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COX-2 Inhibitor (Injectable)·Analgesia - Simple & NSAIDs
Short-term management of acute postoperative pain
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Max Dose
80 mg/day
Half-life
22 mins (Act: 8h)
Caution: CV Risk
HIGH RISK
Caution: Renal Risk
MODERATE
Avoid / Cautions
Post-CABG surgery, active GI bleed, severe heart failure, severe hepatic/renal impairment, severe sulfa allergy. Pregnancy Category C. Contraindicated in 3rd trimester.
Overview
The only injectable highly selective COX-2 inhibitor. An absolute powerhouse for post-operative multimodal analgesia, sparing the gut while heavily sparing opioid use.
Clinical Focus
It is a prodrug that rapidly converts to valdecoxib. Carries the same severe cardiovascular and renal risks as all NSAIDs. Do not use post-CABG.
Bottom Line
Parecoxib is the only injectable COX-2 inhibitor for acute post-operative pain, but carries cardiovascular risk with prolonged use and is contraindicated after CABG surgery.
Brand Names
Dynastat
Parenteral
Vials (40 mg powder) for reconstitution. For IV push or deep IM injection.
Prescribing & PBS
Hospital/OT supply. Restricted for peri-operative use.
Primary
Short-term management of acute postoperative pain.
Clinical Place
Given by anesthetists intra-operatively or prescribed on the ward for 1-3 days post-op to rapidly drop opioid requirements.
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