Parecoxib

ADMINISTRATION ROUTES:

IV

ALTERNATIVE NAMES:

Dynastat

ICU INDICATIONS:

1. Analgesia

PRESENTATION AND ADMINISTRATION:

IV:

Parecoxib 40 mg (powder) plus 2 mL of 0.9% saline for reconstitution. Can also be reconstituted with 5% dextrose.

Reconstitute then administer rapidly as a bolus.

Use as soon as practicable after reconstitution. May be stored at room temperature after reconstitution for up to 24 hours if required.

DOSAGE:

IV:

40 mg stat

then 40 mg every 12 - 24 hrs

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

Contraindicated in renal failure. Do not use if creatinine clearance < 50 mL/min.

DOSAGE IN PAEDIATRICS:

IV:

There are insufficient data to support the use of parecoxib in the paediatric population

CLINICAL PHARMACOLOGY:

Parecoxib is a COX-2 inhibitor non-steroidal anti-inflammatory drug (NSAID).

CONTRAINDICATIONS:

1. Ischaemic heart disease (including after coronary artery bypass graft surgery)
2. Renal impairment
3. Allergy to sulphur drugs

WARNINGS:

Due to an increased risk of death associated with the use of COX-2 inhibitors in patients with coronary artery disease, these drugs should be avoided in patients who are at high risk of coronary artery disease due to the presence of cardiovascular risk factors.

PRECAUTIONS:

General:

May cause fluid retention

Laboratory Tests:

No tests indicated in addition to routine ICU tests

Drug/Laboratory Test Interactions:

None known

IMPORTANT DRUG INTERACTIONS IN ICU:

Avoid concomitant use with other non-steroidal anti-inflammatory drugs (including aspirin)

ADVERSE REACTIONS:

Body as a Whole:

Anaphylaxis

Neurological

Dizziness, aseptic meningitis

Gastrointestinal

GI upset, transaminitis

Haematological

Anaemia, thrombocytopaenia

Renal

Renal failure