Products
Rofecoxib was approved in many countries in 1999 in tablet and suspension form (Vioxx). It was withdrawn from the market again in late September 2004 because of adverse effects and is no longer available.
Structure and properties
Rofecoxib (C17H14O4S, Mr = 314.4 g/mol) is a methyl sulfone and a furanone derivative. It has a V-shaped structure that allows it to fit into the Active Site of the drug target.
Effects
Rofecoxib (ATC M01AH02) has analgesic and anti-inflammatory properties. The effects are due to selective inhibition of cyclooxygenase-2 (COX-2) and inhibition of prostaglandin synthesis.
Indications
- Osteoarthritis
- Rheumatoid arthritis
- Acute pain in adults
- Menstrual pain
- Migraine attacks with or without aura
Adverse effects
In the large APPROVe clinical trial of 2600 patients, it was confirmed that more serious cardiovascular complications (myocardial infarction, cerebral stroke, thrombosis) occurred with rofecoxib than with placebo. Therefore, the drug was withdrawn. It is estimated that the drug has caused many thousands of deaths worldwide.
