Valdecoxib is in a class of drugs called “COX-2” selective nonsteroidal anti-inflammatory drugs (NSAIDs). COX-2 means cyclooxygenase 2 and NSAIDs works by reducing substances in the body that cause inflammation, pain, and fever. This medicine is used to reduce pain, inflammation, and stiffness caused by osteoarthritis, adult rheumatoid arthritis and also treats painful menstruation.
The manufacturer of valdecoxib (Bextra) has announced the voluntary withdrawal of the drug from the U.S. market. This withdrawal is due to safety concerns of an increased risk of cardiovascular events (including heart attack and stroke) in patients taking non-steroidal anti-inflammatory drugs and safety concerns of an increased risk of rare but serious skin reactions in patients taking valdecoxib.
Do not take valdecoxib without first talking to your doctor if you have experienced asthma, hives, or an allergic reaction after taking a sulfa-based medication such as sulfamethoxazole (Bactrim, Septra, Gantanol, and others) or sulfisoxazole (Gantrisin); aspirin; or another NSAID such as celecoxib (Celebrex), ibuprofen (Motrin, Advil, Nuprin, and others), naproxen (Aleve, Naprosyn, Anaprox), ketoprofen (Orudis KT, Orudis, Oruvail), diclofenac (Voltaren, Cataflam), diflunisal (Dolobid), etodolac (Lodine, Lodine XL), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), meloxicam (Mobic), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), or tolmetin (Tolectin). You may experience a similar reaction to valdecoxib.
Valdecoxib should not be used for the treatment of pain after coronary artery bypass surgery (CABG). The use of valdecoxib in such patients has led to an increased incidence of cardiovascular events, deep surgical infections and wound complications. Talk to your doctor before taking valdecoxib if you are being treated for pain associated with CABG.
Before taking valdecoxib, tell your doctor if you
• drink alcohol;
• have an ulcer or bleeding in the stomach;
• have liver disease;
• have kidney disease;
• have asthma;
• have congestive heart failure;
• have fluid retention;
• have heart disease;
• have high blood pressure;
• have a coagulation (bleeding) disorder
You may not be able to take valdecoxib, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Valdecoxib is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Valdecoxib should not be taken late in pregnancy (the third trimester) because it may affect the formation of the baby's heart. Do not take valdecoxib without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether valdecoxib passes into breast milk. Do not take valdecoxib without first talking to your doctor if you are breast-feeding a baby. If you are over the age of 65 years, you may be more likely to experience side effects from valdecoxib. You may require a lower dosage or special monitoring during your therapy.
Valdecoxib overdose symptoms include drowsiness, nausea, vomiting, and stomach pain.
Seek emergency consult if you have any of the above symptoms of suspected overdose.
There are no restrictions on food, beverages, or activity while taking valdecoxib unless otherwise directed by your doctor.
Serious side effects: Serious skin reactions tend to occur within the first two weeks of treatment, but may occur at any time during treatment. Stop taking valdecoxib and contact your doctor immediately if you develop a skin rash; hives; itching; difficulty breathing; swelling of the lips, tongue or face; or other symptoms of an allergic reaction.
Other symptoms that could be signs of dangerous side effects are: abdominal pain, tenderness, or discomfort; nausea; bloody vomit; bloody, black, or tarry stools; unexplained weight gain; swelling or water retention; fatigue or lethargy; a skin rash; itching; yellowing of the skin or eyes; "flu-like" symptoms; or unusual bruising or bleeding.
Other, less serious side effects may be more likely to occur such as diarrhea, nausea or upset stomach; or headache.
Before taking valdecoxib, tell your doctor if you are taking any of the following drugs:
• aspirin or another salicylate (form of aspirin) such as salsalate (Disalcid), choline salicylate-magnesium salicylate (Trilisate, Tricosal, others), and magnesium salicylate (Doan's, Bayer Select Backache Formula, others);
• an over-the-counter cough, cold, allergy, or pain medicine that contains dextromethorphan, aspirin, ibuprofen, naproxen, or ketoprofen;
• a diuretic (water pill) such as furosemide (Lasix), hydrochlorothiazide (HydroDiuril, others), chlorothiazide (Diuril, others), chlorthalidone (Hygroton, Thalitone), and others;
• an angiotensin-converting-enzyme inhibitor (ACE inhibitor) such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), and others;
• a steroid medicine such as prednisone (Deltasone and others), methylprednisolone (Medrol and others), prednisolone (Prelone, Pediapred, and others), and others;
• an anticoagulant (blood thinner) such as warfarin (Coumadin);
• diazepam (Valium);
• phenytoin (Dilantin);
• glyburide (DiaBeta, others);
• an oral contraceptive (Micronor, Triphasil, Levlen, others);
• omeprazole (Prilosec, Zegerid);
• lithium (Eskalith, Lithobid, others); or
• fluconazole (Diflucan) or ketoconazole (Nizoral).
You may not be able to take valdecoxib, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with valdecoxib. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines including vitamins, minerals, and herbal products.
The empirical formula for valdecoxib is C16H14N2O3S, and the molecular weight is 314.36. Valdecoxib is a white crystalline powder that is relatively insoluble in water (10 µg/mL) at 25C and pH 7.0, soluble in methanol and ethanol, and freely soluble in organic solvents and alkaline (pH=12) aqueous solutions. BEXTRA Tablets for oral administration contain either 10 mg or 20 mg of valdecoxib. Inactive ingredients include lactose monohydrate, microcrystalline cellulose, pregelatinized starch, croscarmellose sodium, magnesium stearate, hydroxypropyl methylcellulose, polyethylene glycol, polysorbate 80, and titanium dioxide.
Valdecoxib has the following structural formula: