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Therapeutic Use of Carbonic Anhydrase Inhibitors and Their Multiple Drug Interactions
Published in Peter Grunwald, Pharmaceutical Biocatalysis, 2019
Andrea Angeli, Claudiu T. Supuran
There are few reports on interactions between the other two coxib drugs: valdecoxib and polmacoxib. Valdecoxib is approved by the FDA for the treatment of rheumatoid arthritis (RA), osteoarthritis (OA), and primary dysmenorrhea since 2001 (Gotta, 2002). Polmacoxib is still in clinical trials (Phase II) for the same pathologies (Skarke et al., 2012).
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Published in Caroline Ashley, Aileen Dunleavy, John Cunningham, The Renal Drug Handbook, 2018
Caroline Ashley, Aileen Dunleavy, John Cunningham
Parecoxib is rapidly and almost completely converted to valdecoxib and propionic acid. Elimination of valdecoxib is by extensive hepatic metabolism involving multiple pathways, including cytochrome P 450 (CYP) 3A4 and CYP2C9 isoenzymes and glucuronidation (about 20%) of the sulphonamide moiety.
Clinical pharmacology: traditional NSAIDs and selective COX-2 inhibitors
Published in Pamela E Macintyre, Suellen M Walker, David J Rowbotham, Clinical Pain Management, 2008
Stephen F Jones, Aidan M O’Donnell
Parecoxib is an injectable prodrug of valdecoxib. It is rapidly converted into valdecoxib by enzymatic hydrolysis in the liver. Cutaneous reactions are rare with short-term therapy. Parecoxib will precipitate if mixed with lactated Ringer’s solution. The combined use of parecoxib and valdecoxib after coronary artery bypass grafting was associated with an increased risk of cardiovascular events, including myocardial infarction, cardiac arrest, stroke, and pulmonary embolism.50 Parecoxib and valdecoxib are associated with a slightly increased risk of renal dysfunction, hypertension, and peripheral edema.117
Pharmacological considerations when treating hypertensive patients for osteoarthritis
Published in Expert Opinion on Pharmacotherapy, 2022
Christopher R Piszczatoski, Steven M Smith
Oral non-steroidal anti-inflammatory drugs (NSAIDs) are considered first-line therapy for treatment of OA pain. NSAIDs are thought to produce their analgesic effect primarily by inhibiting the cyclooxygenase-2 enzyme (COX-2), resulting in decreased production of prostaglandins involved in pain and inflammation. Regardless of COX-2 isoform selectivity, the analgesic and anti-inflammatory activities of all oral NSAIDs are considered similar at equipotent dosages. Nevertheless, there does appear to be variability across NSAIDs in terms of risk of drug-induced adverse events, including effects on BP. For example, recent studies indicate essentially no meaningful change from baseline in 24-hour ambulatory systolic BP observed in celecoxib-treated patients compared to a 2–4 mmHg increase from baseline in ibuprofen- or naproxen-treated patients [6]. The COX-2 inhibitors valdecoxib and lumiracoxib appear to have similar negligible effects on BP, whereas rofecoxib and etoricoxib have been associated with greater incidence of hypertension compared with nonselective NSAIDs and placebo [7]. The antihypertensive regimen may also factor into decisions regarding oral NSAID therapy. Prostaglandin inhibition and sodium retentive effects caused by NSAIDs may blunt the effects some antihypertensives, particularly diuretics and renin-angiotensin-aldosterone system inhibitors [8], and oral NSAIDs may be less ideal in patients requiring these agents. Conversely, calcium channel blocker efficacy is not substantively affected and such combinations (CCB + NSAID) have recently come to market [8].
The use of a gene expression signature and connectivity map to repurpose drugs for bipolar disorder
Published in The World Journal of Biological Psychiatry, 2020
Srisaiyini Kidnapillai, Chiara C. Bortolasci, Madhara Udawela, Bruna Panizzutti, Briana Spolding, Timothy Connor, Andrew Sanigorski, Olivia M. Dean, Tamsyn Crowley, Stéphane Jamain, Laura Gray, Elizabeth Scarr, Marion Leboyer, Brian Dean, Michael Berk, Ken Walder
Two non-steroidal anti-inflammatory drugs (NSAIDs; nimesulide and valdecoxib), which are cyclooxygenase-2 (COX-2) blockers were also identified in the CMap analysis. Inflammation is thought to play a significant role in the pathophysiology of BD, which is conceptualised to be a multi-systemic inflammatory disease (Leboyer et al. 2012). Increased levels of circulating pro-inflammatory cytokines in different phases of BD have also been reported (Bai et al. 2014). Moreover, NSAIDs have been shown to have potential anti-depressant efficacy (Köhler et al. 2014), and its adjunctive use might be useful in the treatment of bipolar depression (Rosenblat et al. 2016). Furthermore, Berk et al. (2011) suggested that COX-2 suppressors could potentially be efficacious in the treatment of BD (Berk et al. 2011). Therefore, the use of NSAIDs in BD has some supporting evidence. However, given that only certain cytokines are altered in people with BD, and that not all studies have found inflammation to be significant in them, the use of NSAIDs in BD must be further explored (Stuart and Baune 2014).
Intravenous parecoxib for early postoperative cognitive dysfunction in elderly patients: evidence from a meta-analysis
Published in Expert Review of Clinical Pharmacology, 2020
Jun-Ming Huang, Zheng-Tao Lv, Bin Zhang, Wen-Xiu Jiang, Ming-Bo Nie
The water-soluble parecoxib is the first selective COX-2 inhibitor that could be administered intravenously. As a result, parecoxib is suitable for patients who are unable to take oral nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief because of severe nausea and vomiting. As an amino acid compound of the valdecoxib precursor, parecoxib can be quickly metabolized by the liver to valdecoxib providing anti-inflammatory and analgesic effects by decreasing prostaglandin formation after intravenous or intramuscular injection. As a selective COX-2 inhibitor, it attenuates inflammation in both peripheral and central tissues with minimal adverse reactions by keeping the physiological functions of COX-1 intact [17]. In recent years, parecoxib was applied in pain management after oral, orthopedic, and intra-abdominal surgeries, and its efficacy and safety have been proved [18–20]. Given the characteristic of anti-inflammation and analgesia, some researchers conducted randomized controlled trials (RCTs) to assess the effect of parecoxib on the incidence of POCD. However, no published systematic reviews have summarized the efficacy of parecoxib on the management of POCD. Thus, the aim of our present study is to evaluate the utility of parecoxib on POCD based on RCTs.