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rofecoxib
Vioxx

Pregnancy Risk Category C

How supplied
Tablets:
12.5 mg, 25 mg
Oral suspension:
12.5 mg/5 ml, 25 mg/5 ml

Action
Unknown. Produces anti-inflammatory, analgesic, and antipyretic effects, possibly by inhibiting prostaglandin synthesis.

Indications & dosage
Relief of signs and symptoms of osteoarthritis--

Adults:
initially, 12.5 mg P.O. once daily, increased, p.r.n., to maximum of 25 mg P.O. once daily.
Management of acute pain, treatment of primary dysmenorrhea--

Adults:
50 mg P.O. once daily, p.r.n., for up to 5 days.

Adverse reactions
CNS:
headache, asthenia, fatigue, dizziness.
CV:
hypertension, lower-extremity edema.
EENT:
sinusitis.
GI:
diarrhea, dyspepsia, epigastric discomfort, heartburn, nausea, abdominal pain.
GU:
urinary tract infection.
Musculoskeletal:
back pain.
Respiratory:
bronchitis, upper respiratory tract infection.
Other:
flulike syndrome.

Interactions
Drug-drug.
ACE inhibitors: decreased antihypertensive effects of ACE inhibitors. Monitor patient closely.
Aspirin:
increased rate of GI ulceration and other complications. Don't use together, if possible. If used together, monitor patient closely for GI bleeding.
Furosemide, thiazide diuretics:
potentially reduced efficacy of these drugs. Monitor patient closely.
Lithium:
increased plasma lithium levels and decreased lithium clearance. Monitor patient closely for toxic reaction to lithium.
Methotrexate:
increased plasma methotrexate levels. Monitor patient closely for toxic reaction to methotrexate.
Rifampin:
decreased rofecoxib levels by about 50%. Initiate therapy with a higher dosage of rofecoxib.
Warfarin:
increased effects of warfarin. Monitor INR more frequently in the first few days after therapy is initiated or dosage is changed.
Drug-lifestyle.
Long-term alcohol use, smoking: increased risk of GI bleeding. Monitor patient closely for such bleeding.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug or its components and in those who have experienced asthma, urticaria, or allergy-type reactions after taking aspirin or other NSAIDs. Also contraindicated in patients with advanced kidney disease or moderate or severe hepatic insufficiency and in pregnant women because drug may cause ductus arteriosus to close prematurely.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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