Embolism rofecoxib

However, already in an early clinical trial, rofecoxib was found to produce four times the number of myocardial infarctions than its comparator drug, naproxen. A subsequent trial of rofecoxib compared to placebo in colorectal cancer prevention demonstrated, after 18 months of study, that a greater number of myocardial infarctions occulted in the rofecoxib group. In 2004 the manufacturers of rofecoxib withdrew the diug from the market. A similar study of celecoxib compared to placebo in cancer prevention, showed that celecoxib also increased the risk of cardiovascular embolisms [3]. 

Rofecoxib increases contraceptive steroid levels to a small extent, and would not therefore be expected to reduce contraceptive efficacy. Etoricoxib raises ethinylestradiol levels by 50 to 60%, and also appears to raise the levels of conjugated oestrogens in HRT. Celecoxib appears to have no effect on combined oral contraceptive levels. One case of pulmonary embolism has been reported in a patient taking valdecoxib with a combined oral contraceptive. 

Observational studies In postmarketing surveillance of serious adverse events associated with the use of rofecoxib from 1999 to 2002 there were 31 024 reports of serious adverse events, and the drug was considered the primary suspect in 97.8% of reports [51 ]. There were 3915, 3677, 1653, 1917, and 233 reports of hemorrhage, edema, death, thrombosis, and embolism respectively. The authors argued that, in addition to the risk of myocardial infarction and stroke, rofecoxib use might be associated with an increased risk of hemorrhage. A limitation of this analysis was that the data may have contained multiple reports from the same individual. 

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See also in sourсe #XX -- [ ]

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