News

Parecoxib intravenous for adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Available preparations

Dynastat 40mg vial

Reconstitution

Sodium chloride 0.9% or Glucose 5%  - add 2ml per 40mg vial

Dissolve the powder using a gentle swirling motion

Methods of intravenous administration

Bolus intravenous injection

  • Administer over 1 to 2 minutes (ref 1)

Dose in adults

Usual dose 

  • Give 40mg stat, followed by 20 to 40mg every six to twelve hours as required
  • Maximum dose 80mg daily
  • Elderly patients weighing less than 50kg - use half initial dose, maximum daily dose 40mg 
  • Use for the shortest duration possible, at the lowest effective dose
  • There is limited clinical experience with treatment beyond three days

Renal impairment

  • Severe renal impairment (CrCl <30ml/minute), or patients predisposed to fluid retention: Start with 20mg and monitor renal function closely

Hepatic impairment

  • Severe impairment (Child Pugh 10 or more):  Contraindicated
  • Moderate impairment (Child Pugh 7 to 9): Use half the recommended dose (maximum daily dose 40mg)
  • Mild impairment (Child Pugh 5 - 6): No dosage adjustment necessary

Storage

Store at room temperature

References

1: Injectable Medicines Guide.  Medusa.wales.nhs.uk Downloaded 12th Feb 2020

Therapeutic classification

Anti-inflammatory agent (COX-2 inhibitor)