Rifampicin 600mg/day caused a 50% decrease in plasma concentrations of rofecoxib

Concurrent administration of rofecoxib 75mg/day (3 times the recommended maximum dose in osteoarthiritis) with methotrexate 7.7 to 15mg/week resulted in an increase in plasma concentrations of methotrexate by 23% and caused equivalent reduction in its renal clearance.

NSAIDs may diminish the antihypertensive effect of Angiotensin Converting Enzyme Inhibitors

Concomittant administration of low-dose aspirin with rofecoxib may result in an increased rate of GI ulceration or other compilcations. compared to refecoxib alone.

Sprains and strains

Diarrhoea, headache, nausea, and upper respiratory tract infection, hypertension, dyspepsia, epigastric discomfort, heartburn, nausea, sinusitis, backpain, headache, bronchitis, urinary tract infections

Hypersensitivity

Special Precautions:

Caution to be excercised in patients with hepatic dysfunction. No data aviailable on children below 18 years.

Pregnancy and lactation

Dosage-

Oral- 12.5mg once daily. Max dose 25mg

For Availability/supplies 

EVIDENCE BASED MEDICINE (April 2003)

Pain of Osteoarthiritis Comparative effectiveness of various interventions

Beneficial

1. Systemic simple analgesics (eg paracetamol for short term pain relief, and improvement in function)

2. Systemic NSAIDs (short term pain relief and improvement in function)

3. Topical agents (short term pain relief)

Likely to be beneficial

1. Education, dietary advice,empowerment and support ( improved knowledge of disease and pain relief)

2. Physical support (pain relief and improvement in function)

KEY POINTS

1. There is no good evidence that NSAIDs were superior to simple analgesics such as paracetamol or to suggest that any one of the many available NSAIDs had greater efficacy in relieving pain of osteoarthritis.

2. One systematic review of randomised controlled trials has found that topical agents provide pain relief in patients with osteoarthritis and offer a non-toxic alternative to systemic drug treatment. However there is no evidence to indicate whether the prescribed agents were superior to less expensive, non-prescribtion drugs over the counter (OTC) alternatives, or to other local treatments such as hot or cold packs.

Caution in patients with hepatic dysfunction

Pharmamcolgy:

Rofecoxib effectively inhibits COX2 activity with no significant inhibition of COX1 activity.

Pharmacokinetics:

Rofecoxib is largely eliminated by hepatic metabolism, with less than 1% recovered unchanged in the urine. Can be taken with or without food.

Can be taken with or without food.

Caution to be excercised during pregnancy and lactation