Parecoxib at a glance
Medicine class
Selective COX-2 inhibitor (coxib NSAID)
Licensed use
Postoperative pain in adults
Administration
Injected into a vein or deeply into a muscle by a healthcare professional
Form
Preservative-free powder requiring reconstitution before injection
What is Parecoxib used for?
Parecoxib is licensed for:
Postoperative pain in adults.
How does Parecoxib work?
The body rapidly converts parecoxib to valdecoxib. Valdecoxib selectively blocks COX-2, reducing prostaglandins involved in pain, inflammation and fever. It does not provide aspirin’s antiplatelet effect.
Parecoxib preparations and strengths
Injection
Route: Parenteral
Strengths: 40 mg
How to take Parecoxib
Parecoxib is prepared and administered by a healthcare professional into a vein or slowly and deeply into a muscle. Food does not affect administration because it is not swallowed.
The powder must be reconstituted aseptically with a compatible solution.
The prepared solution should be clear and must not be used if cloudy, discoloured or containing particles.
It must not be mixed with another medicine in the same syringe; an intravenous line should be flushed appropriately before and after use.
Parecoxib side effects
Common or expected effects
- Nausea
- Abdominal pain, vomiting, constipation, indigestion or wind
- Dizziness or reduced skin sensation
- Itching or increased sweating
- Peripheral swelling
- Raised or lowered blood pressure
- Back pain
- Reduced urine output or increased blood creatinine
Get urgent medical advice
- Severe allergic reaction, including breathing difficulty, angioedema or collapse
- Severe blistering, peeling or widespread skin reaction
- Heart attack, stroke, pulmonary embolism or deep-vein thrombosis symptoms
- Gastrointestinal ulceration, bleeding or perforation
- Acute kidney failure
- Severe hypotension
- Bronchospasm or hepatitis
Parecoxib in pregnancy
Parecoxib is contraindicated during the third trimester. Earlier in pregnancy it should be used only when clearly necessary. From 20 weeks, NSAIDs can cause fetal kidney dysfunction, reduced amniotic fluid and constriction of the ductus arteriosus, requiring specialist assessment and sometimes antenatal monitoring. Tell the prescriber if pregnant, planning pregnancy or undergoing fertility investigation.
Parecoxib while breastfeeding
The selected product is contraindicated during breastfeeding. A prescriber should choose an alternative where treatment is required; UK SPS identifies ibuprofen or diclofenac as preferred NSAIDs and celecoxib as the preferred COX-2 inhibitor for full-term, healthy breastfed infants.
Parecoxib interactions
The clinical team should review all prescribed, over-the-counter and complementary products before administration.
Warfarin and other oral anticoagulants
Bleeding risk increases; anticoagulation, including INR where relevant, requires close monitoring.
Aspirin, other NSAIDs, antiplatelets, corticosteroids or SSRIs
Gastrointestinal ulceration or bleeding risk may increase; concurrent non-aspirin NSAIDs should be avoided.
ACE inhibitors, angiotensin-II receptor blockers, beta-blockers and diuretics
Their effects may be reduced, with greater risk of kidney deterioration in susceptible patients.
Common questions about Parecoxib
Answers are fully visible for fast scanning and source review.
Is parecoxib an NSAID?
Yes. It is an injectable selective COX-2 inhibitor, or coxib, NSAID.
Is parecoxib the same as valdecoxib?
Parecoxib is a prodrug that the body rapidly converts into active valdecoxib.
Can parecoxib be given to children?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.