anti-inflammatory drugs in controlled clinical trials.	2004 Jan	14996519
Anti-hyperalgesic activity of the cox-2 inhibitor lumiracoxib in a model of bone cancer pain in the rat.	2004 Jan	14715386
The analgesic effects that underlie patient satisfaction with treatment.	2004 Jul	15275801
Preoperative parenteral parecoxib and follow-up oral valdecoxib reduce length of stay and improve quality of patient recovery after laparoscopic cholecystectomy surgery.	2004 Jun	15155324
Parecoxib: a shift in pain management?	2004 Mar	15853557
The cyclooxygenase isozyme inhibitors parecoxib and paracetamol reduce central hyperalgesia in humans.	2004 Mar	15109518
Gateways to clinical trials.	2004 Mar	15071612
Parecoxib sodium, an injectable COX-2-specific inhibitor, does not affect unfractionated heparin-regulated blood coagulation parameters.	2004 May	15102867
A systematic review of COX-2 inhibitors compared with traditional NSAIDs, or different COX-2 inhibitors for post-operative pain.	2004 May	15101847
Analgesic efficacy of preoperative parecoxib sodium in an orthopedic pain model.	2004 May-Jun	15153593
The analgesic efficacy of intramuscular parecoxib sodium in postoperative dental pain.	2004 Nov	15622663
Parecoxib: renal failure.	2005 Apr	15877325
Reduction of opioid-related adverse events using opioid-sparing analgesia with COX-2 inhibitors lacks documentation: a systematic review.	2005 Feb	15715611
The cyclooxygenase-2-specific inhibitor parecoxib sodium is as effective as 12 mg of morphine administered intramuscularly for treating pain after gynecologic laparotomy surgery.	2005 Feb	15673875
Selective cyclooxygenase-2 inhibition reverses microcirculatory and inflammatory sequelae of closed soft-tissue trauma in an animal model.	2005 Jan	15634827
Cyclooxygenase-2 is a target of KRASD12, which facilitates the outgrowth of murine C26 colorectal liver metastases.	2005 Jan 1	15671526
Parecoxib, valdecoxib, and cardiovascular risk.	2005 Jan 25	15655125
The meaning of pain relief in a clinical trial.	2005 Jun	15943962
[Involvement of L-arginine-nitric oxide-cyclic GMP pathway in the peripheral antinociceptive effect induced by parecoxib].	2005 Mar-Apr	15910705
The cardioprotective effects of preconditioning with endotoxin, but not ischemia, are abolished by a peroxisome proliferator-activated receptor-gamma antagonist.	2005 May	15734901
Cardiovascular issues of COX-2 inhibitors and NSAIDs.	2005 Nov	16299629
Analgesic synergism between intrathecal morphine and cyclooxygenase-2 inhibitors in mice.	2005 Sep	16102800
COX-2 inhibitors and pain after oral surgery - pertinent papers 2002-2003.	2006 Apr	16191457
Constitutive cyclo-oxygenase-2 does not contribute to the development of human visceral pain hypersensitivity.	2006 Aug	16122956

Patents

Sample Use Guides

In Vivo Use Guide

The recommended dose is 40 mg administered intravenously (IV) or intramuscularly (IM), followed every 6 to 12 hours by 20 mg or 40 mg as required, not to exceed 80 mg/day.

Route of Administration: Parenteral

In Vitro Use Guide

100 uM parecoxib inhibited rat osteoclast differentiation by 94%

Substance Class	Chemical Created by `admin` on `Thu Jul 06 00:02:44 UTC 2023` Edited by `admin` on `Thu Jul 06 00:02:44 UTC 2023`
Record UNII	9TUW81Y3CE
Record Status	`Validated (UNII)`
Record Version

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Name

Type

Language

PARECOXIB

Official Name

English

PROPANAMIDE, N-((4-(5-METHYL-3-PHENYL-4-ISOXAZOLYL)PHENYL)SULFONYL)-

Systematic Name

English

SC-69124

Code

English

Parecoxib [WHO-DD]

Common Name

English

N-((P-(5-METHYL-3-PHENYL-4-ISOXAZOLYL)PHENYL)SULFONYL)PROPIONAMIDE

Common Name

English

PARECOXIB [USAN]

Common Name

English

parecoxib [INN]

Common Name

English

PARECOXIB [EMA EPAR]

Common Name

English

RAYZON

Brand Name

English

PARECOXIB [MI]

Common Name

English

XAPIT

Brand Name

English

Classification Tree Code System Code

WHO-ATC

M01AH04