Valdecoxib
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| Valdecoxib
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| Systematic (IUPAC) name | |
| 4-(5-methyl-3-phenylisoxazol-4-yl)benzenesulfonamide | |
| Identifiers | |
| CAS number | |
| ATC code | M01 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C16H14N2O3S |
| Mol. mass | 314.364 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 83% |
| Protein binding | 98% |
| Metabolism | Hepatic (CYP3A4 and 2C9 involved) |
| Half life | 8 to 11 hours |
| Excretion | Renal |
| Therapeutic considerations | |
| Pregnancy cat. |
C(AU) May cause premature closure of the ductus arteriosus |
| Legal status | |
| Routes | Oral |
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US National Guidelines Clearinghouse on Valdecoxib
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Valdecoxib is a prescription drug used in the treatment of osteoarthritis, rheumatoid arthritis, and painful menstruation and menstrual symptoms. It is classified as a nonsteroidal anti-inflammatory drug, or NSAID, and should not be taken by anyone allergic to these types of medications.
Valdecoxib was manufactured and marketed under the brand name Bextra by G. D. Searle & Company. It was approved by the United States Food and Drug Administration on November 20, 2001[1], and was available by prescription in tablet form until 2005, when it was removed from the market due to concerns about possible increased risk of heart attack and stroke.
Uses
Since its registration, Bextra was prescribed for pain associated with arthritis, menstrual discomfort, and other ailments.
Side-effects and withdrawal
On April 7, 2005, Pfizer withdrew Bextra from the U.S. market on recommendation by the FDA, citing an increased risk of heart attack and stroke and also the risk of a serious, sometimes fatal, skin reaction. This was a result of recent attention to prescription NSAIDs, such as Merck's Vioxx. Other reported side-effects were angina and Stevens-Johnson syndrome.
Pfizer first acknowledged cardiovascular risks associated with Bextra in October of 2004. The American Heart Association soon after was presented with a report indicating patients using Bextra while recovering from heart surgery were 2.19 times more likely to suffer a stroke or heart attack than those taking placebos.
Recently in a large study published in JAMA 2006, valdecoxib appears less adverse for renal (kidney) disease and heart arrhythmia compared to Vioxx, however elevated renal risks were slightly suggested. [1]
References
External links
- FDA Alert on Bextra withdrawal
- Large systematic review of adverse renal and arrhythmia risk of valdcoxib and other COX-2 inhibitors, JAMA 2006
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
